Blood thirsty HMOs

Post #290,716 by Lily 8/12/07 1:10:54 PM Reply	Blood thirsty HMOs I work for one of those blood thirsty HMOs and I say that with pride because I am making a difference. Our goal- to improve health to reduce costs. Not to reduce costs at the expense of our membership. I have a caseload of about 70 patients. My goal is to keep them out of the hospital to ultimately cuts costs. I meet with my patients face to face, find out what the barriers are to them accessing health care, and do whatever I can to remove the barriers. They need transportation to doctor appts? I get it for them. They dont understand their disease process? I provide education. They cant manage their disease on their own? I get them home health care, which includes skilled nursing, social work, nutritional counseling, and physical therapy. They are homeless or without utilities or food? I get them hooked up with social services. They need a wheel chair? Done. And on and on and on. If they end up in the hospital, I work with the discharge planners and the family to make sure that patient has what they need to recover when they go home. I've even gone so far as to aruge with my medical director to authorize payment for treatments that arent covered benefits if I think it will be more effective for them. We have a mbr who has been fighting cancer his whole life. He is seeing an alternative healer- I dont know what kind- its not my case. The health plan is covering his herbs and what-not because the healer is keeping the cancer in remission. Is it a placebo? Who knows. But it is working and we are paying for it. I work my ass off to improve the quality of life for my patients, which ultimately will save the HMO money and promotes health in wellness in my community. Doesnt sound very blood thirsty to me.
Post #290,724 by rcareaga 8/12/07 2:27:08 PM Reply	parse the sage, rosemary What I said (speculating as to a possibility I did not endorse but could not dismiss), was a cabal of particularly bloodthirsty HMO, Big Pharma and insurance executives [could be] dictating the published clinical "results, but in that sentence "bloodthirsty" is intended to modify "executives" rather than the individual or collective industry sectors. No indictment of HMOs generally or yours specifically was intended. That your employer does not cavil at paying for "herbs and what-not" speaks well of it, although to assert as confidently as you do that the "healer is keeping the cancer in remission" seems a bit of a stretch, given that you're familiar with the case only in broad outline. The remission and the alternative regimen may simply be occurring simultaneously without any deeper connection. It sounds as though someone has elected—wisely, it is to be hoped—to let sleeping oncogenes lie. Some other HMOs...not so good. WellPoint, the largest of the lot, has been implicated over the past couple of years in some treatment decisions so heartless that it is difficult to imagine any administrator issuing these orders without cackling and twirling his moustache. I'm glad you're working for one of the good guys. cordially, Die Welt ist alles, was der Fall ist.
Post #290,739 by Lily 8/12/07 5:53:45 PM 8/12/07 5:56:47 PM Reply	If you stop spending your thyme generalizing... I'll stop parsing my sage. Edited by Lily Aug. 12, 2007, 05:56:47 PM EDT Expand All History

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