Word: hmos
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...saving Social Security is a high priority, but he makes like a conservative Republican when he adds that privatizing part of the system is the way to do it. In his Meet the Press interview, Bush broke with his party by endorsing the right of patients to sue their HMOs, but he burnished his social-conservative credentials by declining to meet with the leading group of gay Republicans. He's against hate-crimes legislation aimed at protecting minorities, gays and women, but he's for set-aside programs that give 10% of government contracts--and maybe more--to firms owned...
RICHARD SCRUGGS Attorney-hero of The Insider has new target: HMOs. But should lawyers set national policy...
...almost anyone what's wrong with HMOs these days, and the answer is often the same: precertification. Before ordering tests for colon cancer or even scheduling surgery, many doctors must submit their therapies and plans to company reviewers. Examples of denied care have produced the worst horror stories associated with managed care. The process has left doctors frustrated and patients anxious. It also fueled a revolt in Congress last month in which a band of rebel Republicans rolled over the House leadership to pass a bill giving patients the right to sue their insurance companies for the medical decisions they...
...HealthCare, the nation's second largest managed-care company, pulled the plug on precertification. The company, which is based in Minneapolis, Minn., and covers 14.5 million Americans, is betting the move will improve the quality of care and its bottom line, and maybe even help convince Congress that the HMOs can heal themselves. Nearly everyone applauded the decision, but practicing physicians were cheering loudest. Says cardiologist George Rodgers, in United's Austin, Texas, pilot program: "It's just made my work much more enjoyable...
...view of the Senate's opposition, argue that United's move shows the bill is moot. "The market is far ahead of politicians," says Karen Ignagni, president of the industry trade group, the American Association of Health Plans. But proponents of the bill argue that as long as most HMOs resist going United's way--and they will until it is clear that the company can manage costs without micromanaging its doctors--patients will need the protection that comes from the threat of a lawsuit. "We need to codify [this] into law," says Republican Congressman Charles Norwood, a Georgia dentist...