Presented
at the Annual Meeting of the Eastern Section of the American Federation
for Clinical Research, New York, NY, November 5, 1992. Clinical Research
vol. 40, September, 1992.
"Risk Analysis within Proposed Medical Care Plans."
John H. Frenster, M.D.
Physicians' Educational Series
Atherton, CA 94027-5446
Many new plans for medical care have been proposed with emphasis
on cost containment, quality assurance, and manged care, but with the role
and effects of risk ratings minimally analyzed. The present federal MediCare
program and each of 14 newly-proposed medical care plans were analyzed
for their type and effect of risk factors, and were then ranked by a matrix
cognition decision-making program (Clinical Research vol.40, 277A (April,
1992) for each of 10 criteria for risk analysis of medical, social or microeconomic
significance, including: risk of patient or physician exclusion; risk of
malpractice; risk of over-pricing; risk of over-utilization; risk of under-utilization;
risk of funding loss; risk of bankruptcy; risk of political interference;
risk of over-concentration of lethal diseases; and risk of loss of physician
morale. Several proposed medical care plans contained little or no analysis
of the risks of medical practice, while others contained an already out-dated
analysis. The present federal MediCare program revealed a worsening risk
rating, while the Canadian plan of rationed care is stable at a high-risk
level. The Double-Voucher plan for patients and physicians had the least
overall risk, but external risks threaten all medical plans. It is concluded
that risks must be assessed as well as gains in selecting a medical care
plan, and that external risks must be reduced for any medical plan.
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John H. Frenster, M.D.
Physicians' Educational Series
247 Stockbridge Avenue
Atherton, CA 94027-5446
Phone: +1 650 367 6483
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WebSite: http://www/frenster.com/
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