Sociology of Medicine and Health CLASS 21

Sociology of Medicine and Health CLASS 21 - Class 21 HMOs...

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Class 21 – HMO’s & Rationing I. Rationing influences medical care organization A. Demand for medical care always greater than supply (new technology increases demand) 1. Rising demand cannot be satisfied 2. Rationing is inevitable B. We have always had rationing in some form 1. Economic rationing – economic free market decided who gets medical care 2. Implicit rationing – doctor makes the decision on who got medical care 3. Explicit rationing – 3 rd party make decisions (insurance companies decide on who gets medical care a. Most Americans get it this way II. Economic Rationing (free-for-service) A. Doctor bills patient directly for treatment 1. Especially when doctor had his own practice 2. Either you pay it or insurance pays for it B. Claim – based rather than need-base 1. Insurance claim = pay first withou7t evaluating medical care C. You get only what you pay for, or what your insurance pays for 1. Old people in the past did not get medical care or the poor D. Rich people get more, poor people get less or none
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This note was uploaded on 11/16/2011 for the course SOC 210 taught by Professor Hanssell during the Fall '10 term at Rutgers.

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Sociology of Medicine and Health CLASS 21 - Class 21 HMOs...

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