Grupo Mello

Para Salvador de Mello, presidente do Grupo José de Mello Saúde , a ADSE «é um exemplo positivo de modelo a seguir», porque «há um contratador em que existe liberdade de escolha, que pode ser exigente na contratação». link
Substituir a contratação pela concorrência, promover a livre escolha, e muitos, muitos seguros públicos ou privados, tanto faz, eis a receita milagrosa de SM para o problema da sustentabilidade do SNS em processo de morte lenta.
Há quem prefira falar de recuo: « À medida que o SNS for recuando (mesmo não sendo posto em causa o seu carácter universal), pela incapacidade de dar resposta a crescentes necessidades e expectativas, o sector privado e os seguros de saúde vão ganhar um peso que hoje não têm.» link

Via Saúde SA

Indiana

If you want a textbook example of how to “bend the cost curve down,” I recommend taking a look at the state of Indiana and how it funds health care for its employees. The governor, Mitch Daniels, explained it yesterday in the Wall Street Journal. The state of Indiana puts $2,750 into a medical savings account for every state employee who signs up for this sort of coverage. (When it started five years ago, 4 percent signed up; this year 70 percent signed up.) The employee then pays all medical expenses out of that account. If there is money left over at the end of the year, it’s the employee’s to keep. If expenses exceed that sum, the state shares expenses up to an out-of-pocket maximum of $8,000 and covers all expenses above that sum.
The program has been a huge success, saving millions for both employees and the state. Why? As Governor Daniels explains,

It turns out that, when someone is spending his own money alone for routine expenses, he is far more likely to ask the questions he would ask if purchasing any other good or service: “Is there a generic version of that drug?” “Didn’t I take that same test just recently?” “Where can I get the colonoscopy at the best price?”

In other words, a system that incentivizes health-care consumers (that’s everybody) to ask the magic question, “How much is this going to cost?” will drain billions of wasted money out of the health-care system, as Indiana has already demonstrated.
Via Commentary Magazine

ADSE

A ADSE é o melhor “managed care” em Portugal. Gasta apenas 1% do orçamento na administração.

Faça aqui download do relatório de actividades de 2008 (PDF)

Temos um problema

Health-care systems everywhere encounter cost overruns and rationing devices, like queues, in their diverse attempts to deliver products for which demand has long grown faster than other economic sectors. Why is it so difficult to find the private and public means, the combination of markets and government assistance, that enables a preferred outcome to emerge?

This question has a simple answer that plagues health care everywhere.

The health-care provider, A, is in the position of recommending to the patient, B, what B should buy from A. A third party—the insurance company or the government—is paying A for it.

This structure defines an incentive nightmare. You do not have to be an economist to realize that, when phrased in this way, nobody knows how to solve this problem. Hence the many experiments, all of which have been deemed less than satisfactory.

Via WSJ

Bio: Vernon L. Smith recebeu o prémio Nobel em 2002

Inovar na Saúde

Entrevista com Elizabeth Teisberg

Concorrência

Um tratado indispensável sobre gestão de saúde.