OFF WITH THEIR HEADS ...
and any other parts that might require medical attention
By sonya hammond
With the unrelenting
enthusiasm of Lewis Carroll's Red Queen, and more stealth than
our 478 trillion-dollar bomber can manage to achieve on any given
low visibility day, insurance providers are busy insinuating a
concept known as 'Capitation' into what is
erroneously referred to as the U.S. 'Health Care System'.
Considering what this misguided attempt to dump the burden of financial accountability on medical providers accomplishes, 'Decapitation' would be a more appropriate designation.
This nifty curtailment of any ill-advised attempts to cure patients of what ails them consists of insurance companies pre-paying medical providers each month for services they 'expect' to give their patients. The sum of money per patient is arrived at through a mathematical formula rivaled only by the Federal Reserve Board's mythical method of reaching the discount rate, and 'expected services' are apparently determined by a scientific process involving the reading of chicken entrails by medical insurance salespersons.
Theoretically, the purpose of capitating our health care is to rein in escalating costs by rewarding physicians for slashing their services to the point where the most expensive procedure will be a suggestion to purchase Dr. Scholl's inserts for fallen arches.
[The alert health care consumer may begin to notice a trend in medical terminology here...i.e., '[de]Capitation', 'slashing'.]
While physicians whose ethics are more Hypocritical than Hippocratic may welcome this quantity for quality tradeoff, Pythagorean expertise is not required to add up who benefits the most under the system.
Its proponents, with creative mathematical facility, can demonstrate that physician incentives to designate procedures as 'unnecessary' should their allotted monthly budget of illnesses be endangered, plus the expectation of profits when the cost of providing services comes in under the capitation ceiling, somehow equals a yellow brick road to higher quality health care.
We are told that we, the health care consumers, have demanded changes to a system that has become so expensive that only the rich or members of Congress can afford to access it. While we can't argue with that, we might question the logic of medical care with a glass ceiling.
We might at least want to challenge the motives of medically illiterate insurance company pundits whose budgeted plans control everything from the amount of time our physicians can listen to us to the number of tests, if any, that can be taken to help in our diagnoses.
The1996 Patient Protection Act on their November ballots would mandate several revolutionary concepts such as the assurance that only a doctor who has examined a patient can deny them care. If these initiatives make it to the polls, voters in at least two states will have a chance to checkmate the Red Queen.
© sonya hammond 1996