On Tue, 08 Sep 2009 07:50:50 -0400, Tom Francis - SWSports wrote:


On the face of it, it's a sound idea - actually, a little like an HMO in
concept which seem to work well.

But you pointed out the problem yourself - depending on how they are set
up.

It's my understanding that Blue Cross/Blue Shield started as a co-op. In
some states it is still the dominate player in health insurance. Don't
quote me on these numbers, but I believe collect 90% of the premiums in
North Dakota, and 70% in Iowa and South Dakota, clearly the big player.
I wonder how well they perform in keeping costs down.

The simple truth is this - a public option would not be more efficient
or cost effective than private plans. You just have to look around at
various government run health care systems to see how inefficient they
are - the Indian Health Service is one good example. The VA is another,
although the VA has cleaned up it's act over the past few years quite a
bit and the general care levels are becoming much better. I'm going
into the VA system myself shortly - I looked at it hard and was
satisfied that my situation will be handled well.

So will a co-op work? It does in some states and they seem to be very
effective and efficient in patient care. The few that I know about are
small, self-contained (all-in-one service centers from testing to care)
and being non-profit, the costs are containable and in general, less
than standard health plans.

I was in a similar system quite a few years ago - it was a non-profit
health care system run by Hanneman Hospital in Worcester. To tell the
truth, it was high quality care, the specialists were top rank and in
general, the feeling was of a small doctors office where people knew who
you were - a very nice. Everything was contained within one facility -
you see the doctor, get an x-ray (or CAT/PET/MRI) on the spot readings,
go back and see the NP or PA and if they needed to get the doc, they got
the doc. It was good.

So in my experience, the co-op seems like a good idea. Run by the
government though? No - I can't see that. The very nature of
government does not allow for efficiency, cost containment and
effective.

It's my understanding that it wouldn't be run by the government, but set
up as a non-profit, owned by the subscribers.

http://www.nytimes.com/2009/08/18/he...n.html?_r=2&hp