| | Merlin -- I jumped into the discussion without RTFA. Rookie mistake. After actually reading your article, I agree that the particular quote, isolated out of the total context of what you were saying, appears to be advocacy when it in fact it's intended to be descriptive. My apologies. Personally, I would have tried to phrase that sentence to make it clearer what your POV was on price controls -- I think you were trying to say that they might appear to work in the very short term, but longer-term they would fail.
As a former health insurer married to a physician, though, I must take issue with what I think is your perception of how insurance companies work. (If I've misunderstood this, too, please let me know.) For example, this:
The truth is much nearer the exact opposite -- insurance companies, especially HMOs and PPOs, are simply collection agents for doctors, nurses, and hospitals!
This appears to assume that insurance companies act simply as claims processing agencies. The reality is more complex. While many larger employer groups do use insurance companies primarily as claims processing agencies, with control over physician charges being a secondary effect, PPOs generally dictate to a great degree what physicians may charge. I used to work for Blue Shield of California, which had only a 2% market share, so there doctors had some degree of negotiating power over how much they got paid for a given procedure. If a doctor thought they were being gouged, they could threaten to quit treating BSC patients. In Hawaii, though, the local Blues plan has acquired a near-monopolistic control of the PPO market, and so they can be pretty high-handed about how much they deign to pay for a given procedure. Your only practical recourse as a doctor is to pack up and move to a different state, which is happening slowly but surely, resulting in a growing crisis of access to care. Obviously, much of this nastiness is due to government meddling in giving employers tax breaks for offering health insurance coverage, thus propping up the health insurers instead of having patients go directly to doctors and paying out of their pocket, with a high-deductible insurance to cover catastrophic stuff.
HMOs don't function at all like collection agencies for doctors. They employ doctors and pay them a set salary, so there is no direct connection between how busy a doctor is and how much they get paid. There is an indirect connection, as an underperforming doctor may get the boot or not get hired in the first place, and there may be some bonus pay for doctors finding a way to not treat patients, or treat them less, but HMOs are collection agencies for themselves, with doctors (and patients) just being an annoying drag on their bottom line that they try to minimize.
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