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Essay / Research Paper Abstract
A 7 page paper answering 4 questions about the current health care infrastructure; how managed care came to increase costs rather than reduce them; what alternative measures might be used to effect change; and what obstacles such measures might encounter. Answers to these questions focus on the medical community’s long-standing rejection of any alternative measures in which pharmaceutical companies cannot hope to control (such as using St. John’s wort for mild depression rather than an ethical drug that is still profitable for its pharmaceutical manufacturer). It also discusses the use of chelation therapy. Bibliography lists 8 sources.
Page Count:
7 pages (~225 words per page)
File: CC6_KShlthCareInfraQue.rtf
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Unformatted sample text from the term paper:
The cost-plus, retroactive reimbursement system was intended to be rather straightforward, but it grew in complexity with the passage of time. It was only after blatant
fraud was discovered that Medicare administration began investigating providers on a routine basis. Years ago, investigating on a spot-check basis was not cost effective and gave too much warning
time to those who needed to alter their methods in the face of investigation. Communications were difficult and slow, and accountability was difficult. Today, fraud investigators have no
need to alert providers that they are about to be investigated, and their recovery efforts now produce more in recovered funds than the recovery operations cost (Rehnquist, 2001).
Lack of accountability and rapid advances in available technology combined to lead to gross overspending. The managed care requirement for physician referral to another
physician was intended to hold the line on costs, but the effect was that it became a matter of standard procedure to have the patient see other physicians (Cantone, 1999).
Another factor is the cost of malpractice insurance and the necessity for physicians to be able to prove due diligence in their decision-making processes. The grand culmination likely
can be blamed on the political process in which any workable attempts to control costs were met with accusations of rationing health care. Ultimately, the one factor that best
enabled the cost-plus system to lead to overspending was the shift in the social view of health care as a privilege to that of health care as a right. 2.
How do prospective payment (DRG) and Managed care propose to correct this excess spending? Fee-for-service medicine tends to result in overuse of
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