The HMO backlash
Survey finds skepticism about managed-care motives
November 5, 1997
Web posted at: 5:04 p.m. EST (2204 GMT)
From Correspondent Jeff Levine
(CNN) -- In general, people are pleased with their personal
medical coverage, but those who belong to a health
maintenance organization tend to believe their HMO cares more
about saving money than it does about them, a survey found.
Mark and Lisa Burns are among those who feel that way. The
Burns, both nurses, were in for a shock after taking their
son Eric to an emergency room in July. They feared the boy
had appendicitis, but when his illness turned out to be
constipation, the family's HMO wouldn't pick up the $750
The HMO said it wasn't a real emergency, a decision that
angered Mark Burns as he tried to convince the managed care
provider to help cover the cost.
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Six weeks later, the Burns finally got their claims paid.
But such complaints are frequent, says Drew Altman of the
Kaiser Family Foundation, which financed the study. "The
managed care industry has a real image problem," he told CNN.
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Overall, most Americans surveyed felt their personal health
plans deserve a grade of "B" or better. But the study also
reveals concerns that add up to an HMO backlash:
- 59 percent complained managed care makes it tougher to see
- 51 percent worry that the quality of treatment has gotten
- 55 percent say HMOs care more about money than about
providing the best treatment.
Altman says the foundation was surprised to see such "strong"
For its part, the managed care industry says it's responding
to consumer anxiety. "The challenge for us is to demonstrate
that we are taking information presented in the polls
seriously and that we are making changes when needed," says
Susan Pisano, a spokeswoman for the American Association of
But in case the industry doesn't get the message, the forces
of change are already at work. Both the White House and
Congress are looking at a variety of remedies to deal with
the HMO backlash.