ABLEnews Extra
          
               HMOS: The Ultimate Economy 

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A health maintenance organization in my area is trying to enroll
senior citizens like me who have Medicare. As a result, I have been
swamped by a barrage of invitations to come have continental
breakfasts where I would be exposed to the HMO's recruiters and their
pitch.

The pitch, of course, emphasizes all the many goodies I would
supposedly have if I signed the membership agreement.

What the sales agreement omits is that a continental breakfast has the
same relationship to a good old hearty breakfast that HMO membership
has to decent medical care.

The US government's efforts to promote HMOs for Medicare patients goes
back two decades to the days of Richard Nixon's presidency. To date it
has been a fiasco.

Now the pressure has increased for Congress and the White House to get
more steam into the drive.

Medicare cost are predictably rising as the number of older citizens
increases and the national debt sets new records every year. HMOs, so
the theory goes, will cut Medicare expenditures.

Most older Americans avoid HMOs because they understand the first
imperative for those organizations is to cut costs by reducing the
amount of medical care given to members and sharply cutting free
choice of doctors and access to specialists.

Seniors also intuitively grasp the first law of medical economics,
which is the ultimate economy is death, after which no operations are
needed, no expensive consultants, nothing. But, of course, death is
precisely what we seniors want our doctors to help us avoid.

The great danger is that increasing Washington pressure to cut
Medicare spending will come ever closer to forcing senior citizens
into HMOs.

Now the emphasis is on offering goodies like free eyeglasses, but
tomorrow the weapon may be greater charges for enjoying non-HMO
Medicare.

There is still plenty of fat in the federal budget that can be trimmed
if saving are really wanted. But seniors were promised first-class
medical care when Medicare became law in 1965. HMOs don't supply
first- or even second-class medical care.

[HMOs Are Wrong Answer, Harry Schwartz, op-ed, USA Today, February 8,
1995]

ABLEnews Editor's Note: Harry Schwartz is a retired New York Times
                        editorial writer, who specializes in medical
                        and health issues as a free-lance writer.

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