Do you want physicians? Or Accountable Care financiers deciding your healthcare? (salaries, health care)

[EricS39]

Republicans and Conservatives are big on this extending power and rewards incentives to Accountable Care Organizations (ACO) to decide the future of Disease Management, Preventive coverages, who should and should not be allowed a CAT scan or MRI...

which Hepatitus C patients should and should not be allowed to take Solvaldi medication to cure their disease because it's too expensive

What plans should go away and which plans should stay. How long you should be allowed to stay in intensive care to save money .

Such that one of my in law cousins was suicidal and was stabbing herself due to low self image and she's only 13 years old. After she attempted to cut her throat, they took her into intensive care and then released to save money. The next day, she overdosed on pills on purpose to make suicide attempt #2... Back in intensive care she will be released again

This is low cost above quality care

Other nations people get care as needed and rationing is used instead. This is better because people who are overusing the doctor and are healthy really don't need preventive care. But instead of cutting people put who have high claims, in UK and France and Australia and Canada these people get the most attention, not the least .

We focus too much on cost saving on the people who are poor and most need the care. It's not right to mess with health the same way we deal with paying rent.

[aneftp]

A lot of people don't realize there has been a huge consolidation within medicine and it's accelerated since the PPACA was passed.

Skeptics will try to point out "buyouts" and "sellouts" have always happened.

Yet in many hospital based specialties like anesthesiology, radiology, and emergency medicine. Many corporations are taking over these practices. Buying up more practices and trying to strengthen themselves in order to protect themselves against ACO practices.

ACO practices will squeeze the little guys.

Say a shoulder surgery case is expected to generate $10000. There may be a slight reward for "certain metrics" being met. There will be decreases in revenue when certain metrics aren't met. We all know how "metrics" work with the VA scandal. Metrics don't necessarily measure quality health care.

The ACO model doesn't save the system much. What's going to happen is people are going to be splitting this pie. The reasons hospitals merged and other specialties merge is to all angle for the piece of the pie in the ACO.

The hospital wants their piece of the pie. The specialists want their piece of the pie as well. It's a fight. This is where the corporations come in. They will try to say they will do it for less. Win the contracts.

Yet there is very little cost savings. The corporation needs to operate on profit margin. So healthcare workers salaries get lowered. People think this is a good thing. Except big companies like Mednax which controls the pediatric cardiology practices as well as anesthesiology use their brute force and demand higher reimbursement. They gobble up a market and will demand more of that pie. Same with hospital systems.

End result, the ACO doesn't work well. Because companies will initially under bid and than demand more. Since they are large companies they can threaten to pull out of these ACOs quickly unless they get their ransom.

Of note 33% of ACOs have broken up within the past 12-18 months. That's the scary part. Too much power. Too much money involved.

[brentwoodgirl]

I want the government in charge of my care. Look at what a great job the VA is doing.