Why do you think the funds are behaving this way? I was thinking of passing your email over to those in the Private Health Insurance Branch of DoHA, as this seems rather puzzling.
Regards Peter MacIsaac MacIsaac Informatics Consulting in Health Informatics, Terminology & Data management and Health Policy. [EMAIL PROTECTED] 0411403462 (mobile) 61611327 (office) peter_macisaac (skype) 8 Ewart St. Yarralumla 2600 "We trained hard, but it seemed every time we were beginning to form up into teams, we would be reorganised. I was to learn later in life that we tend to meet any new situation by reorganising, and a wonderful method it can be for creation the illusion of progress while producing confusion, inefficiency and demoralisation." - From Pertonii Arbitri AD 66, attributed to Gaius Petronus, a Roman General who later committed suicide. -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Andrew McIntyre Sent: Monday, 6 March 2006 10:03 AM To: Ken Harvey Cc: General Practice Computing Group Talk Subject: Re[2]: [GPCG_TALK] Efficient health care; role of PHI 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 _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
