[FoRK] Poverty In America: A Special Report

Reza B'Far (Oracle) reza.bfar at oracle.com
Sun Sep 18 16:22:30 PDT 2011


I really can't comment on that from a professional and day-job 
perspective.... I don't have data points and if I did, it would be 
problematic to post them on an email thread.

Theoretically though, I don't think that today's model works where there 
is not enough competition at the level of tightly-integrated providers.  
Also, I think a quality problem arises when you allow the provider to 
become the insurer.  The insurer is not really part of the supply-chain 
and I think you have to keep the risk model separate from service 
delivery, otherwise, you get reduced quality of service delivery at the 
cost of risk management.

On 9/18/11 2:46 PM, Bill Humphries wrote:
> On Sep 18, 2011, at 2:33 PM, Reza B'Far (Oracle) wrote:
>
>> The waste, IMHO, comes from fundamental inefficiencies in the market system that are otherwise great in other areas, but are not compatible with providing the best health-care to as many people as possible.  I'm not saying I have an answer, but it kind of doesn't matter since the "wastes" in the extra exams, people that don't pay their fair share, etc. are far surpassed by supply chain wastes such as unbundling of services between payers and providers.
> In your experience, does a tightly integrated provider system such as Kaiser Permamente do a better job?
>
> -- whump



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