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Originally posted by Not Me
So are you saying that a $5 cafeteria lunch meets the definition of a kick-back? If so, every hospital in the US is guilty of these kick-backs. I don't know of any hospitals that don't have doctor's lounges in which they provide free food for the doctors except for maybe county hospitals on tight government funded budgets. It is a common practice for hospitals to do this. If you have any friends who are doctors, ask them.
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Depends on the hospital. I went back and checked again, because it was bothering me, and the stark exception is more likely to be in 42 C.F.R. section 411.357 (m) (medical staff incentives). There are a lot of hospitals in the Texas Medical Center that only provide meals to residents and medical staff members with Medical Director appointments.
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What specifically in my posts makes you think I don't read public health literature?
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Your comments regarding education and lifestyle as not being part of health care. Public health, in part, is about developing programs to assist people in changing lifestyle. From simple things like washing hands and brushing teeth, to more complex nutrition education.
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The problem is indeed that they have been limited to self-employed individuals. There were a few employer-based plans that used the MSA approach and were studied by economists and had good results.
The main difficulty in MSAs is structuring the incentives properly and if it is an employer-based plan, all the EEOC regulations. Sometimes it is not clear cut what is discretionary healthcare spending and what is not and if it is considered discretionary and the employee has to pay more for this, would the EEOC find some sort of discrimination is occuring.
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I agree, and I think that MSAs could be promising. I think, though, that there need to be some minimum, perhaps rationed, safety nets put in place outside of the MSA that would help in the event that there is not enough in the MSA to cover an otherwise treatable disease or condition.
