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Pastimes : Don't Ask Rambi -- Ignore unavailable to you. Want to Upgrade?

To: Rambi who wrote (31938)	7/14/1999 8:58:00 PM
From: melinda abplanalp	Read Replies (1) \| Respond to of 71178

I pay extra to avoid them too...but I have almost no coverage now. They pay 80 I pay 20 but they decide what is\a fair fee and pay 80 of that. It's laughable what they pay.

To: Rambi who wrote (31938)	7/14/1999 10:25:00 PM
From: Ilaine	Read Replies (1) \| Respond to of 71178

>>>>>They have restrictions about telling you-- that sounds illegal!<<<<< It would have been, if Congress had passed the Patient's Bill of Rights. And it is illegal in some states, but not in others. But no one likes it except HMOs, which are really insurance companies in disguise. Suing HMOs is fun. Heh-heh-heh. (My Black Knight personality talking.) Stuff like that makes everyone mad. Makes me mad, and we belong to an HMO. We usually get good treatment, but when I am dissatisfied, I go to an outside Dr. and get them to tell me what I need and then go back to the HMO and tell them that an outside Dr. said I needed something and they always give it to me. CYA. The dirty secret is capitation. The doctors usually have a contract with the HMO, and get X dollars a year per patient. If you never need the Dr., s/he keeps the money. If you need a lot of medical care, the Dr. loses money. And if there's money left over at the end of the year, it's Christmas bonus time. Like everyone else, some Drs. treat you right and some go for the money. It's kind of a double-edged sword (can anyone tell me what that phrase means?) for the patient and the Dr. The medical care is cheap, but you get what you pay for, and the Dr. feels screwed, and has divided loyalty.