tag:blogger.com,1999:blog-4221799618451541568.post3352451224168023499..comments2023-10-15T03:19:37.093-06:00Comments on Great Northern States Health Care Initiative: Medicare Advantage: “The Average Person Is Probably Appalled by This”Unknownnoreply@blogger.comBlogger1125tag:blogger.com,1999:blog-4221799618451541568.post-51010294892276642972017-06-28T06:49:47.722-06:002017-06-28T06:49:47.722-06:00I'm summarizing this history as follows:
Fro...I'm summarizing this history as follows:<br /><br />From the late 1800s through well into the 1950s,<br />U.S. physician practices were forming cooperatives and prepaid group practices in which communities paid a monthly amount to receive all the health care they needed. Physicians were paid a salary. <br />Physicians made the transition from individual practices to group practices as health care became more specialized, to integrate care so various practitioners were on the same page about treatment plans, and economies of scale. Note that there were no insurance companies in this structure, health care was exclusively a relationship between patients and practitioners.<br />However, every time these self-funded coverage models were formed,(described as a "movement"), it was the AMA, and County<br />Medical Societies, whose members sat on state licensing Boards, whom would have such practitioners licenses revoked, or prevent hospital admitting privileges, in order to stop this movement.<br />In short, the AMA and organized medicine so vehemently opposed these physician group practices and later, government intervention, (such as Trumans Universal Health Insurance proposal), that the AMA embraced and launched the health insurance company model, including the establishment of Blue Cross in the 1930s. The AMA was a staunch proponent of individual, fee-for-service practice under the private intervention of insurance companies.<br />But the physicians whom created prepaid cooperatives and group practices fought back and filed suits against the AMA, as did farmer, consumer, and employer groups whom also started to jointly sponsor the prepaid group practices, (again completely devoid of insurance company involvement). And in every case group practices and communities won on the basis of "restraint of trade", or "antitrust" and received payments, often in the millions.<br />The article immediately prompted me to revisit <br /> a book on my shelf about the history of Group Health Cooperative in MN, entitled, " An Enduring Mission." Sure enough, Group Health was to be a prepaid group practice under physician control, starting in 1937, but, for the exact reasons I just stated above, and because MN State statutes only permitted it to incorporate as "Group Health Mutual Insurance Company", it did so in 1957. That was a key turning point toward health insurance company intervention, rather than keeping medical coverage community and practitioner based. <br /> A New England J. Of Medicine article from 1985, "HMOs: Origins and Development", corroborates the above point. Before this, in 1932, the AMA issued a statement strongly opposing prepaid group practices, which, again, paved the way for the creation of Blue Cross, that is, the intervention of a health insurance company.<br /> I believe that once practitioners and communities understand, in historically developing terms, that self-funded insurance, i.e. prepaid group practices, was the norm, yet was undermined, that practitioners and communities can take health care back. <br /> Certainly today's advances in health information technology make this feasible, practical and sensible. An self-funded AgCoop for MN farmers' health insurance was just created this year via an ERISA waiver. Getting back to this community and practitioner based approach is a reasonable strategy for proceeding to a single payer system.<br /> I emailed the book's writer who replied to say: "the AMA had over 30 states pass laws "against the corporate practice of medicine." They varied from state to state but most of them were used against medical cooperatives and prepaid physician groups." She also said her article was the most widely read and shared that day and the next, and that few physicians know this history.<br /><br />Joel <br /><br />Joel Albers<br />Health Economist<br />Co-op Care, an initiative of Universal Health Care Action Network of MN > 501(C)(3)Craighttps://www.blogger.com/profile/09441179663166775526noreply@blogger.com