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Humana Inc. Message Board

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  • friend_of_the_deceased friend_of_the_deceased Jun 7, 2000 2:38 PM Flag

    wsj editorial pt1

    This is penny-foolish. You want your suppliers to
    have healthy profits, or they aren't going to be there
    when you need them. Medicare's false economies through
    the years have already starved the hospital industry
    of the funds needed to modernize, and now its
    short-sighted desire to milk insurers has driven them to drop
    730,000 HMO seniors in the past 17 months.

    The
    urge to meddle is also reflected in the use of
    "risk-adjusted" premiums to punish insurers for signing up
    healthy seniors. Aside from a desire to move the
    costliest patients off its own books, Medicare has a hard
    time explaining why it wants to tilt the private
    insurance pool this way. Managed care's real strength is
    keeping people healthy by using "disease management"
    techniques, such as screening and preventive medicine and
    drug therapy for conditions that might otherwise get
    worse.

    Part of the HMO problem is that Medicare was
    ratcheting down reimbursements just as new and expensive
    drugs were being introduced to treat the ravages of old
    age. So now the failure of Medicare+Choice (as the
    managed care option is known) has gotten mixed up in the
    Clinton-Gore scheme to bring the drug industry under control
    of the government-run medical system.

    The
    salami slicers figure once they have drug benefits under
    Medicare, the next move is to take a program for the old
    and extend it to everybody -- presto, national
    health! And the failure of the private insurance option
    is necessary to this end.

    We'd love to think
    this was just a policy fight, but experience suggests
    the Clinton-Gore motive is mainly politics; what's on
    their minds is expanding the pool of unionized, mostly
    public health care workers, who then become lockstep
    Democratic votes unto eternity.

    As Gail Wilensky, one
    of Washington's savviest health care policymakers,
    noted last week, whether legislation is enacted to save
    the experimental Medicare HMO program "depends on the
    party controlling the White House and the party
    controlling Congress" after the November
    elections.

    Translation: It's up to Republicans to save this experiment by
    paying realistic premiums. Otherwise, the salami slicers
    are a big step closer to their goal of quashing an
    enlightened alternative to a creeping government takeover of
    health care.

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