It doesn't seem likely that avoiding HMO's is an option for
most Americans. A newspaper article on the Managed Care Bill
passed by the House on Friday, reported that managed health-care
plans cover more than 75% of privately insured Americans.
Our local newspaper also reported that a group of local
physicians who have become so fed up with interference by the
area HMOs, are trying to start their own, doctor-run health plan.
Is this happening in other parts of the country as well? I
believe it was brought on mainly by the threat of one of the
local insurers (our HMO) to withhold a percentage of their
payments to the doctors because they were ordering too many
expensive tests and prescribing too many expensive medications
(like Requip, I suppose.) The HMO claimed it would have to either
(a)withhold these payments from the doctors or (b)increase their
premiums. I believe it turned out that the doctors will be fully
paid; we haven't heard about our premiums yet. Oh yes, the HMO
did make a good profit last year.
In spite of these comments, and my previous HMO complaints,
I do realize my family is still among the fortunate ones - we do
have comprehensive medical insurance and a prescription plan. The
millions of Americans lacking any medical insurance or those with
very limited coverage are the ones in the greatest need of
meaningful health care reform.
I was wondering about the views of the Canadian list
members. Some Americans believe if we ever do get National Health
Insurance it should be modeled after the Canadian system. Others
are very opposed to it. Do you have similar problems with your
National Health System, as we do with the HMOs, or do you think
it generally provides well for your health care needs? I think
many of us in the U.S. would be interested to hear about your
experiences.
Thanks,
Linda Herman
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