I am responding to a totally irresponsible column in the Jan. 19 Herald, titled, “HMOs have delivered no health answers” by Marie Cocco.
I have worked in the health insurance industry for over 20 years. For the past 11 years I have worked for a large company that is one of the last surviving Medicare HMOs in the business. The poor reporting in this article with huge titles blaming HMOs, once again, for causing a health care crisis in the United States is shameful.
First of all, Cocco stated that Medicaid costs are rising and the unemployment and uninsured numbers are rising. How did the HMOs cause that?
The next issue is doctors who are starting “boutique” practices, who may be outrageously greedy, or just outraged at the transformation of their offices into assembly lines. The writer also said HMOs mandate that doctors see so many patients an hour. I challenge Cocco to find one that does indeed do this.
The other huge issue is HMOs in Medicare. I take a special issue with the statement it has been “a disaster.” In Washington there never were promises of generous prescription drug coverage, because there never has been such coverage offered here. Ask the states who do indeed offer prescription coverage and, because of those costs, how well they are doing.
And the talk of abandoning seniors is made to sound very cold and deliberate.
The facts are that the companies that have withdrawn from our local markets have lost millions of dollars in trying to provide this type of coverage with the low reimbursement from the federal government.
Washington and Oregon have the two lowest reimbursement rates in the nation by Medicare. If we can’t pay our participating physicians enough money to cover their costs, we do not have a health plan. Our company has given any additional reimbursement from the government to our participating physicians.
Also, it is a little known fact that Medicare HMOs are limited to the profit they can make on the business. Why does the press like to blame HMOs for trying to make money? You have to make some to continue in business.
I would challenge Cocco to find another health plan with as much value as our Medicare HMO anywhere – which has approximately 70,000 members – with the rich benefits it does provide, for under $60 a month for our senior population. Ask these members how they feel about their coverage. Ask them how they would feel if they were to lose the coverage.
Arlington
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