<<Perhaps but at higher end cost to...not the end user, but the 'end payer', most often a corporation, or the US Government.
Risk management means reducing a highly probable higher end cost.>>
I don't agree. To me risk management is to decrease the potential volatility of costs but at probably a higher fixed cost than what the average cost would be over time if risk is not managed.
<<About 25 years ago, NY State decided that any medicaid patient having prostate surgery needed a questionaire filled out by their doctor.before it would be approved. A year and a half later...99.5%........well maybe not that exact number, but the program was cancelled that quickly.
Which implies...? >>
The risk management program was not cost effective. It didn't save any money. All the procedures were approved.
<<Regarding the rubber stamp accusation, a committee chair once said..."I know...I know...but we have to do it. The insurance companies expect it"
You only could have such intimate knowledge if you were on the committee.>>
Well just take it for whatever you think it is worth.
<<If you do, then you have no business accepting your company's coverage. In any event, you do accept, but not because of your own logic, but because you think you get something cheaper than it would otherwise cost, and this secret reasoning is inconsistent with how you see the system. This is standard American thinking: the system is rotten, but as long as I'm getting something for nothing, I prefer to keep the system.>>
This line of reasoning was based upon someone who accepts whatever insurance their company provides?
<<So how can you reach the conclusion that middlemen, committees, rubber stampers, are defrauding the public?>>
Well I never said defraud. I just think these entities exist because the entities in control think the middlemen, rubber stampers, etc, do more good than they actually do.
The only situation I can think of where such entities are useful are for expediting treatment and discharges for inpatients. For inpatients, it is in the middlemen's interest to make care as effective and efficient as possible to minimize hospital stays, so here the motivations are often in sync with the patients best interests as well.
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