This is scary...has it come to this with HMO care...if you have an alcohol addiction problem you can get help, but only 3 days...and then advised by the representative to go out and get drunk again so you can be admitted for another 3 days if you still need care....one doctor speaking out on managed health care today....BD
SOON AFTER HMO/managed care came to Massachusetts in the late '80s, I got a call from a patient I had admitted to the 28-day alcohol unit at the hospital. He said that he was being discharged after three days because that was all that the HMO would now pay for alcoholism. He said the HMO representative told him to go out and get drunk again and they would readmit him.
How did this happen? Managed care let it be known through massive advertising that either doctors join up, or be left out -- we would lose patients to HMO doctors. This seemed strange: Doctors did the work; without us, there was no "care" to manage. If we stuck together, we could get what we wanted from the insurance industry. Instead, doctors elbowed each other out of the way to make sure they would "get in." We lost our clout in setting standards for good care for patients, and a work environment that would allow it.
Their doctors are rushed, mistakes are made, good care is hard to find. Private health insurance spends about 30 percent on administrative costs; government-run Medicare spends 3 percent. The single-payer national model seems inevitable.
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