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Denying expensive medical care




The Reality of HMOs Today

By now, HMOs have gained a firm chokehold on most of our medical resources and are fast moving toward total ownership. About two-thirds of the insurance companies have pulled out of the healthcare market, with the remaining few engaged in government-sanctioned price fixing and restraint of trade. Most hospitals and medical groups have collectively formed or become part of an HMO conglomerate. This is true of both proprietary and not-for-profit organizations. The federal and state governments have even placed Medicaid and Medicare into corporate hands by paying managed-care companies to accept recipients as members. While it is still voluntary, the government bureaucracies are leaning toward mandatory privatization of all Medicaid and Medicare programs. The U.S. Congress has even passed a law prohibiting lawsuits against managed-care companies and their employees for damages resulting from delayed or denied coverage for necessary diagnosis and treatment. Thus the HMO medical directors can arbitrarily deny expensive medical care, and the victim has no legal recourse other than to file an appeal with the state insurance department unless there is a breach of contract. By the time they complete that lengthy process, it is usually too late. In our multibillion-dollar health-care industry, free enterprise has given way to regional monopolies.
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