oh, and question about the vaccine costs. i was told that doctors in the provider network are given mandates from the insurance companies about what kind of care they must provide in order to be part of the network. if i were an insurance company, i would absofuckinglutely want them to adhere to these standards, right? if i prescribe vaccinations and drugs that make people not get sick, then that means they don't have to go to the doctor, which means i don't have to pay the doctors to treat them, which means i make more profit, right? am i missing something here?
I didn't really comment on this before, but this is something you are going to see more of in the future. Insurance companies giving physicians "bonuses" if you will for following certain guildlines or for keeping their population of patients healthy.
Here is an example. Lets say that an insurance company has decided that a certain set of care guidelines is the best at reducing the chance for a person to have heart problems. That insurance company then has a lot of power in getting a physician to treat their patients in a certain way. They will give a provider more money for peforming the "correct" care. It may be as simple as making sure the provider has tried to control the patient's weight by recommending an exercise program or diet. It could however get the point where a insurance company will only pay a provider if they perscribe a specific medication or follow a extremely narrow plan of care.
So, is this good or bad? Well it has the potential to act as a double check to make sure a physician is providing the appropriate and recommended care. However, if the physician feels like they are forced into providing care that is not appropriate for a specific patient then these incentives have basically taken the power out of the physician's hands and put it into the hands of insurance companies.
The company I work for is trying to "eliminate insurance companies" by basically becoming one and doing it better. What I described above is part of what they hope to accomplish.