ObamaCare Prototype Already Exists
©By Karen Russo 2010
Those who are curious as to how health care delivery under ObamaCare might work need look no further than their state penitentiary.
Prison HMOs have been in existence for more than twenty years. There are now as many as 75 prison HMOs or hybrids that deliver medical, mental and dental healthcare to the jail and prison population in the U.S.
These HMOs represent what happens to health care when the government assumes progressively more control over expenses, diagnoses, and treatment regimens. And the picture is not pretty.
Myriad news articles have been written about prison health care in all parts the country. They inevitably highlight the botched delivery of medical or mental healthcare to an inmate that reporters have cherry-picked out of the masses.
Rarely, however, do these articles explain the mechanics of how the prison HMO works, how it feeds off the state and the taxpayers for a service inadequately delivered, if delivered at all, and why all such state-dominated systems function so badly.
News reporters fail to connect the dots, either out of laziness or ideological complicity. They should have been more thorough. The current proposed health care legislation will ensure prison health care for everybody.
The state control of a closed system, even with private ownership involved, inevitably results in the omission of key information from medical records and the silencing of dissent. Given the economic shortfalls within state budgets nationwide, quality assurance and risk management personnel will ensure that access to adequate health care will be more and more difficult to obtain. That's a prison HMO. That is what the American public does not see.
In a prison HMO, medical decisions and approvals are often made by non-medical personnel, unqualified medical personnel, or contract vendors who are encouraged to buy into the prison HMO cost containment measures.
To be sure, some contract vendors-specifically medical doctors and hospitals--are not willing to put their reputations on the line for the sake of the prison HMO. As a result, when an inmate is actually taken to an outside appointment, usually as a result of family pressure, those outside doctors are not shy about sharing their recommendations with the prison HMO medical personnel.
But here's the rub. The inmate's "attending physician" is the prison doctor. As the attending physician he is not required to follow recommendations from an outside doctor. And even if he wanted to, he often cannot because he is not calling the shots.
The prison doctor has to get approval from his superiors within the prison HMO to prescribe recommended medications, treatments or surgeries. Inmates do not understand this hierarchy-neither do their families-and most often neither do lawyers.
If the inmate dies, cause and manner of death is determined by a contracted medical examiner who has a vested interest in doing exactly what the Department of Correction expects him to do. Death reporting is often skewed and inaccurate.
In a private health care system it is the government that referees and insists on fair play. When the government controls the system, and the media are complicit with the government, there is no one left to lobby for the unconnected individual.
And in the game of ObamaCare there are no "get out of jail free" cards.
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