Professional Caregiver Insurance Risk Resource Page

Thomas Cox PhD, RN
Mathematician
Statistician
Social Worker
Nurse
Researcher
Author
Psychotherapist
Chartered Property Casualty Underwriter
SMQT Health Facility Surveyor

Critical Issues

Insurers handle insurance risks more efficiently than individuals.

Large insurers handle insurance risks better than small insurers.

Managed care operations use capitation contracts, utilization review, and other tricks of the trade to handle insurance risks by transferring them to smaller organizations and employed health care providers.

Clients/Patients of managed care and integrated health care delivery systems are relying on their health care providers to correctly diagnose and treat them at the same time that these providers are acting as these patients health insurance companies - not a good idea at all.

Health Care Providers should not be acting as health insurers.

Health Care Providers are very inefficient insurers.

Managed Care Organizations do not provide better or more efficient care - they provide less care and less efficient care than care financed by indemnity insurance products.

Tax deductions of $5,000 for purchasing individual health insurance are wasteful, inefficient, and a regressive tax. Most families cannot afford the price of individual health insurance and most insurers do not want to waste time and money writing individual policies.

Individual health account tax benefits are useful for people earning more than $250,000/year. I don't know many people making less than that who expect to benefit from these high income tax breaks.

Health Care Intermediaries - the companies that unnecessarily stand between health care providers and health care payors are a lot like ENRON - they provide no intrinsically valuable products or services, divert funds away from health care providers and consumers, and reduce the availability of health care services - Billions of dollars wasted each and every year with no benefit to anyone but these companies while health care costs more and people receive fewer services.

Under construction!

This page will contain links to a wide range of my Working Papers & Presentations.

Many of these items are not ready for prime time - that is why they are "Working Papers & Presentations".

In essence, some of them are my raw thoughts and others are very well developed . I think it will be pretty obvious. Over time I will clean up the weak materials and move them to a more refined page.

Please note that all the materials on this and other pages on this website, whether specifically stated or not, are copyright 2009 by Thomas Cox PhD, RN. Materials whose copyright holder are different will be very obvious.

In doubt? Assume the copyright is mine.

I encourage the use of these materials with appropriate citation and credit for my intellectual work products, in order to further the recognition of the failure of managed care and insurance risk transfers.

PAPERS

Cox, T. (2009). A Critique of Managed Care & Capitation Financed Health Care: A Prologmena - Revised 06/26/09 pdf

Cox, T. (2009). Risk Induced Professional Caregiver Despair - A Learning Module - Revised 06/18/09 pdf

Cox, T. (2009). Probabilistic Proof of PCIR - Revised 06/16/09 pdf

Cox, T. (2009). Frequently Asked Questions About PCIR - Revised 06/11/09. pdf

Cox, T. (2007). March 2007 draft submission to Chance, The Journal of the American Statistical Association. It didn't get published. I wonder if the editor is having second thoughts yet? I am sure he will sooner or later. pdf

Cox, T. (2000). December 2000 paper for one of my early doctoral courses. A brief overview of the philosophical foundations of Professional Caregiver Insurance Risk. Better written than I thought, but still not ready for primetime. pdf

ABSTRACTS

Cox, T. (2009). Katrina and Wall Street: Risk, Uncertainty and the Unfolding Future of Nursing and Health Care (Finance) Reform. Abstract submitted for the 2009 Conference: Visions of Rogers' Science of Unitary Human Beings: A Celebration of the Relative Present. October 23-25, 2009. pdf

Cox, T. (2009). On slinkies, fleas, and health care (finance) and nursing reform: Knowingly participating in a perfect storm and swimming to shore. Abstract submitted for the 2009 Conference: Visions of Rogers' Science of Unitary Human Beings: A Celebration of the Relative Present. October 23-25, 2009. pdf

Bradley, S.L. & Cox, T. (2006). Managing Financial and Clinical Risk: Risk Theory and Operations Research for Nurse Administrators. 17th International Nursing Research Congress Focusing on Evidence-Based Practice. Sigma Theta Tau International. Montreal, Canada. pdf

Cox, T. (2006). Managing Nursing Risk and Uncertainty: Balancing Expected vs. Extreme Service Demands. 17th International Nursing Research Congress Focusing on Evidence-Based Practice. Sigma Theta Tau International. Montreal, Canada. pdf

Cox, T. (2006). Making Choices Under Fiscal Constraints and Uncertainty: Helping Nursing Students Make Clinical Decisions in Resource Constrained Environments. 17th International Nursing Research Congress Focusing on Evidence-Based Practice. Sigma Theta Tau International. Montreal, Canada. pdf

Lapchak, M.C. & Cox, T. (2006). Legacy, Proprietary, and Open-Source Software and Interdisciplinary Collaborations: A Comparative Case Study. 17th International Nursing Research Congress Focusing on Evidence-Based Practice. Sigma Theta Tau International. Montreal, Canada. pdf

Logsdon, D.T. & Cox, T. (2006). Hospital Contracting and Management Operations for Managed Care: A Comparison of Two Rural Hospitals. 17th International Nursing Research Congress Focusing on Evidence-Based Practice. Sigma Theta Tau International. Montreal, Canada. pdf

Walsh, L.A., Debari, M.A. & Cox, T. (2006). A Case Study Analysis of the Impact of Revenue Uncertainty on Hospital and Nursing Operations. 17th International Nursing Research Congress Focusing on Evidence-Based Practice. Sigma Theta Tau International. Montreal, Canada. pdf

Cox, T. (1999). Abstract submitted to the American Association of Colleges of Nursing for the conference " Faculty Practice: Essential or Extraneous to the Mission" in February 2000. I have learned a bit since then about writing abstracts - my big achievement being having had all seven abstracts with which I was involved being accepted for presentation at the Sigma Theta Tau conference in Montreal in July, 2006. pdf

PRESENTATIONS

Bradley, S.L. & Cox, T. (2006). Managing financial and clinical risk: Risk theory and operations research for nurse administrators. 17th International Nursing Research Congress Focusing on Evidence-Based Practice. Sigma Theta Tau International. Montreal, Canada. pdf

Cox, T. (2006). Managing nursing risk and uncertainty: Balancing expected vs. extreme service demands. 17th International Nursing Research Congress Focusing on Evidence-Based Practice. Sigma Theta Tau International. Montreal, Canada. pdf

Cox, T. (2006). Making choices under fiscal constraints and uncertainty: Helping nursing students make clinical decisions in resource constrained environments. 17th International Nursing Research Congress Focusing on Evidence-Based Practice. Sigma Theta Tau International. Montreal, Canada. pdf

Logsdon, D.T. & Cox, T. (2006). Hospital contracting and management operations for managed care: A comparison of two rural hospitals. 17th International Nursing Research Congress Focusing on Evidence-Based Practice. Sigma Theta Tau International. Montreal, Canada. pdf

Walsh, L.A., DeBari, M. & Cox, T. (2006). A case study analysis of the impact of revenue uncertainty on hospital and nursing operations. 17th International Nursing Research Congress Focusing on Evidence-Based Practice. Sigma Theta Tau International. Montreal, Canada. pdf

Cox, T. (2005). Professional caregiver insurance risk: Implications of healthcare provider insurance risk assumption. 6th International Conference on Health Policy Research. American Statistical Association. Boston, MA.

Cox, T. (2005). Unitary appreciative inquiry: Theory and practice. Annual Research Conference - Society of Rogerian Scholars. Joint collaboration with Dr. W. Richard Cowling, III and Dr. Alison Rushing. Savannah, GA.

Cox, T. (2005). Risk induced professional caregiver despair: Voices of nurses. Annual Research Conference - Society of Rogerian Scholars. Savannah, GA.

Cox, T. (2005). Professional caregiver insurance risk: Impacts on health care providers, consumers, and communities. Joint poster presentation with Bonnie Sturm EdD, Katherine M. Willock, PhD, APRN, BC, Patricia E. Kizilay, EdD, CS, ARNP-BC, Marion C. Lapchak, MSN, MBA, MS, RN. 16th International Nursing Research Congress - Renew nursing through scholarship. Sigma
Theta Tau International. Kona, HI.

Cox, T. (2005). Risk-induced professional caregiver despair: Nursing at the crossroad of finance and caring. 16th International Nursing Research Congress - Renew nursing through scholarship. Sigma Theta Tau International. Kona, HI.

Cox, T. (2005). Applying alternate measures of distance to Barrett's Power as Knowing Participation in Change Tool (PKPCT). 18th Annual Reinkemeyer Research Day. Gamma Nu Chapter Sigma Theta Tau International. South Orange, NJ.

Cox, T. (2004). Unitary appreciative inquiry: Praxiological investigation of risk induced professional caregiver despair: Reflections and implications, International Society of Psychiatric-Mental Health Nurses, 6th Annual Conference. St. Louis, MO.

Cox, T. (2004). Professional caregiver insurance risk and NNN: Risk theoretic models for predicting nursing services and costs, NNN (NANDA, NIC and NOC) Conference 2004. Chicago, IL.

Cox, T. (2003). Using unitary appreciative inquiry: Reflections on praxis and dissertation research, Society of Rogerian Scholars Research Meeting, Savannah, GA.

Cox, T. (2002). Professional caregiver risk and despair: A unitary appreciative inquiry. Virginia Nursing Association - District 5, Richmond, VA.

Cox, T. (2002). Professional caregiver despair: A unitary perspective. Society of Rogerian Scholars Research Meeting, Richmond, VA.

Cox, T. (2002). Professional Caregiver Insurance Risk and Average Cost Based Reimbursement Plans: Implications for Nursing, Advancing Nursing Practice Excellence: Sigma Theta Tau International Honor Society, State of the Science Congress, Washington, D.C.

Cox, T. (2002). Average cost based reimbursement and risk theory: Implications for health care policy and practice, Poster Presentation, Academy for Health Services Research And Health Policy - Annual Research Meeting, Washington, DC.

Cox, T. (2001). Average cost based reimbursement and risk theory: Implications for health care policy and practice, American Public Health Association, Atlanta, GA.

Cox, T. (2001). Average cost based reimbursement and risk theory: Implications for health care policy and practice. International Society for Research in Healthcare Financial Management Annual Conference, Baltimore, MD.

Why you might want to check this site out more thoroughly

Are you trying to understand why your 'health insurer' is denying your benefits?

Are you trying to understand why your health provider seems more interested in delaying your care than providing it?

Are you running out of time or money but you are still sick?

Do you wonder whether Managed Care or Capitation contracts are compromising your care?

Are you an attorney wondering how to best represent clients denied health care access, benefits, timely diagnosis and treatment?

Are you a health care educator or researcher trying to understand the impact of health care finance issues on access to health care?

Are you on Medicare or Medicaid and cannot find a physician in your local community at a fee you can afford?

Are you a community/health care advocate who is trying to understand why health care services are collapsing in your area?

Are you a doctor, advanced practice, registered or practice nurse

This is where you need to be!

Click on the Quick links menu for answers to all your questions.