Page 63 - Just Deserts

TotalCare

it puts a squeeze on us, and I feel it is up to financial analysts like me
to give management the tools it needs to tune up the system to
optimal economic performance.”
“And it is your opinion,” said Dr. Bellarian, “that I should be
made aware of something which could work to our benefit?”
The accountant nodded crisply. “Yes, exactly—but how to make it
work is not my concern; I am a technician, a creator of ledgers and
statements, not goals and policies. Again, I have taken data from
many sources to arrive at my conclusions; possibly others have
performed the same exercise without leaving any documentation
behind for those who followed. So you may already be familiar with
this sort of analysis. It does require sophisticated computer skills,
many of which I acquired recently at night school.”
Rose extracted a sheaf of papers from her attaché case and
glanced quickly at their contents.
“All right. The modern health maintenance organization, as
perceived by most people, operates on the same principle as the
traditional Chinese doctor who was paid only as long as his patient
remained in good health. It seems obvious that our interest lies in
giving our clients good preventive treatment and advice early so they
will not require costly procedures later. Any uneasiness a patient
might have about not being given the wider range of tests typically
ordered by physicians paid by private insurers is offset by that
assumption. And that works in tandem with what I mentioned earlier
about the public perception of runaway medical costs in that sector:
most HMO patients accept a technically lower level of service
because it should reflect the fact that they are being kept healthier
than wealthier people who do obtain the panoply of state-of-the-art
diagnosis and treatment. They believe this because, whatever their
educational or cultural background, and despite the widely
disseminated Hippocratic mythology, they are certain that doctors
ultimately behave like everyone else; that is, they are greedy.”
“But that brings us back to the binding red tape in which the
HMO does business. A Beverly Hills physician may raise his fees
with no explanation, and get away with it because of his reputation.
However, the doctors here are each given a fixed amount of money
to spend per patient; if the populace were basically healthy and
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