A child’s mind in an adult body. This is the most accurate way I can describe Ezehiel J. Emanuel’s opinions expressed in a recent article on the future extinction of health insurance companies. Mr. Emanuel knows not the history and the polarizing affects limited health plans have on a population. Read his prediction on the future of health insurance companies.
The new term Accountable Care Organization, ACO, varies little in concept from the Health Maintenance Organizations, HMO. Exceptions are some technological advancements in reporting that have evolved in the last decade. On March 3, 1978, in a Senate hearing the late Senator Ted Kennedy celebrates HMOs:
- “Today the Subcommittee on Health and Scientific Research holds hearings on proposed amendments to federal statutes supporting the development of health maintenance organizations…These amendments would extend and strengthen current authorities supporting HMOs in this country….
- “As the author of the first HMO bill ever to pass the Senate, I find this spreading support for HMOs truly gratifying. Just a few years ago, proponents of health maintenance organizations faced bitter opposition from organized medicine. And just a few years ago, congressional advocates of HMOs faced an administration which was long on HMO rhetoric, but very short on action.
- “The current revival of the HMO movement should come as no surprise. HMOs have proven themselves again and again to be effective and efficient mechanisms for delivering health care of the highest quality. HMOs cut hospital utilization by an average of 20 to 25 percent compared to the fee-for-service sector. They cut the total cost of health care by anywhere from 10 to 30 percent. And they accomplish these savings without compromising the quality of care they provide their members.
- “In fact, many medical experts argue that the peer review built into group practice in the HMO setting promotes a quality of care superior to that found in the traditional health care system….
- “In our enthusiasm to see HMOs proliferate throughout this country we should not lose sight of the need to guarantee the quality and integrity of the prepaid plans we create.”
Compare this to is remarks on May 15, 2001:
On May 15, 2001, Senator Ted Kennedy released a statement regarding the need for an effective patients’ bill of rights to end HMO abuse. Following are excerpts from that press release:
- “Today, if your child has a rare congenital heart defect and no specialist in the plan is equipped to treat it, your [HMO] plan can condemn your child to second rate care from the doctor who happens to be on the plan’s list…”
- “Today, if you have incurable cancer and your best hope of a cure is participation in a clinical trial, your [HMO] plan can deny you access to that trial…”
- “Today, your doctor can be financially coerced by your HMO into giving you less than optimal care…”
- “Today, if you need an expensive drug that is not on your plan’s list, the [HMO] plan can make you pay for it yourself or go without…”
Senator Kennedy continues: “It is time to end the abuses of managed care that victimize thousands of patients each day. It is time for doctors and nurses and patients to make medical decisions again, not insurance company accountants. The American people deserve prompt action, and we intend to see that they get it.”
Mr. Emanuel would be better writer if you studied history more than what he apparently has. The market will likely bifurcate into two fractions:
- One, those in need of being directed and taken care of my our medical system through ACO (HMO) and
- two, those who desire more autonomy and ability to self-direct their own care using higher deductible plans that resemble insurance combined with the tax incentives present within our tax code.
