Who Pays Whom For What In Health Care?

  1. Check out this still pertinent series of articles found at Online Journal of Issues in Nursing, June 10, 1998.

    Overview:
    http://www.nursingworld.org/ojin/tpc6/tpc6intr.htm


    AN OVERVIEW OF HEALTH CARE SPENDING PATTERNS IN THE UNITED STATES: Using National Data Sources to Explore Trends in Nursing Services
    http://www.nursingworld.org/ojin/tpc6/tpc6_1.htm

    ADVANCED NURSING PRACTICE IN THE 21ST CENTURY: Do We Want To Be Right or Do We Want To Win?
    http://www.nursingworld.org/ojin/tpc6/tpc6_2.htm

    PHYSICIAN AND NURSE REIMBURSEMENT
    http://www.nursingworld.org/ojin/tpc6/tpc6_3.htm

    FINANCIAL COMPENSATION AND ETHICAL ISSUES IN HEALTH CARE
    http://www.nursingworld.org/ojin/tpc6/tpc6_4.htm
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  2. 5 Comments

  3. by   Mijourney
    Karen, you've done it again!. I've not finished reading all the articles. But so far, the content of the articles you posted is great. I've read about some of the information in the articles over the years, but you've done a great job of providing those of us who are deeply interested in the future of health care and the role that nurses and APNs play with information.
  4. by   NRSKarenRN
    Check out all the indexed articles @OJIN, their great! Scholarly , but very readable AND enjoyable.


    See related topic:

    Who Does What in Healthcare? (OJIN, December 30, 1997)
    http://www.nursingworld.org/ojin/tpc5/tpc5toc.htm


    DETERMINANTS OF WHO DOES WHAT IN HEALTH CARE
    http://www.nursingworld.org/ojin/tpc5/tpc5_1.htm

    HOW NURSING SHOULD RESPOND TO THE THIRD REPORT OF THE Pew HEALTH PROFESSIONS COMMISSION http://www.nursingworld.org/ojin/tpc5/tpc5_2.htm


    ROLE REDESIGN: What Has It Accomplished?
    http://www.nursingworld.org/ojin/tpc5/tpc5_3.htm
  5. by   WashYaHands
    Thank you, Karen for the great links. I'm not sure if this is an appropriate thread to post this under, but this was an artilce in my local paper on 11-30-01. The journalist writes a daily column. Keep in mind, he writes in satire. He's written some very pro-nurse/anti-establishment articles in the past.
    http://www.gazette.com

    Rich Tosches: Health-care costs rising, all right -- along with salaries
    []
    About a month ago, I wrote a column about the salaries of the people who are in charge of our health care, including the head of our city-owned hospital, who makes $310,000 a year and is in line for yet another raise in a few weeks.
    (Memorial Hospital nurses will get a nice bonus, too: free tours of the huge home on Star Ranch Road that their boss purchased this year for $578,000.)
    The column pointed out that one HMO chief -- former Memorial Hospital doctor Bill McGuire, now the CEO of the Chicago-area United Health Group -- was given a compensation package last year potentially worth $357 million, depending on the company's stock price.And certainly no one would suggest a guy in that position (if the stock performed well, McGuire would have earned the equivalent of $972,082 each day) would raise premium costs and slash patient care -- even though it would certainly boost the stock price and allow him to purchase, let's say, a new golf club.
    Such as Pebble Beach.
    All of which prompted reader Timothy Gentry of Ellicott to send a letter to the editor referring to me as "Comrade Tosches" and likening me to the founder of communism, Karl Marx. (It wasn't the first time I've been compared to Marx, although generally it's Harpo.)
    "How dare these robber barons think their hard work, risk and initiative entitle them to any more than the proletariat which they exploit!" he wrote.
    My response? Well, I actually enjoyed the letter, which showcased a writing style known as satire.
    However, Timothy, hang on to your goat, because here we go again:
    On Jan. 1, rate increases for companies in Colorado Springs will range from 15 to a staggering 60 percent -- meaning another big chunk out of your paycheck, or reduced benefits. Or both.Example, from a recent Gazette story: "About 62,000 senior citizen Secure Horizons members across the state will face increases and benefit changes next year, PacifiCare of Colorado announced."In Pueblo, for example, Secure Horizons customers -- elderly people living on fixed incomes -- will pay $40 for an office visit, up from this year's $15.PacifiCare also said it would stop offering any coverage at all in 15 rural counties in Colorado, leaving tens of thousands of people struggling to find coverage.This was done, PacifiCare said, because of "mounting financial losses."Note: Last year, ol' "mounting financial losses" PacifiCare gave six of its executives a total of $5.6 million in salary -- and a potential $28 million in stock options.Here is PacifiCare spokeswoman Amy Hudson to explain it to us: "The simple answer," she said, "the reason premiums are increasing, is that our health-care costs are increasing."They certainly are.In addition to the six PacifiCare executives whose salaries and stock options were listed above, new PacifiCare president and CEO Howard Phansteil got a compensation package last year that could have reached $11 million.All he had to do, as Timothy Gentry pointed out, was demonstrate "hard work, risk and initiative."
    Such as gouging old people who live on fixed incomes.
  6. by   NRSKarenRN
    Thanks for posting this article. I have no problems with healthcare management making a salary around $100,000/yr (double staff nurses). Or Senior MGMT 350,00-500,000/yr.


    But HMO salaries are WAY out of control. Since they have the power to DENY a member benefits and are the ones setting rates, what incentive is there for them to minimize financial impact of salaries on the company? A HMO CEO making $972,082 each day??

    That could be an additional 20 nurses performing case management and 10 customer service reps on the telephone lines verfying insurance benefits, preventing an HOUR wait time! When HMO's plans started, there should have been a rule capping the amount of salaries for Senior Management to say 7% of profits to prevent gouging of the HMO members, IMO.
  7. by   Mijourney
    Hi. Karen, I agree with your assessment except I do have a problem with CEOs making $350 K when many of them may only attend meetings and delegate the real work to someone of a lesser title or status. The president of the U.S. only makes $400,000 if I'm not mistaken. I know that's a public service job with some good fringe benefits, but it's appears to me to be a very weighty job especially in times like these.

    I perhaps wouldn't have a problem with a CEO making alot of money, if my income was a true reflection of my practice activities.

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