Selma in Sandy Eggo wrote:jamiebk wrote:Where do you place the HMO's in your list? (besides burning in hell)
HMO's (your parenthetical placement is absolutely correct) used to be Kaiser. It was the only one, and it worked like socialized medicine: you pay your annual fee and they provide whatever you need at their facilities. Somehow, they picked up the copay idea from the insurance companies and the insurance companies picked up the cover-everything idea and the bastard HMO was born.
The idea of the HMO is excellent. Collect money, provide payment for whatever service the client needs. In practice, I have to fight like mad with HealthNet clerks and "gatekeeper" staff whenever anything the least bit unusual comes along. Somehow, "provide service" turned into "decide if the doctor is qualified to say this is medically necessary".
Sadly, I'd now count HMO's as part of the insurance industry.
The only significant problem that sets HMOs apart from other insurance is the financial incentive for health care providers to minimize treatment.
The rule of thumb for differentiating between HMOs and PPOs is: PPO providers get money directly proportional to the treatment they provide. HMO providers are essentially the inverse - the more treatment they provide, the narrower their profit margin.
As long as insurance is involved with health care, we will have the best health care money can buy.
And if you've got no money, you get bupkis...