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Edited on Thu Oct-06-05 03:37 PM by daveskilt
I employee a whole department of people to deal with HMO's. The HMOs employ a whole departments of people whose job is to try not to pay for patients who got health care services. More than 50% of the cost in your HMO premium comes from the wages of the risk adjusters and people who figure out ways not to pay health care providers - in addition to the costs of my business staff that I in turn pass back to the HMO and they pass back to you in your premium. If there were no HMO's and the government paid for all health care I would have 8 people who would have no job (and I am in a small 160 bed facility). The national health system in Britain has no equivalent position for the majority of HMO employees - no one needs to spend time deciding who to pay for or when.
I was born in the UK and lived there on and off untill 96. I have more money taken out of my check here in the US (even with those CEO tax cuts - I'm kidding I'm not that kind of CEO) than I did in Britain - my british taxes were a lot higher BUT no FICA, no SS, no HMO payments. The cost is better and the care is better too
I lose money on every single medicaid patient. I almost break even on private payers and HMO's and medicare keeps the doors open with a modest profit. In order to pay the bills, I have to have patients requiring skilled services (therapy, IV drugs, isolation rooms, wound care) Often I have a long term patient on medicaid who needs or could benefit from physical therapy. If there secondary payer is medicare - no issues they get the care and I get reimbursed for my therapists who I have to pay a lot for. If the secondary is a non government agency like an HMO or PPO then I get zip zero for the therapy. We do freebie therapy here (1 unit or 15 minutes of PT is $45 so freebies kill us) when someone needs the therapy they get it. In most facilities this is not the case - I fortunately work for owners that let me take losses to do the right thing. Most hospitals just don't do the care unless there is a payor.
The cost is cheaper the care is better. people win. I would have much less potential for profit in nationalized health care, HMO's would have no more reason to exist, and most of all drug companies with incestous relationships with HMO's would lose.
So why are we the only non third world country without universal health care - follow the money.
incidently after 3 years on here does outing myself as a CEO with an MBA disqualify me from ever posting again?
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