Abdul, I don't have time nor inclination to do point-counterpoint with you on this. Consider this my last post on the subject. I can't imagine why you didn't go to law school.
>At 05:28 PM 8/13/2004 -0400, Abd ul-Rahman Lomax wrote: >>At 12:06 PM 8/13/2004, Frank Gilley wrote: >>>Well, while it is true that there are both bad and good HMO's, as well as PPO's, >>>you never really know what's going to happen until you get sick. >>> >>>My personal experience with an illness suggests that I might well not be here if I >>>were using an HMO. > >The story told does not convince me of that. Sheesh, no I didn't go into every detail. The situation was serious, much more so than I knew at the time. You will have to accept my statement. This is not a court of law and I'm not presenting the evidence. Case Closed. A related point... >Further, in the example given, if an HMO concluded that you didn't need treatment, >and even if they did not allow a change of primary care physician, you could still go >to an outside doctor and get an opinion. That isn't terribly expensive.... And then, >assuming the outside doctor said you needed treatment, in writing, you'd have >ammunition to use to get your HMO off its duff. > >Further, while the bad news is that you can't sue your HMO, the good news is that >HMOs are required to provide an arbitration procedure. You are not without recourse. >Arbitration should be much faster than suing! I didn't have time to use "ammunition". I didn't have time to arbitrate. I needed immediate treatment. Obviously you cannot relate. >The difference in price isn't paltry. Other options similar in level of benefit to >Kaiser were double the cost, as I recall, when we were in California. The difference for me, in Oklahoma, at the time, would have been less than $60 a month. Paltry compared to what you give up. Dunno what planet your figures are on, or what planet California insurance is on. >My point is that I would not suggest making the decision simply on the basis of "HMO >bad PPO good." There are a lot of other factors. Some HMOs are better in quality of >care than some PPOs. Yes, I already acknowledged this point. I agree, the better HMO's are probably better than bad PPO's. Sure, avoid bad PPOs. My point is this: HMO's are specifically about containing costs. Hopefully, you will not be one of those people who gets the run-around when they decide to contain YOUR costs for some life-threatening illness. After you personally have had a life-threatening illness and have been through the system, perhaps you will have more insight into what can happen. I had a chance to follow some legal proceedings against an HMO once- Pacificare. What I saw during that was a very graphic illustration (to make a long story short again) of how you can get the shaft from an HMO when they decide against you for a given treatment. PPOs are also attempting to save money, but they go about it an entirely different way. They generally do not attempt to make decisions about whether or not you should be treated for anything. And they make it easy and quick to circumvent any bad doctors you run into along the way. -Frank * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * To post a message: mailto:[EMAIL PROTECTED] * * To leave this list visit: * http://www.techservinc.com/protelusers/leave.html * * Contact the list manager: * mailto:[EMAIL PROTECTED] * * Forum Guidelines Rules: * http://www.techservinc.com/protelusers/forumrules.html * * Browse or Search previous postings: * http://www.mail-archive.com/[EMAIL PROTECTED] * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
