Hello Ken,

I would have to disagree with you as what you propose is a HMO
situation where the health funds are for profit and are bound to serve
their shareholders rather than their customers. ie the more services
they can deny the better off they are.

I have to deal with them with a day surgery hat on and they are hell
bent on eliminating any Medically run facilities. They happily pay
corporate Hospitals twice what they would pay us and at every turn try
and put smaller medically owned facilities out of business. This is
despite glowing accreditation reports and excellent quality monitoring
etc. We only survive by getting another level of accreditation (2nd
Teir) which forces them to pay us 85% of average contract price (Does
that figure ring a bell). Currently the health funds are trying to
eliminate 2nd tier so they can pay us 20% of the average contract
price.

I also know they have shut out smaller independent pathology groups
while embracing large corporate players.

What you propose is a US style health care system, even hollywood
refers to them as "####ing HMOs"

Many of us have seen the damage done to public hospital systems by
rampant managerialism. Surely for profit health funds would mark the
end of Private Medicine as we know it. Through "Selective Tendering"
without any accountability in the tendering process, they can
eliminate small players at will, and make no mistake that's what they
will do. In the US their "administration" chews up %30 of their funds
and with 8-10% of GDP going trough health, every executive with $$ in
their eyes will want to get on board to get their cut of a very big
pie.

Its not that we will have a better system overall, but doctors will be
worse off, The private system will end up resembling the public system
where the inefficiency ends up denying care to patients while the
shareholders do well. In the case of public hospitals the shareholder
is the government and their profit is "Control". Nowdays you can close
wards in the middle of a flu epidemic to control costs. Sensible
medical management would never do that, and that represents loss of
control by the shareholders, hence the demise of Medically trained
management.

Monday, March 6, 2006, 7:46:13 AM, you wrote:

KH> Oliver Frank wrote:

>> .. the above seems to describe much of what our government is doing 
>> now through the Medicare benefits and payments system.  Ne'cest pas?

KH> Others might wish to comment on whether the Medicare schedule really 
KH> does encourage the provision of cost-effective services!

KH> But there is no doubt that private health insurance (and the new 
KH> Medicare safety-net) encourages any such impact to be bypassed!

KH> Cheers
KH> Ken



-- 
Best regards,
 Andrew                            mailto:[EMAIL PROTECTED]

Andrew McIntyre
Buderim Gastroenterology Centre
www.buderimgastro.com.au
PH: 07 54455055 FAX: 54455047


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