Word: hmos
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Dates: during 1990-1999
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Bill Clinton would not be among those who've been pointing out that these are just the sorts of horrors now identified with American health-maintenance organizations. He doesn't want to be taken for a liberal, liberal, liberal. The difference between HMOs and socialized medicine, the Bill Clinton of this presidential campaign might say, is that an efficiently run hmo can produce a CEO who walks away with $4 million or $5 million a year without ever seeing a patient--proof that America remains the land of opportunity for all our citizens as we build a bridge...
Patients who aren't covered face a tougher challenge. More than 40 million Americans are uninsured, and some who are insured aren't adequately covered. Some HMOs, for example, consider the cocktail therapy too expensive to offer their clients. To fill at least part of the gap, Congress in 1990 created the AIDS Drug Assistance Program (ADAP). Each state administers its portion of the $165 million budget as it sees fit, however. States like New York and California, which supplement the federal money with state funds, are among the most generous, covering more than 50 different medications. Georgia, by contrast...
...been shifted into health-maintenance organizations, dramatically restructuring the financing and delivery of health care. The original impetus for managed care came from physicians who wanted the freedom to treat their patients without being worried about whether they could pay for each visit, test or procedure. In the early HMOs, cost containment was an unexpected benefit, not the primary purpose. Since then, in many cases managed care has lived up to those ideals--by paying far more attention to preventive care, by standardizing medical practices to produce better outcomes and by eliminating many unnecessary tests and procedures...
...rapidly proliferating HMOs--most of them investor owned and for profit--seem to be interested firstly in managing costs and only secondarily in maintaining health. When profit, not health, is the objective, it poses a real threat--to the doctor-patient relationship, to academic medical centers, to medical research and to those who are unable to obtain health insurance. Whatever its flaws, traditional fee-for-service medicine always allowed physicians to act as advocates for their patients. HMOs cannot assure us that physicians will, in every instance, put their patients' interests first...
...public school teacher with two kids in college, ailing parents, giant hassles with HMOs, a vehicle that has more than 175,000 miles on it, and dogs with fleas. Do you really think I give a hoot about what possible ethical violations [NATION, June 10] (not even criminal acts) Bill and Hillary Clinton may have committed almost 20 years ago? I'm not sure there's a person living, this side of Mother Teresa, who didn't do at least one dumb thing 20 years ago. CHRISTINE GRASDORF Fayette, Missouri...