Professional Caregiver Insurance Risk Resource Page

Thomas Cox PhD, RN
Mathematician
Statistician
Social Worker
Nurse
Researcher
Author
Psychotherapist
Chartered Property Casualty Underwriter
SMQT Health Facility Surveyor

Critical Issues

Insurers handle insurance risks more efficiently than individuals.

Large insurers handle insurance risks better than small insurers.

Managed care operations use capitation contracts, utilization review, and other tricks of the trade to handle insurance risks by transferring them to smaller organizations and employed health care providers.

Clients/Patients of managed care and integrated health care delivery systems are relying on their health care providers to correctly diagnose and treat them at the same time that these providers are acting as these patients health insurance companies - not a good idea at all.

Health Care Providers should not be acting as health insurers.

Health Care Providers are very inefficient insurers.

Managed Care Organizations do not provide better or more efficient care - they provide less care and less efficient care than care financed by indemnity insurance products.

Tax deductions of $5,000 for purchasing individual health insurance are wasteful, inefficient, and a regressive tax. Most families cannot afford the price of individual health insurance and most insurers do not want to waste time and money writing individual policies.

Individual health account tax benefits are useful for people earning more than $250,000/year. I don't know many people making less than that who expect to benefit from these high income tax breaks.

Health Care Intermediaries - the companies that unnecessarily stand between health care providers and health care payors are a lot like ENRON - they provide no intrinsically valuable products or services, divert funds away from health care providers and consumers, and reduce the availability of health care services - Billions of dollars wasted each and every year with no benefit to anyone but these companies while health care costs more and people receive fewer services.

Under construction!

This page will contain links to useful - and in some cases useless, links.

Useful means that the linked sites contribute to understanding and reform of the negative impacts of Professional Caregiver Insurance Risk.

Useless means that the linked sites do not contribute to understanding and reform of the negative impacts of Professional Caregiver Insurance Risk but actually impair such efforts.

Readers are encouraged to think carefully and very critically about the plans of providers, managed care advocates, and politicians to fix the problems of inadequate health insurance. In particular, if you hear that an actuary is discussing managed care, health insurance, and health care finance you ought to be extremely skeptical. Actuaries should have prevented this decades ago. Their failure to speak out against managed care has been a fundamental breach of their duty to protect the public. Lawsuits against actuaries are probably going to be a hot area for future litigation.

If you would like to contribute your links to this site let me know.

Thomas Cox PhD, RN
1711 NW 55 Terrace
Gainesville, FL 32605
nurse.statistician @ yahoo.com

USEFUL LINKS

USELESS LINKS

# 1 Useless Link - AMA Voice for the uninsured This is the grand-daddy of all useless links - the American Medical Association's proposal for taking care of uninsured Americans. Late to arrive at realizing the enormous problems for uninsured patients, focused primarily on securing future income for medical doctors, and flat out unrealistic. The American Medical Association stood by while physicians and hospitals ignored the needs of patients and fought the rationalization of the health care system proposed by the Clinton Administration in the early 1990s. The AMA has ignored the severe ethical compromise of capitation. The focus on choice for patients is simply wrong-headed. If you are a Medicaid or Medicare patient having trouble finding a physician willing to see you and accept your insurance cards you know that this proposal is like "putting lipstick on a pig".

Why you might want to check this site out more thoroughly

Are you trying to understand why your 'health insurer' is denying your benefits?

Are you trying to understand why your health provider seems more interested in delaying your care than providing it?

Are you running out of time or money but you are still sick?

Do you wonder whether Managed Care or Capitation contracts are compromising your care?

Are you an attorney wondering how to best represent clients denied health care access, benefits, timely diagnosis and treatment?

Are you a health care educator or researcher trying to understand the impact of health care finance issues on access to health care?

Are you on Medicare or Medicaid and cannot find a physician in your local community at a fee you can afford?

Are you a community/health care advocate who is trying to understand why health care services are collapsing in your area?

Are you a doctor, advanced practice, registered or practice nurse

This is where you need to be!

Click on the Quick links menu for answers to all your questions.