Untitled Essay

1310 words - 5 pages

Mark Miller ENG 101 December 2, 2000 HMO Regulation Health Maintenance Organizations, or HMO?s, are a very important part of the American health care system. Also referred to as managed care programs, HMO's are combinations of doctors and insurance companies that are formed into one organization. This organization provides treatment to its members at fixed costs and decides on what treatment, if any, will be given based on the patient's or doctor's current health plan. Sometimes, no treatment is given at all. HMO's main concerns are to control costs and supposedly provide the best possible treatment to their patients. But it seems to the naked eye that instead their main goal is to get more people enrolled so that they can maintain or raise current premiums paid by consumers using their service. For HMO's, profit comes first- not patients' lives.HMO?s are groups of doctors hired by insurance companies and are usually controlled or regulated by the hospitals who facilitate them. The majority of this limitation is due to pressure from within the organization or government pressure. The government influences hospitals into denying treatment in order to cut federal costs. These government actions generally result in a revision of private employee health care claims, and in turn certain businesses can no longer afford to provide health insurance for their employees. Consequently, approximately 50 to 60 million people go without insurance for at least one month each year. Many HMO?s constantly evaluate their services to "ensure" the best care and coverage. But in many cases, what is happening is the exact opposite.HMO's can and do conduct their business quite ruthlessly. Patients are continuously unable to receive the necessary treatment due to the insufficient HMO coverage. Many HMO's actually make more money if their doctors see or treat fewer patients. According to the Associated Press, ?Consumers who have been denied a treatment that the HMO says is not covered, or who inadvertently fail to follow HMO guidelines in seeking treatment and are therefore denied reimbursement, will continue to have little recourse.? (2) Many people must drive for hours, generally sick or injured, simply to receive treatment from a doctor that will be covered by their HMO.Another downfall to HMO coverage is selective-contracting. This is a process where hospitals deny treatment to patients because their HMO is not on the hospital?s provider list. Doctors repeatedly turn away patients, even those with severe ailments, simply because if they were to treat them, then the cost for this treatment would come out of the physician's own pocket. Thomas Bodenheimer said, ?Selective contracting is common in managed care throughout the United States. It was created so that managed care could negotiate discount prices for physician, ancillary, and hospital services.? (3) But in fact selective contracting is used only to restrict doctor availability and in turn raise profits for the...

Find Another Essay On Untitled

Untitled Essay

2241 words - 9 pages It's almost midnight and I still lay awake, outside my window I look at the broken sky, every night in the sky I look for a shining star, the one that I have not found yet. I don't quite remember where and when I lost it. It appears that my star has grown tired of this gruesome world and has lost its ability to shine. The sound of the angry rain pattering upon the rocky road like a thousand bombs that have lost their purpose. The tapping of the

Untitled Essay

1110 words - 4 pages VolcanosVolcanos occur all over the world.The best know volcano zones occur on the destructive plate margin around the Pacific Ring of Fire.This chain of volcanos that lie along the west coast of central and south America,Japan and the Philippines,across New Zealand and into the Atlantic.Volcanos also occur in mid-ocean along the line of ocean ridges.The Mid-Atlantic Ridge is an example of ocean floor volcanos.When these volcanos erupt lava flows

Untitled

1372 words - 5 pages April 28, 1997 "Legalization of Marijuana" Cannabis sativa or marijuana has been cultivated for over 5,000 years. The plant spreads like milkweed and will eventually run out any other plants nearby. In the wild, or grown with care marijuana can grow to be 3 - 20 feet high. The plant itself can be used for rope, material, medicine or for smoking. But, whatever way you choose to use this plant, it is illegal.It was made a law in the early 1900's

Untitled - 1311 words

1311 words - 5 pages INDUSTRY STUDIES QUESTION 1. (a) Student -centred learning could be described as student-independence learning. The student has to some degree the ability to choose the time and place of study, the methods and order of studies and can vary his pace of study as well as the length of his studies to suit his needs. Student-centred learning puts the students needs to a large extent first. Having a learner-centred approach gives students options in

Untitled - 525 words

525 words - 2 pages A Stranger is WatchingA Stranger is Watching is a terrific book. I enjoyed reading this book very much. The non-stop action kept me reading for hours.One of the best features of the book is how it was written.The point of view changes every chapter.For example Chapter 1 is written in the point of view of the infamous Foxy character.Chapter 2 is written in the point if view of our protagonist, Steve; and so on.I also liked how the author built the

Untitled - 2141 words

2141 words - 9 pages The Positive and Negative Effects of Immigration Ryan Bohn Mr. DiMauro Government Period 1/2 B Immigration Ryan Bohn Government Period 7/8 A During the first 2 million years of the United States' history, the human population was a minor element in the world ecosystem, with at most 10 million members. One Hundred thousand years ago, with the dawning of the Stone Age, the number of human beings began to increase more rapidly. The relative

Untitled - 590 words

590 words - 2 pages Society has always placed a great emphasis upon the importance of a woman's appearance, and through that emphasis women have instinctively been taught to measure their self-worth in terms of the image they present, even more so than their intelligence. They have been given rigid and challenging standards to live up to, standards that are usually unrealistic, unattainable, and disheartening. Many women spend a large majority of their lives

Untitled - 2162 words

2162 words - 9 pages December 11,2001 MY INTERNSHIP Through out my one hundred and twenty-hour experience with the Gloversville Police Department, I learned many skills, values and the ways of this Police Department. Many of the calls and situations I went to often could relate to a certain theory that I learned in any of my law classes. I would recommend any student majoring in Criminal Justice to try to take an internship with a local law enforcement agency. I am

Untitled - 881 words

881 words - 4 pages Iroquois Culture In order to fully understand and appreciate a culture different from one's own, one must first have a grasp on ethnocentrism and how it can change thoughts and viewpoints. Ethnocentrism is a term used when someone is judging a culture's ethics or way of life based upon his or her own belief structure or cultural values. Granted, being ethnocentric is not necessarily something to be ashamed of; everyone does it as a part

Untitled - 1763 words

1763 words - 7 pages The Very Basics Curling is played on ice with (approximately) 42-pound granite stones. The size of the playing surface (a 'sheet') is 138 feet long by approximately 14 feet wide. The goal is, after all 16 stones are played (8 by each team), to have a stone of your team's closest to the center of the house, called the 'tee' (see above). This is accomplished by sending your stone to rest in scoring position (a 'draw'), by knocking your opponent's

Untitled - 1308 words

1308 words - 5 pages Nicholas Pantazelos Marketing Principles Jamba Juice Feburary/5/2002 Marketing often comes down to making your customers intelligent enough to buy your products or services. They have to understand what it is you're selling, how it'll help them, and how much better it is than any other solution. Jamba Juice is a leading juice and smoothies retail chain in the country. Started in 1990, originally called The Juice Club, their stores are now open in

Similar Essays

Untitled Essay 1058 Words

1058 words - 5 pages The park is beau’iful in winter, thought Thomas, shivering slightly in the frosty breeze. Bu’ I wish there were somefin to brigh’en the dull colours. It’s so… dead-lookin’. His red scarf whipped about his face, blinding him momentarily; he swatted it away, folding the ends between his arms, before continuing on his way home. While he was walking, he pretended he was a tight-rope walker in the circus; one toe in front of the other, stepping

Untitled Essay 1510 Words

1510 words - 7 pages All she sees are the reeds whispering soft, sweet, crooning, kind words while her parents shout loud, bad-mouth, I TOLD YOU THIS AND I TOLD YOU THAT. Harsh, chemical, acid burning hate they propel at each other each day while she lays in the soft grass. Their words are melting the sugar off the bare, candy-cane box-cut home. “Cuz we’re poor, baby, we’re filthy poor, and you and your new shoes ain’t helpin’.” Money. It always comes back to

Untitled Essay

1801 words - 8 pages Arab spring, the domino effect in the Muslim countries in the Middle East leading to violent and non-violent movements either being successful or not, depending on the relative countries. It is difficult for one to understand this whole predicament in the broad aspect, therefore for this particular reason the focus will be on two countries where in one non-violent movements were successful and in the other violence had to be used for their to be

Untitled Essay

1266 words - 6 pages The first thing you notice about these places is the putrid smell. Every den reeks of desperation, the smell of men and women who gave up on existence long ago. The splitting headache makes it hard to open my eyes, besides what’s the point; it always looks as bad as the aroma it puts off. I’ve grown accustom to the sense offending hell holes that are sloth dens but you never truly get use to it, it just becomes easier to ignore over time. Looking