THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Friday, August 11, 1995 TAG: 9508110209
SECTION: FRONT PAGE: A14 EDITION: FINAL
TYPE: Letter
LENGTH: Short : 45 lines
Anyone insured under an HMO managed-care plan should worry about his health care.
Dr. Robert Su's letter (July 6) was correct: We are giving up our choices under these plans. We are limited to certain hospitals, doctors and other health-care providers.
T. W. Mostiler's letter also made a very good point: ``Managed care is managed neglect'' (July 22).
Horror stories abound about negligence due to HMO physicians refusing to refer patients for proper treatment. The physicians do not want to give referrals because that reduces their income. There are many dedicated and caring physicians under these plans, but there are also those more interested in their income than the patients' welfare.
In this area look at who is now in the insurance business - our hospitals! It is almost unbelievable that the state allowed the parent companies of Sentara (Sentara HMO and Optima) and Virginia Beach General (Priority HMO) into the insurance business. So they now control the insurance coverage hospitals are allowed to use, the doctors and all affiliated care. That should give everyone a scare about conflicts of interest within health-care monopolies.
If problems arise obtaining referrals, health-care consumers should complain to member services for the HMO and find another doctor - fast. Since most HMOs are through employer plans, complain to the benefits manager. If not comfortable with a doctor's diagnosis, seek another opinion even if it means going outside of the plan.
We must realize that we risk our health, maybe even our lives, by not being informed and insisting on proper care. The web of paperwork and telephone calls involved in these plans is enough to drive providers and patients to distraction.
These plans are limiting people's health care, not bringing down actual charges for care.
B. L. FOXWELL
Virginia Beach, July 31, 1995 by CNB