Very good article. I agree that capitation is onerous, but the trend is moving away from HMO's towards PPO's anyway, for the reason that the article stated...they aren't controlling costs, and CEO's and benefit managers are fed up with their antics. Of course, they're shifting costs back to employees in increasing amounts. This is somewhat masked by the CPI, BTW, which measures only costs to the end consumer (though it should be seen in measurements like the ECI). Come to think of it, if ERISA were dismantled completely, I'd predict that indemnity plans would come back simply because no one (employers or insurors) would want the increased risk and uncertainty of being a fiduciary in that environment. Insurance cos would pay a percentage of the claim after deductable, and the insured would pay the rest. It won't be 80/20 either....more like 60/40. And of course, nationalized medicine wouldn't be far behind.....
This part struck me as funny though:
"The cost explosion is going to get worse," said Helen Darling, a health care expert at the Watson Wyatt benefits consulting firm. "We haven't seen the full impact of
new technology across the board."
LOL! They never will see the "full impact" on costs of new technology...because it just keeps on coming, it's a never-ending flow in medicine. And unlike in information processing, new tech in medicine is often inflationary rather than deflationary (not always, but often). |
