Commentary on Managed Care
(licensed vs non-licensed de facto practice of medicine)



"Managed care is a social experiment involuntarily imposed upon a group of unconsenting subjects... the physician and his patient." Anon.

Wednesday April 30, 2008

Commentary by
Roger S Case, MD

(Health Officer, Island County & Commissioner, Whidbey General Hospital)


This is the tenth in a series of commentaries addressing the subject of the funding of (y)our medical care, and what we as wage earners (and businesses) can and must do to regain control of his/her/our healthcare dollar.

Friday, 18 April 1997

  Saturday, 26 April 1997

Saturday, 11 April 1998

Friday, February 15, 2002

Friday, 11 July 2003

Saturday, 7 January 2006

Friday, 10 November 2006

Sunday, 18 March 2007

Wednesday, 13 February 2008

Wednesday, 30 April 2008

Tuesday, 30 December 2008

Monday, 29 June 2009

Sunday, 16 August 2009

Monday, 26 April 2010

Monday, 15 November 2010



This commentary will be one of referral to an article printed in the New York Times of 29 April 2008 entitled "As Doctors Get a Life, Strain Shows" By JACOB GOLDSTEIN. It highlights some of the reasons the field of health care is in a permanent trending toward a new model of how we will be receiving medical services in the years to come. It highlights WHO will be providing your medical care, but does not address how these services will be paid for... that is a quite another subject — one that is best addressed by the combined will of the public, the subject of my previous commentaries.

So please read this article: http://online.wsj.com/article/SB120942599600151137.html

The United States is one of the least healthy nations in the industrialized world, ranking 44th in the world in life expectancy and 41st in infant mortality. . . while spending at least twice as much on health care per person than does any other industrialized country. Why? Surely, this is a decidedly poor ROI for our health care dollars, don't you think?

We do not invest our health premium dollars in "health" care but in sickness mitigation, with a significant portion being apportioned to the 'administrative overhead' of moving our premium dollars to insurance company staffs and dividends for the companies' stock holders. So why do we do this?

 We do not reward healthy lifestyles, but willing pay 27-30 % or more of this now-eroded premium dollar to managing 'disease mitigation' for the last 6 months of life. Much of these mitigation efforts are directed to ameliorate the effects of a lifetime of indulgence without regard to adhering to a healthy lifestyle. Again, why do we do this?

Perhaps we need a real train wreck with our industry in order to get attention focused on health care vice disease mitigation.

Only an informed, concerned and enjoined public will be able to effect change.

I caution you... keep yourselves informed. The real revolution in health care lies ahead, and each of us must become involved!

Roger S Case
, MD, FAAFP, retired Family Practitioner

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