tailieunhanh - AIDS and Health Insurance: An OTA Survey

While the resulting American health care model proved a clever way to ensure that the money would roll in from patients, employers, and government, it contained a flaw that is proving fatal. The flaw is that health care consumers have been removed from par- ticipating in decisions regarding their care. Our approach to health insurance ignores the important role consumers play in controlling costs and enhanc- ing quality. Dr. Gorman found that people who pay for their own care cut utilization by 10% to 30% with no discernable effect on health. Saving even 10% of Wisconsin’s 2002-2003 health care spending would have saved $260 million. Fortunately a movement has begun to put con- sumers. | AIDS and Health Insurance An OTA Survey February 1988 NTIS order PB88-170204 IK rl A l RELATIZR SSL I s AIDS AND HEALTH INSURANCE Aft OTA Survey IVhiujiv I4HH s TAI I I AI I 2 AIDS and HEALTH INSURANCE An OTA Survey by Jill Eden Study Director Laurie Mount Lawrence Miike Health Program Office of Technology Assessment United States Congress Washington . 20510-8025 February 1988 A Staff Paper in OTA S Series on AIDS-Related Issues The views expressed in this Staff Paper do not necessarily represent those of the Technology Assessment Board the Technology Assessment Advisory Council or their individual members. CONTENTS Page Number SUMMARY. I INTRODUCTION. 5 Commercial Health Insurers. 5 Blue Cross Blue Shield Plans. 7 Health Maintenance Organizations. 8 SURVEY RESULTS. 11 Medical and Other Factors in Risk Classification. 11 Commercial Health Insurers. 11 Blue Cross Blue Shield Plans. 16 Health Maintenance Organizations. 19 Sources of Medical Information. 22 Commercial Health Insurers. 22 Attending Physician Statements. 25 Physical Exams. 25 Blood and Urine Screening. 25 Blue Cross Blue Shield Plans. 27 Health History Questionnaire. 27 Attending Physician Statements. 27 Physical Exams. 27 Blood and Urine Screening. 29 Health Maintenance Organizations. 29 Health History Questionnaire. 29 Attending Physician Statements. 29 Physical Exams. 30 Blood and Urine Screening. 30 AIDS Policies and Experience. 30 Commercial Health Insurers. 30 Blue Cross Blue Shield Plans. 35 Health Maintenance Organizations. 39 Continued. .

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