The Problems with HMOs

The Problems with HMOs

It was no surprise when I interviewed my English class about HMOs, that out of 13 students, seven currently having HMO coverage, 77% felt HMO healthcare inferior to traditional insurance. This group closely represents the U.S. population, as HMOs have become practically synonymous with health care and the idea that Americans are no longer receiving the quality care they received from unmanaged plans. Managed care plans have succeeded in dramatically cutting the rate at which medical spending in the United States has been growing. Does it matter that 100 years after Lincoln freed the slaves that we have found another way to trade lives for money? HMOs have introduced an innovative way to provide health services: incentives for doctors not to treat patients. The less a physician practices, the more the company makes. HMOs make money by not providing a product. (Physicians Who Care, Internet 1999).

What exactly is an HMO? HMO is an acronym for health maintenance organization. An HMO is an organization that provides comprehensive health care to voluntarily enrolled individuals and families in a particular geographic area by member physicians with limited referral to outside specialists and that is financed by fixed periodic payments determined in advance. (Merriam-Webster’s Dictionary-1996) Sometimes considered a new concept, HMOs have been around since the 1930s. The difference today is that consumers are being nudged into them by their employers, in an attempt to hold down costs, and out of traditional insurance plans, in which the insurer reimbursed the patient directly and covered most of the cost of medical treatments. To encourage consumers, the HMOs promote their preventative services. Since t...

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