4 replies »

  1. Give up they did but not because its methods had no merit, but because of political backlash and organizing providers. Most countries have no problem rationing care, the US does and the managed care experiment of the 90’s proved that (my understanding is the the UK national health system even uses some sort of capitation).
    United (I never worked for them) seized the opportunity to create a branded marketing image and raise rates substantially. And what did everyone receive in return for United “giving up” unabated cost increases and purchasers convinced that if they pay more they somehow get better services.

  2. John–I’m glad that United had such success exporting managed care to the UK, because they gave up using it here circa 1999!

  3. I like your writing style. Don’t agree with the conclusion, but I like your style 🙂
    Other industrialized government have done a relatively better job of controling health care growth because of price controls and rationing. Both of which scare off providers and patients. And as both of these stakeholders are major political contributors and voters unless the government wants to wholly own the health care system (Canada owns most of its hospitals) the US will not get there any time soon.
    Also remember that the health care numbers provided by CMS include ALL health care expenditures including those not traditionally paid by payors, ie, plastic surgery, voluntary services. I am not sure how this stacks up against other countries but in the studies I have read no adjustment has been for made for these nonaligned expenditures. I still believe we are higher, but not as divergent as the raw numbers suggest (% of GDP)
    I support the concept of “coverage for all”, however I don’t believe that an exclusive government run system is the final answer. Instead of assuming that the best solution is that we emulate what “everyone else has”, I think we should learn from our experience as well as others in developing a solution. Example, United Health Group is exporting its “managed care techniques” in the UK assisting the NHS. And Holland consolidated its 2 tier system into a one tier system purchased through private insurers which can be termed as regulated competition.