Word: hmos
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...years ago, as an accommodation to my patients who were being forced into managed care by their employers, I joined several HMOs. I struggled with the problem of denials and delays for years. Finally, at a substantial loss of income, I quit them all. I am much less busy, but my remaining patients are happier, and so am I. To pay for their competitive marketing and bloated administrative overhead, the HMOs must raise premiums. It is time to get rid of HMOs. There are 41 million people in the U.S. without health insurance. We need a national, single-payer system...
...troublesome that Americans seem to think HMOs "deny their patients proper care." HMOs mostly do exactly what they are contracted to do. If people want more, they should supplement the coverage with their own money or go somewhere else. That's the American way. And if HMOs are making such obscene profits, let's go buy stock in 'em. CHARLES H. LOWRY Garden Grove, Calif...
...prove fatal. Ever so slowly, the medical establishment has been warming to the idea that massage helps sickly babies. Yet only a handful of hospital nurseries in the U.S. offer massage to these tiniest of patients. Hospital administrators remain skeptical of claims about its therapeutic value, and since most HMOs don't cover baby massage, there's little incentive to start pilot programs. Besides, harried nurses can barely handle the steady stream of critically ill infants with special needs, much less find time to give thrice-daily rubdowns...
...turnabout from Republican opposition to the reforms proposed by President Clinton last fall. "Republicans running for reelection were finding that their party's apparent support of the insurance companies was working against them," says Tumulty. Both parties now agree on reforms that would speed access to specialist care, make HMOs pay for unnecessary emergency room treatment when it was reasonable for the patient to assume there was a crisis, give patients access to more information on treatment options, and subject disputed coverage decisions to speedy third-party review. What they can't agree on is a mechanism for enforcing those...
...Jersey Last year New Jersey published its first HMO report cards, using information HMOs are required by law to provide. The 1997 report showed that New Jersey hmos fell short of national averages when it came to preventive care such as child immunizations and screenings for breast cancer. Many hope the ratings, which let consumers compare their HMOs with others, will pressure HMOs to increase their benefits...