HMOs Take The ‘Care’ Out Of Health Care.
In the early 1990s insurance companies, in attempt to control spiraling medical costs, created what would be termed “health maintenance organizations”, also known as HMOs. What HMOs do is create a team of physicians and medical personnel that the patients agrees to use. Within the contracts both the patient and the doctor sign, limits and restrictions are put on what the hospital will reimburse and what they will or will not provide in order to keep the costs down. At the beginning, these organizations were successful in bringing medical costs down and has made health insurance more affordable than ever. However, the contracts that the HMOs have you sign basically limits the doctor on how he or she can treat their patients, thus putting their job as the physician in the hands of the HMO. As profits began to go up and down these organizations have put more effort into keeping their costs down and have lost sight of actually caring fir the patients they are insuring.
To prove my thesis in this paper I will discuss how our senior citizens and the chronically ill have been hurt by recent cuts their HMOs have made. I will discuss the many reports of HMO negligence and the issues concerning the patient doctor relationship. I will also go into what actions, or lack thereof, our government has taken in response to HMO woes. All of these points will show that HMOs have lost the concept for caring for their patients including our elders who are one genre that are being hit hard by the actions these HMOs have taken.
In January of 2001, nearly one million senior citizens were kicked out of their Medicare health plan (“What’s Behind” 1). Why have so many HMOs dropped these health plans? The reason why is because these Medicare programs are for the elderly only and simply were not profitting, and in response, the insurance companies shut them down. The HMOs claim that federal reimbursement levels were not keeping up with the medical cost inflation forcing them to cut these programs. For instance, in 2001, the government’s reimbursement to the HMOs went up only 2 percent while the insurance company’s costs went up between 11 and 13 percent (par.3). Though the reimbursement level issues may have contributed to the HMOs decision to cut these programs they are just the surface to the problem. Back in the mid-1990s HMOs began purposely enrolling more senior citizens in their mid-60s who did not require as much medical attention as do people in their mid-80s. This made it so that the younger senior citizens were covering the costs of the older ones while the HMOs cashed in. This worked out well for the HMOs until there was a sudden increase in the average age of their patients and costs began to skyrocket, thus leaving one million of our elders with out health insurance.
Senior citizens are not the only...