Word: aetna
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...being with my son," Lindsay says, "and I'm on the phone trying to figure out what happened to my insurance and how I'm going to pay for this." He's still not sure. The Lindsays owe $150,000 in medical bills, for which they are suing the Aetna insurance company and the owners who ran Regina. And while Lindsay has found another job, his new health plan doesn't cover existing medical conditions for his children. "This should not happen," Lindsay says. "No executive should have the right to say, 'We're going to play with the company...
...independent surveys of the users of Health Maintenance Organizations, CareData Reports of New York has compiled a list of what it says are the best HMOs in the United States. The health plans rated most satisfactory by 10,272 members of 33 different HMOs were: Kaiser Permanente in Connecticut; Aetna Health Plan in greater Cleveland; Cigna Healthplans in Houston; Oxford Health Plans in New Jersey; and Kaiser Permanente in Southern California. Even the best could work on their bedside manner, however. CareData reports that customers who were pleased with their HMOs tended to think the medical care was better than...
Faced with the prospect of being put out of business, old-fashioned fee-for- service doctors have mounted a campaign to secure their way into managed care and gain some control over it. In Texas, with support from the Texas Medical Association, doctors who were let into Aetna and Prudential managed- care networks and then dropped are suing them, arguing that they are being denied their "right" to serve their patients. In Virginia, doctors are suing a plan that fired them, citing an 11-year-old law called "any willing provider" that guarantees them the opportunity to continue serving their...
...number at an insurance company somewhere when you are sick and take orders from someone he doesn't know and who may know nothing about medicine?" Other fee- for-service doctors echo his concern. In Houston, Dr. Robert Maidenberg says that he and 36 other physicians were dropped by Aetna's network because they cared too much about their patients. "Nobody ever said the best was the cheapest," he says. (Aetna's response is that the 37 doctors it dropped were not as skilled, productive or conveniently located as the 2,200 doctors it kept...
...talk about good medicine, though, the current battle over access to patients is a sobering reminder that at bookkeeping time, patients are just a source of cash. In Texas the lawsuit brought by Dr. Maidenberg and four other doctors accuses Aetna of violating their "property rights" by taking away their patients. In Florida, when the Humana insurance plan sued Dr. Ira Jacobson because the Miami family physician quit and took 170 Humana patients with him, it demanded payment of $700 a head for its lost customers. A state appeals court ruled in December 1992 that Dr. Jacobson owed nothing; after...