Healthcare infrastructure systems and development

¶ … managed care be handled through private insurance providers.

MANAGED CARE

Should managed care be handled through private insurance companies?

Should managed care be handled through private insurance companies?

Managed Care is defined as " a health care plan, such as health maintenance organization (HMO), that "manages or controls costs by monitoring how medical professionals treat patients, limiting referrals to expensive specialists and requiring preauthorization for hospital care and other services to hold costs down." ("Triggers, caps, mandates: decoding the health care debate," 1994.) Managed care is now offered by all types of health insurance providers. The term includes health maintenance organizations (HMOs) that combine insurance with direct delivery of care and the preferred provider organizations (PPOs) that offer discounted medical bills if certain providers are used. In some cases, In many states, Medicaid coverage is now provided through private managed care organizations that have contracts with the state. Thus people insured by Medicaid, as well as people in private employer-based group plans or those who are shopping for insurance on their own are being persuaded, urged, or even pushed to change from traditional fee-for-service insurance plans to an HMO (Hinson-Smith, 1999).

Managed competition through private provices is not universal health insurance; it will not cover a single uninsured American. A the Congressional Budget Office reported, scant evidence exists that managed competition can control soaring health care costs. In 1992, 35 million Americans have no health insurance, and health care costs are growing at the rate of 12% a year and consume more than 14% of the gross national product. (Bodenheimer, 1992). The figures are even higher today. The private insurance company's main interest is profit; hence, it is not in their interests to insure everyone, especially the sickest and often poorest members of the community. Also, having health care administered through private provider is inefficient and ineffective.The only solution a universal health insurance program that substitutes a single public insurer ("single payer") for the current multiple private insurance companies, The amount saved by cost savings in staff and marketing costs would be phenomenal, more than enough to fund health care costs for everyone in this country. No one in this age of catastrophic health costs, should have to go without health care just because they are not fortunate enough to work for a company that pays health insurance and no one, for example, a great writer or artist, should have to waste their time working in a mindless, mundane 9-5 job when they could be out there creating great works of literature or music for the rest of humanity