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Thanks for that info, I should not have assumed that all HMO's are bad news. If they would all take care of patients like Kaiser, I assume they would be able to make money and still provide good care. I have been having enough problems with a PPO, which should be better, but they make many errors and hold bills and keep making excuses for slow payments to doctors. I am constantly complaining to my employer, but it does not seem to help. I also do not like the concept of having to see one doctor to get permission to see another, it is hard enough to miss work for one appointment and the extra travel is a waste. Of time. MOST people know what kind of doctor they need to see without having to have the blessing of a primary care doctor. If I had Parkinson's, I would not want to deal with those rules. [log in to unmask]