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 contain links to some of my professional poster presentations related to Professional Caregiver Insurance Risk. These are PDFs made from PowerPoint - so they should be about 7' x 3'. Unless you have a really big monitor you will probably have to look at it one section at a time.

Please note that all the materials on this and other pages on this website, whether specifically stated or not, are copyright 2008 by Thomas Cox PhD, RN. Materials whose copyright holder are different will be very obvious. In doubt? Assume the copyright is mine.
I encourage the use of these materials with appropriate citation and credit for my intellectual work products, in order to further the recognition of the failure of managed care and insurance risk transfers.

July 2005: Cox, T. Professional caregiver insurance risk: Impacts on health care providers, consumers, and communities. Joint poster presentation with Bonnie Sturm EdD, Katherine M. Willock, PhD, APRN, BC, Patricia E. Kizilay, EdD, CS, ARNP-BC, Marion C. Lapchak, MSN, MBA, MS, RN. 16th International Nursing Research Congress - Renew nursing through scholarship. Sigma Theta Tau International. Kona, HI. pdf

April, 2005: Cox, T. Professional Caregiver Insurance Risk: Actuarial and Decision Making Tools for Nurse Managers and Executives. 18th Annual Scientific Sessions “New Momentum for Nursing Research: Multidisciplinary Alliances” Eastern Nursing Research Society. Cherry Hill, NJ. pdf

June 2002: Cox, T. Average cost based reimbursement and risk theory: Implications for health care policy and practice, Poster Presentation, Academy for Health Services Research And Health Policy – Annual Research Meeting, Washington, DC. pdf

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.