The Covert Rationing Blog

Pay for Performance and Covert Rationing (1)

Pay for Performance (P4P) is the latest trend among health insurers and our friends in the government in their never-ending efforts to assure that patients in their charge are receiving top-quality healthcare. At least, that’s what they say.
Under P4P, certain “clinical practice guidelines” are developed by Medicare or private insurers, based on the principles of […]

Posted in Gekkonian Rationing, Wonkonian Rationing, General Rationing Issues, Primary Care in America | 8 Comments »

Weep Not for UnitedHealth Group

Vanessa Furhmans of the Wall Street Journal Health Blog reports that a group of state insurance commissioners “plan to announce a multi-state settlement with [UnitedHealth Group] concerning some of its claims-paying systems.” It appears that regulators from four states have been negotiating a settlement with the health insurance giant for years. According to Furhmans, “the […]

Posted in Gekkonian Rationing, Wonkonian Rationing | 1 Comment »

Feds May Begin Physician Profiling in 2008

The Government Accountability Office (GAO) says that Medicare is ready to begin physician profiling as early as next year.
Physician profiling, the actual (and refreshingly honest) term used by GAO, is also known as “resource use comparison.” Under this system the feds will compile statistics on the utilization of healthcare resources by individual doctors and […]

Posted in Wonkonian Rationing | 1 Comment »

SiCKO and Covert Rationing

DrRich finally saw Michael Moore’s film SiCKO this week, and found it to be surprisingly affecting. DrRich is quite jaded about the injustices routinely and systematically performed by the American health insurance industry, and has written about them extensively. But even he was moved by the personal stories Moore presented of those who […]

Posted in Gekkonian Rationing, Wonkonian Rationing | No Comments »

Former CMS Official “Admits” to Covert Rationing

In his forthcoming book, Fixing American Healthcare - Wonkonians, Gekkonians and the Grand Unification Theory of Healthcare, DrRich demonstrates how the imperative to covertly ration healthcare causes payers to bastardize evidence-based medicine. In a recent interview in Health Affairs, Sean Tunis MD, formerly Medical Director for the Centers for Medicare & Medicaid Services (CMS), […]

Posted in Wonkonian Rationing | 2 Comments »

The Regulatory Speed Trap

In their efforts to control the behavior of physicians for the purpose of covertly rationing healthcare, regulators have developed a particularly effective technique that DrRich calls the Regulatory Speed Trap. The first readily recognizable application of this technique occurred during the Reagan administration, in its crackdown on fraud in the defense industry.

When the […]

Posted in Wonkonian Rationing | 5 Comments »

The Two Flavors of Covert Rationing

As we learned in the previous post, the behaviors used to covertly ration healthcare in America are advanced by two different schools of thought. Once we are introduced to these two schools and become familiar with their philosophies, it will be easy for us to begin spotting covert rationing behavior when we encounter it, and […]

Posted in An Introduction to Covert Rationing, Gekkonian Rationing, Wonkonian Rationing | 1 Comment »