HMO architect has died — what he did to socialize medicine in America

Dr. Paul Ellwood, MD, died in June at the age of 95. He’s been called “the father of the HMO.” These American-made HMOs, now known as “health plans” are the corporate version of socialized medicine.

In 2001, article, “Blame Congress for HMOs” was published. It’s as relevant today as it was then. HMOs and health plans are officially called “prepaid health plans” or unofficially “managed care.” Like socialized medicine:

  • Care and coverage are melded together (conflict of interest)
  • Care and coverage are prepaid (taxes)
  • Doctors are under control of outsiders (health officials)
  • Medical treatment choices are limited (treatment protocols)

Ellwood’s HMOs were the foundation of Bill and Hillary Clinton’s proposed Health Security Act of 1993, and his health plans are the foundation of Barack Obama’s Patient Protection and Affordable Care Actof 2010 (ACA), which eliminated catastrophic (real) medical insurance and required all Americans to have a “qualified health plan,” with few exceptions.

In 1970, Ellwood created a new name for the Kaiser Permanente “prepaid health plan.” He coined the term Health Maintenance Organization, or HMO. Abandoning the fee-for-service payments of the free market, he wanted physicians to be paid for the number of patients they saw (production), not for their care or their procedures. In other words, not for their skills, their intellect, their critical thinking skills, or their excellence. With the help of President Richard Nixon (R) and bill sponsor U.S. Senator Ted Kennedy (D-MA), the HMO Act became law in 1973.

Ellwood achieved his goal of overhauling health care in America—but not the way he wanted it. He once said, “The whole HMO thing was perverted by the desire for maximizing profits.” He wanted market forces, not the government-regulated, for-profit health plans of today. He wanted “consumer choices based on quality first and then, secondarily, price.” That’s not what happened. Perhaps Dr. Ellwood thought he could play with fire—implementing his vision by government force—and not get burned. He was wrong.

Ellwood’s HMO campaign harmed patients and doctors. Empowered by the HMO Act of 1973 and enriched by the ACA, health care has been consolidated into powerful, all-controlling, corporate structures that control physicians and put patients second, or third, or fourth. Patients are essential to keep the system in place—but they’re no longer the priority.

Today, the mission of medicine has been taken over by the business of health care.

As care and coverage merge, conflicts of interest with patients are created. Health plans (coverage) are buying hospitals and physician practices (care), and hospitals are purchasing health plans. Today, nearly 70% of physicians are employees. Treatment decisions are controlled by corporate computers (electronic health records), and doctors spend about 50% of their time reporting data to their overseers just to get paid. Highly skilled professionals, physicians have become “data clerks.”

Dr. Ellwood once said, “To be an independent practitioner was never a goal.” As a result, independent physicians are rare today—but many can be found in our Wedge of Health Freedom, a free online directory of cash-based practices.

Citizens’ Council for Health Freedom (CCHF) is focused on building a parallel system – a New Framework for Health Freedom that puts the cash and the control back into the hands of patients.

In short, CCHF is working to overhaul the health care system – the right way. Join this important mission to protect patient and doctor freedom by donating to CCHF.

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