Insurance vs. HMO

By Tyler

Featured Rightgrrl April 19998
September 11, 1999

Tyler passed away on April 9, 2000, after a long battle with cancer. Tyler, we will miss you.....

For any of you who might not know the exact definition of an HMO, it is a for profit organization that contracts usually with an employer to provide medical care to a group of individuals. The employer pays a fixed rate per patient and the patients aren't supposed to have any real "out of pocket" expenses. Out of pocket is a key phrase here because it is not true at all. First of all, and I say this from personal experience, coverage is only usually fully provided for the employee. The employee must then pay a set amount per week or month to cover his spouse and children. So right away there are out of pocket expenses if you want to take care of your family. Then, you have the issue of exactly what type of medical care you will receive from an HMO. HMO's really couldn't care less about your medical care, their priorities lay with their stockholders and we're left with the short end of the stick.

The people who suffer the most with this type of system are the working class. Since insurance is so expensive, people opt to go with an HMO because they can't afford the high insurance premiums. They have no choice in the matter. It's either that or no health care at all.

The Democrats want to allow patients to sue the HMO's when they are not able to receive the treatment they need.

The Republicans feel that it would drive up health care costs even more to allow this, which is probably true. But what about the doctors? What happens when a doctor can't provide the medical care that is needed for a patient because an uneducated, non-trained person at an HMO says that the patient doesn't need that care. Does this not then put the doctor at risk of a malpractice lawsuit? So we also have the situation of doctors not wanting to work for an HMO. So who does work for an HMO? Doctors who didn't make the grade to get into a good hospital. The doctor's who were lower in their graduating classes. So this is who we have taking care of us in an HMO based health care system. Once again the working class is penalized.

I write this article out of anger and fear. Not long ago I myself was diagnosed with cancer. Although we were part of an HMO at that time, we are now no longer insured.

I was fortunate that the HMO we belonged to provided for treatment at the state cancer research center but it was limited. Ct scans weren't allowed so to this day, I really don't know if the cancer is anywhere else in my body. This is an example of the wonderful medical care you receive through HMO's. It is very difficult to change any federal system once it is in place. However, this is a system that needs to be obliterated. We shouldn't have to suffer because those pansies in the White House don't know how to put an end to a system that obviously isn't in our best interest.

I wouldn't say that I received the best medical care because I didn't. I still have enormous medical bills because the HMO didn't pay everything. Please. Write to your Senators and Congressmen and ask them to come up with something better.

This article copyright © 1999 by Tyler and may not be reproduced in any form without the express written consent of its author. All rights reserved.