At 06:43 PM 4/3/97 -0500, you wrote:
>Jeff Newton posted a question for another web site which I answered.  My
>reply might be of interest to some of the list members receiving care
>from managed care organizations:
>QUESTION
> at "http://www.amso.com". The topic is:
>
>"We currently have many 'for profit' HMO's in the healthcare industry
>today.
>Does their "for profit" status improve or impair the quality of
>healthcare?"
>Please share your viewpoint(s).
>
>
>
>
>As both a physician (psychiatrist)practicing part time in a managed care
>situation, and as an individual with a chronic illness, (Parkinson's
>Disease) I highly doubt for profit status improves patient care and I
>think it pushes us toward mediocrity.  While the fee for service system
>rewards over treatment and certainly contributes to increasing costs,
>the incentive is to not treat in order to make the maximum profit.  This
>makes sense to bean counters but is the antithesis of why I got into
>medicine.  While I could go on in detail about various aspects of this
>let me give one example and invite anyone to provide logic which proves
>me wrong.
>
>If I as a physician wanted to have the group start a Parkinson's Clinic,
>hire a movement disorder specialist instead of having Parkinson's
>patients treated by a general neurologist,  how could I sell that to my
>HMO.  I live in an area where there are 4 competing HMO's.  A large
>portion of the population has a choice yearly as to which they enroll in
>for that year.  If HMO "A" provides the best Parkinson's care in town
>where are all the Parkinson's patients going to go.  If HMO captures its
>market share by providing the best Parkinson's care and best care for
>other chronic diseases, where are Parkinson's patients going to enroll
>when they hear in their support group that HMO  "A"  has the best
>Parkinson's treatment in town?
>
>The economics are simple-  you get a reputation for providing the best
>care,  you get rewarded by a a large percent of the patients with a
>chronic disease to join your HMO and then you get saddled with a group
>of patients who utilize an incredible amount of recourses for the rest
>of their lives.  Excellence = negative cash flow.
>
>If you advertise and invest your resources in Sports Medicine, well baby
>care and obstetrics you attract a population who is not sick.  Yes you
>may provide preventive care which is valuable but who is going to take
>care of the sick patients?  I invite anyone to counter this argument.
>--
>**********************************************************
>CHARLES T. MEYER, M.D.
>MADISON, WISCONSIN
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>**********************************************************
>