HMOs & Managed Care

MN's System Reform Was Once Considered "Communism"

MN's System Reform Was Once Considered 'Communism'

WALTER MCCLURE, who worked with Paul Ellwood to create the HMO, was interviewed in August 2012. Minnesota's health care system is close to where he wants health care to be with outside analysis of patients and doctors. From the Interview: "When [McClure's] team started on [cost and quality] assessment in the 1980's, the idea that someone would be looking over a physician's shoulder was considered communism. Physicians were convinced of their right to autonomy. However, by 2008 Minnesota's private and voluntary sector had accomplished a sea change in this culture with 85 percent of providers in the state participating in having their outcomes measured." [our emphasis]


Paul Ryan's "Medicare Exchange"

Paul Ryan's 'Medicare Exchange'

Paul Ryan is Romney's choice. Conservatives remember with glee how Ryan shredded Obamacare at the President's health care summit. Ryan said the bill was "full of smoke and mirrors." He looked right into the President's eyes. Six minutes later, Obama could barely respond. Ryan's Medicare proposal now takes center stage. In March, Paul Ryan created shock waves with the Medicare reform proposed in his 2013 budget called "The Path to Prosperity."  

State Health Insurance Exchanges Will Impose Federal Control

State Health Insurance Exchanges Will Impose Federal Control

Some State legislators believe a federally-approved Exchange established by the State will be better than a federally- imposed Exchange established by the Secretary of Health and Human Services (HHS). However, the federal law makes it clear that every Exchange must conform to federal requirements, including pending regulations. Thus, a “State Exchange” is actually an imposed Federal Exchange. Some might call it a "lobster trap" for States - once in, there's no getting out.

National Health Reform ("Obamacare")

HMO Guidelines or New Mandates?

The key to cost-containment is consumer control over health care dollars. Personal financial incentives, such as medical savings accounts and federal health care tax deductions, will drive health care costs down by encouraging individual cost-consciousness. Although HMOs want their enrollees to believe treatment guidelines will provide safer and better medical care, patients should be cautious about embracing an initiative that may use words on a page to limit health care services.

Blame Congress for HMOs

Blame Congress for HMOs

Only 27 years ago, congressional Republicans and Democrats agreed that American patients should gently but firmly be forced into managed care. That patients do not know this fact is evidenced by public outrage directed at health maintenance organizations (HMOs) instead of Congress.

DIAGRAM - Government, Health Care and Taxpayers

DIAGRAM - Government, Health Care and Taxpayers

One page diagram showing the expensive bureaucracy of government, the limited access of captured HMO patients and the freedom available through fee-for-service payments to doctors and hospitals.

HMOs' Rise Driven by Government, Not Market

Dissatisfaction with HMOs has led some to call for increased regulation of the HMO industry. Government officials express concern for patient protection and access to health care. Yet government action did much to encourage the spread of HMOs'and government action continues to steer people into HMOs.

HMOs and Managed Care

Center for Managed Care Established in Federal Government. On September 3, 1998, the Federal Register announced the new organizational statement regarding the establishment of the Center for Managed Care (CMC) in the Health Resources and Services Administration (HRSA).

EXIT INTERVIEW: David C. Anderson, M.D.

Certainly the reason to go to Arizona is not to make more money. My income will drop--maybe 30-40%. On the same hand the income factors in Minnesota are so driven by non-patient oriented mechanisms that my idealistic mind doesn't allow me to continue to practice that way.