Word: hmos
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...handwriting is on the wall for HMOs, and it isn't hard to read: A jury in San Bernardino, Calif., ordered Aetna U.S. Health Care of California to pay $120.5 million -- a record sum for an HMO suit -- to the wife of a man who couldn't get the company to cover his experimental cancer treatment and died. "The jury's statement is clear: Many people are just fed up with HMOs," says TIME medical columnist Christine Gorman...
...bureaucracy, hurdles and information gaps that many HMOs have set up between patients and doctors in order to protect their corporate bottom lines have infuriated huge segments of the population. The Aetna verdict is the latest indication that, when given the chance, citizens are willing to vent their frustrations big time. "If I were anyone affiliated with running an HMO, I'd be worried about this development," says Gorman. For the moment, the Aetna verdict is an aberration in the sense that most people cannot sue their HMOs for large, punishing damage claims -- federal law forbids it. "The only reason...
...options: you can enroll in another HMO, or you can opt for "traditional" Medicare coverage, in which you choose your doctor and pay certain deductibles for hospitalization and a 20% co-payment on other services. By law, your soon-to-be-ex HMO must inform you of alternative HMOs. But it's still up to you to call those HMOs and see whether they offer a plan that's right for you--say, one that covers prescription drugs (as traditional Medicare does not). Don't wait until the last minute to do this because the best HMOs are likely...
Which HMO or Medigap policy should you choose? The most comprehensive ranking of Medicare HMOs and Medigap policies I've seen was in the September issue of Consumer Reports (a copy is available for $3 from Consumers Union Reprints, 101 Truman Avenue, Yonkers, N.Y. 10703-1057). Or for $49, you can get a customized report from Weiss Ratings (800-289-9222) on the Medigap and HMO options in your area. The reports also include an evaluation of the plans' financial health and therefore their ability to make good on their promises...
Long before medical costs became a national issue, Reuther was advocating universal health care. He organized the Committee of One Hundred to put the issue on the national agenda and set the stage for congressional action. At the same time, he helped establish one of the early HMOs, an association that eventually became the Health Alliance Plan, a major health-care provider in the metropolitan Detroit area. Whether testifying before Congress or elsewhere, Reuther threw his weight behind the public issues of the day. He called for a Citizens Crusade Against Poverty, federal aid to housing and education, the peaceful...