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1996-01-01
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134 lines
MCL Extra
Last month, Boston's Channel 5 aired
a series on managed care. A transcript
of the first program in that series
follows:
"HMO's: Prescription for Concern?"
With the revolution in health care, expressions like "managed care"
and "HMO's" have slipped into our vocabularies and our lives.
But what's the impact on your health? To find out NewsCenter 5 and
the Boston Herald commissioned two polls.
We asked patients and physicians how they really feel about managed
care. Can you cut costs and still provide quality health care?
Tonight, Dr. Timothy Johnson reveals the surprising results from our
doctor's poll in "HMO's: Prescription for Concern?":
It's hard to escape the dizzying pace of health care changes from
pitches for your business to the revolution in your doctor's office.
What's called managed care is changing medicine in Massachusetts.
Dr. Burt Hall:
"The times have changed and now we're dealing with something
completely different--the HMO's."
Dr. Burt Hall sees patients every 15 minutes in his Wellesley
office. Many are still in the traditional fee for service insurance
plans, where patients can see any doctor they like. But more and
more his patients are in managed care . . . developed to hold the
line on health care costs gone out of control. They are usually
called HMO's. Dr. Hall calls them bad medicine.
Dr. Burt Hall:
"They're managing the care of the patients totally separate from
the physicians."
Hall's charge is a strong one . . . that HMO's compromise patient
care . . . as they run a business bent on controlling the bottom
line.
And he's not alone.
While the majority of doctors believe HMO's provide high quality
care . . . an exclusive NewsCenter 5/Boston Herald poll finds
* 46% of the 200 physicians surveyed agree that HMO's prevent
doctors from providing needed care to patients in order to save
money
* and that half believe business people decide your care in an
HMO, not doctors.
Dr. Burt Hall:
"Now you have to call up and talk to some nurse practitioner and
then she makes the decision whether the person should be
hospitalized. Not me who's examining the patient."
Dr. Jennifer Leaning (Harvard Community Health Plan):
"We don't cut costs on serious care. We pay great attention to
what the standards of care are and we do everything important
and necessary to take care of patients."
But to control costs . . .
* HMO's require prior approval for certain tests
* for hospitalization and visits to specialists.
* and doctors who order less for their patients can sometimes
make more money.
Dr. Jerome Kassirer (editor, N.E. Journal of Medicine):
"We're talking about the conflict between the doctor wanting to
do the right thing for the patient and his own personal
livelihood."
But companies and their employees are switching to HMO's in huge
numbers. In part because there is little choice . . . .
Bill Dowd, compensation director (New England Electric Systems):
"It's no secret that health care costs have been rising at
alarming rates and they did for this company throughout the 80's
and into the early 90's."
However some choose HMOs because of an emphasis on preventative
medicine.
And even dental insurance---all at lower costs to employees, make
them attractive and for many a better plan.
Here at New England Electric System, just 5 years ago only 15% of
their employees were in HMO's. That number is now up to 40% and
rising quickly.
Maureen Wright (New England Electric Systems):
"The small co-pay, the coverage, especially with two young
children we're always at the pediatricians office."
But for the convenience, the cost and the coverage . . . many
Massachusetts doctors believe patients are paying a higher price.
* 36% of specialists we polled say care is worse for managed care
patients when compared to traditional-fee-for service
insurance.
* Only 8% of the specialists said the care was better.
Dr. Burt Hall:
"The physician is sometimes out of the loop completely."
Dr. Hall also says that his relationship with some of his patients
has been distanced by managed care. He has to enforce the guidelines
of the individual HMO's and some patients take it out on him.
[This report by medical editor, Dr. Timothy Johnson, aired
13-Nov-1995.]
...For further information, contact CURE, 812 Stephen St., Berkeley
Springs, WV 25411. 304-258-LIFE/258-5433 (CUREltd@ix.netcom.com)