Word: optioned
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Dates: during 1990-1999
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...basically only three ways to extract the necessary billions out of Medicare. One is to make Medicare beneficiaries pay more. Another is to reduce the quality and/or quantity of care that Medicare delivers. And the third is to deliver the same services more efficiently. Naturally, everyone prefers the third option. But no serious person believes that efficiency alone can produce the necessary savings. And even efficiency is not a free lunch. The fat in the current health-care financing system, both public and private, helps to support teaching hospitals, medical research and health care for people without insurance. Squeezing...
Medicare is rapidly becoming the last bastion of traditional "fee-for-service" insurance, in which you are free to choose any doctor you want and have any treatment he or she recommends. And even Medicare is experimenting with managed care. For more than a decade, enrollees have had the option of joining an HMO, if one is available in their area. Some 9% are currently signed up. Medicare usually pays the HMO a premium equal to 95% of its average per person costs in the area, adjusted for a few factors like age and sex. Nevertheless, Medicare loses money...
...forbidden to discriminate against sicker people. This puts much of the burden of risk pooling on private insurers. There would be a tremendous incentive for insurers to "cherry pick"--to try to sign up healthier people--as is happening in a small way now with Medicare's HMO option. Even without purposeful discrimination, healthier people will naturally drift toward the cheaper, less elaborate plans, making them cheaper still--not because of greater efficiency but because of what is known as "adverse selection." The consequence? To avoid punishing sick people--simply for being sick--will require far more government regulation than...
...ADDRESS THE DESIRES OF African-American families who wish to adopt but cannot get through the door of an adoption agency. The majority of national organizations, while supporting transracial adoption, nevertheless believe that a same-race home is a better option. African-American families adopt at higher rates than white families. However, many adoptions are informal, relative or friend-of-family arrangements rather than legally finalized adoptions. But when an African-American family approaches an adoption agency to pursue a formal adoption, it is often turned away by social workers with middle-class white values. In truth there are many...
...tactic, humility was clearly not an option. Not for Bernie Nussbaum. In repeated exchanges with Republicans on the special Senate Whitewater committee last week, the former White House counsel defiantly insisted that he had done exactly the right thing in July 1993 when he restricted the ability of federal investigators to review documents in Vince Foster's office in the days after Foster's apparent suicide. "I'm proud of my conduct," Nussbaum declared at one point. To which Alabama's Richard Shelby, a former Democrat, replied with a convert's contempt for his old faith: "You're probably...