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Politics : Politics for Pros- moderated -- Ignore unavailable to you. Want to Upgrade?


To: LindyBill who wrote (486555)5/10/2012 5:01:19 PM
From: SmoothSail  Respond to of 793896
 
This is why I advocate HMO's if you can find a decent one. Long term, they will be the cheapest and best way to handle your health needs, IMO.

Before I was eligible for Medicare, I had Kaiser and really liked it and wanted to continue with it, but here in Southern California, it is almost double the cost of Anthem, so I'm stuck - at least for the time being. I'd love to go back to them.



To: LindyBill who wrote (486555)5/10/2012 7:31:42 PM
From: skinowski4 Recommendations  Read Replies (1) | Respond to of 793896
 
This is why I advocate HMO's if you can find a decent one. Long term, they will be the cheapest and best way to handle your health needs, IMO.

Back in the 90's, for a number of years I was a member of a large Medicare Advantage total risk medical group. Total risk means that our group was responsible for covering all healthcare costs of of our patients. Since Medicare does not make deals directly with physician groups, we had to have a contract with an HMO. The HMO collected 21% of the total Medicare funding off the top, and transferred to us the balance - which covered all costs, including the administrative costs. We even paid for our own re-insurance for expensive cases.

Question -- what is it that the HMO did for their 21%? Answer -- They didn't do much, maybe a little of marketing, which they did on THEIR behalf, without ever mentioning our name. Long story short, the HMO was getting paid huge bucks simply for agreeing to be the conduit between us and the government.

Waste, waste, waste. I like Ryan's idea better - give those who want a choice an opportunity to use their funding to buy private packages.

I know that you like the "staff model" HMOs, where the docs are salaried employees. Well, that's a horse of a different color. They should have an opportunity to compete for patients, along with other options.

We will never know what is the best and most cost effective way, for as long as there is no choice and no competition.