Crunch time for the HMOs

The giant health insurer, Aetna, announced this week ahead of the the July 3rd deadline, that they will be exiting Medicare in some areas. This will leave many beneficiaries without the coverage of their managed health care plans, starting December 31, 2000. Other companies are still yet to announce. Nancy DeParle, head of the Health Care Financing Administration (HCFA) expects the pullouts to be higher this year, than in 1998 when more than 400,000 individuals lost HMO coverage.

The HMOs claim they need a bigger cut of the government's money for the services they provide, while the government says the HMOs are adequately reimbursed for services provided. The HMOs fear escalating drug costs and health reform that would require them to provide some coverage for prescription drugs. Karen Ignangni, head of the American Association of Health Plans, states ''this should be a wake-up call to members of Congress that this program is in crisis.''

It should be a wake up call to every American. Yes, contact your congressperson, write your State Insurance Commission, talk with your insurance company, form an affirmative action group, but for God's sakes take care of your health! America, you can no longer afford this broken, sometimes backwards, and always very frustrating health care system. It's a Caddy with wings, it's a bee hive hairdo, it's a dinosaur, it needs a proper burial.

Talk with your local family doctor; he's probably the most frustrated of all. If he's being open with you, he'll tell you how many times he feels he's had his hands tied. He can't practice the medicine he needs or wants to without the okay from the insurance company. Who's practicing medicine here, the doctor or the insurance company?

We need fresh ideas and new minds -- not more money to fuel a system that is in serious crisis. One such ''new thinking mind,'' Andrew Weil MD, states his goal is ''nothing less than the reshaping of American health care.'' In a recent interview with Popular Science Magazine, Weil, clinical professor of internal medicine, at the teaching hospital of Tucson's University of Arizona College of Medicine, believes the entire system is hurtling toward economic collapse. His answer is to marry the best of conventional medicine with respected alternative therapies. Of course many of the ''powers that be'' that would like to see the likes of Weil and others just disappear. But individuals driven by the desperation of incurable diseases, sick with pain, and short on money many times find welcomed relief with alternative therapies when conventional treatments have failed. With a third of all Americans now seeking alternative therapy, I don't think the world of alternative medicine will ever take a back seat again.

To achieve a goal of a healthier America free from the likes of HMOs, we must first convince Americans to take responsibility for their health care. Taking care of your health is more than finding a doctor and then following his advice. Yes, you still need to see your doctor, have a mammogram, have your blood pressure checked, have your prostate checked but it doesn't stop there! Actually I should say it doesn't start there.

A good beginning would be a re-education about foods, as this is where most disease begins, with foods that deaden our bodies and drain us of our energy. Allowing yourself to eat your way into the need for cholesterol-lowering drugs, insulin, diet pills and other expensive, sometimes dangerous, drugs is right where you won't want to be when you find your HMO will not pay for such expensive treatment. Take charge of your own health and don't leave your health singularly in the hands of your physician or an HMO.

Till next time, Rebecca.

Uploaded to The Zephyr Online June 14, 2000

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