Can We Allow Medical Management Care to Continue?

To contact us Click HERE
This is one of the more interestingdiscussions about managed care. Medical management is managed careand needs to be something everyone is aware of how it will affect himor her. This is a large area of contention between doctors,hospitals, and the medical insurance industry including Medicare. Who is right? After reading and researching this on my own, I thinkthere are valid positions on both sides of managed care. I will saythat hospitals have the least favorable position in their goal oflarger and larger profits. Physicians may have the strongestpositions and the insurance industry has made some very serious anddeadly mistakes. In addition, the health insurance industry has toooften turned away from serious auditing of fraudulent hospital andphysician claims.
The author is well qualified forwriting about the topic, but as a patient with a chronic disease, Ihave some experience with managed care (2004 to Dec 2005). I wasconstantly battling to remain on insulin, as they wanted me on oralmedications. My first wife was also under a managed care plan (1998to 2002) which prevented some cancer treatments. So the first errorin the article is that managed care started to disappear in the early1990's needs to questioned. At least one commenter to the blogagrees with this. Managed care has continued despite this author’sposition. It may have decreased in volume of managed care, but hascontinued to exist.
I can see both sides; however, untilMedicare and the medical insurance industry does their due diligence,most managed care efforts will continue to be less than effective orefficient. Hospitals will continue to recode to obtain fees thatshould never have been allowed for procedures that never happened andmake makes patients appear on paper as being sicker that they actuallywere. Hospitals will continue to do tests on dying patients that arenot warranted, but will probably not be questioned once the patientdies. Physicians will continue to perform tests for defensivemedicine purposes to prevent lawsuits.
Some of the comments to the blog areinteresting and do point out some areas that are abused by allconcerned. It does raise questions about the reliability of managedcare; however, other issues that managed care has abused in the pastare presented as well. Managed care in the past has been equatedwith excessive use of euthanasia when proper patient care would haveadded life and even quality of life. This is a reason to opposemanaged care. Under the current healthcare law, it appears thatmanaged care may be even more reckless.
I am in favor of proper managed care,but there will need to be changes to the way it is administered andmore thought incorporated into the decision making. In myperspective as a patient, I can see the rise of a new class ofpatient advocates that will be needed to work for the patient toprevent abuse of managed care. I oppose some of those that areoperating now as termed “ambulance chasers”; however, the newclass of advocates may need to have some legal training and extensivemedical knowledge.
The other requirement that may not bewanted is complete transparency by all concerned – hospitals,physicians, and insurance. If managed care is set up as anotherentity, then they will need to be transparent as well.