Cover image for Making a killing : HMOs and the threat to your health
Title:
Making a killing : HMOs and the threat to your health
Author:
Court, Jamie, 1967-
Personal Author:
Publication Information:
Monroe, ME : Common Courage Press, [1999]

©1999
Physical Description:
vii, 230 pages : illustrations ; 21 cm
Language:
English
Added Author:
ISBN:
9781567511697

9781567511680
Format :
Book

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RA413.5.U5 C68 1999 Adult Non-Fiction Central Closed Stacks
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Summary

Summary

Do HMOs provide good health care while keeping costs down? Or is their dominance a major threat to American health, safety, and pocketbooks?In Making a Killing, you'll meet some of the victims trapped in corporate medicine's stark financial calculus: the less you care, the more you profit.
-- Diagnosed with stomach cancer but unable to get HMO approval for recommended treatment, David Goodrich finally started therapy anyway. But by then the cancer had spread to his liver. He died leaving his wife Teresa, a kindergarten teacher, with $750,000 in medical bills his insurer refused to pay.
-- Five-month-old Chad Aitken was given vaccine shots which caused a reaction. When his mother called their HMO doctor for assistance, she was told, incorrectly, that her insurance had lapsed, and was refused care. Chad died.Americans are angry -- and ready to take back control of their health. In Making a Killing, consumer activists Jamie Court and Frank Smith indict the corrupt world of managed care, and provide a Self-Defense Kit for overcoming HMO stonewalling techniques and getting the care you deserve. Included is a mail-in postcard for readers to vote on what kind of health care system they think is right for the country. The verdict count will be maintained on the Internet.


Summary

Do HMOs provide good health care while keeping costs down? Or is their dominance a major threat to American health, safety, and pocketbooks?In Making a Killing, you'll meet some of the victims trapped in corporate medicine's stark financial calculus: the less you care, the more you profit.-- Diagnosed with stomach cancer but unable to get HMO approval for recommended treatment, David Goodrich finally started therapy anyway. But by then the cancer had spread to his liver. He died leaving his wife Teresa, a kindergarten teacher, with $750,000 in medical bills his insurer refused to pay.-- Five-month-old Chad Aitken was given vaccine shots which caused a reaction. When his mother called their HMO doctor for assistance, she was told, incorrectly, that her insurance had lapsed, and was refused care. Chad died.Americans are angry -- and ready to take back control of their health. In Making a Killing, consumer activists Jamie Court and Frank Smith indict the corrupt world of managed care, and provide,a "Self-Defense Kit" for overcoming HMO stonewalling techniques and getting the care you deserve. Included is a mail-in postcard for readers to vote on what kind of health care system they think is right for the country. The verdict count will be maintained on the Internet.


Reviews 4

Publisher's Weekly Review

One of the most powerful indictments to date of the managed care industry, this scathing expos‚ presents case histories of those who have lost their health or their lives because an HMO denied or delayed vital treatments, tests or surgery. Consumer activist Court, advocacy director of the Foundation for Taxpayer and Consumer Rights, and public policy consultant Smith zero in on the insidious incentive for HMOs to withhold medical care in order to increase profits, thanks to the current capitation system, which allocates a fixed lump-sum payment for every patient under a provider's care, regardless of how much treatment each needs. HMOs, as portrayed here, are institutions driven by shortsightedness, negligence and greed, in which clerks without medical licenses overrule treating physicians to make life-and-death decisions, accountants scale down medical procedures and determine patient discharge times, and taxpayers are cheated out of billions by distorted federal expense claims for reimbursement. The authors set forth an arsenal of sensible proposals for reforms that would level the playing field for patients. An appendix, "HMO Patient Self-Defense Kit," offers practical pointers on how readers can negotiate with their HMOs to get the care they need. This lively probe is must reading for anyone concerned with the health of the U.S. medical system. (Dec.) (c) Copyright PWxyz, LLC. All rights reserved


Choice Review

This advocacy-oriented book integrates human experience and data in order to support Court and Smith's contention that HMOs, as they are currently structured and regulated, are allowed to be willful in their devotion to the financial bottom line and neglectful of the needs of their patients. By telling stories of personal tragedy, the impact of corporate decision making that is allowed to overrule care decisions by physicians--often supported by clinical evidence--is painfully illustrated. The culmination of the book is a call for institutional reforms and suggestions for effective patient self-advocacy. The authors conclude by posing a challenge to readers to step up and speak out on this important issue. Recommended for upper-division undergraduate and graduate students focused on issues of health policy and consumer advocacy. M. Richardson University of Washington


Publisher's Weekly Review

One of the most powerful indictments to date of the managed care industry, this scathing expos‚ presents case histories of those who have lost their health or their lives because an HMO denied or delayed vital treatments, tests or surgery. Consumer activist Court, advocacy director of the Foundation for Taxpayer and Consumer Rights, and public policy consultant Smith zero in on the insidious incentive for HMOs to withhold medical care in order to increase profits, thanks to the current capitation system, which allocates a fixed lump-sum payment for every patient under a provider's care, regardless of how much treatment each needs. HMOs, as portrayed here, are institutions driven by shortsightedness, negligence and greed, in which clerks without medical licenses overrule treating physicians to make life-and-death decisions, accountants scale down medical procedures and determine patient discharge times, and taxpayers are cheated out of billions by distorted federal expense claims for reimbursement. The authors set forth an arsenal of sensible proposals for reforms that would level the playing field for patients. An appendix, "HMO Patient Self-Defense Kit," offers practical pointers on how readers can negotiate with their HMOs to get the care they need. This lively probe is must reading for anyone concerned with the health of the U.S. medical system. (Dec.) (c) Copyright PWxyz, LLC. All rights reserved


Choice Review

This advocacy-oriented book integrates human experience and data in order to support Court and Smith's contention that HMOs, as they are currently structured and regulated, are allowed to be willful in their devotion to the financial bottom line and neglectful of the needs of their patients. By telling stories of personal tragedy, the impact of corporate decision making that is allowed to overrule care decisions by physicians--often supported by clinical evidence--is painfully illustrated. The culmination of the book is a call for institutional reforms and suggestions for effective patient self-advocacy. The authors conclude by posing a challenge to readers to step up and speak out on this important issue. Recommended for upper-division undergraduate and graduate students focused on issues of health policy and consumer advocacy. M. Richardson University of Washington


Table of Contents

Ralph NaderRalph Nader
Acknowledgmentsp. iv
Forewordp. v
Introductionp. 1
1. The End of Health Care Who Plays God in a System Bent on Profitp. 6
2. A Deadly Fraud Behind the Caring Image of HMOs and Managed Care Companiesp. 40
3. The Death of Community Health Care and Hospitalsp. 70
4. The Financial Sting--Paying More for Lessp. 99
5. Getting Away with Murder Why You Can't Sue Your HMOp. 120
6. The Battle to Make Health Care Workp. 153
Appendix 1 HMO Patient Self-Defense Kitp. 178
Appendix 2 State Regulatorsp. 189
Appendix 3 Consumer Resourcesp. 197
Notesp. 201
Indexp. 222
About the Authorsp. 231
Stay Involvedp. 232
Acknowledgmentsp. iv
Forewordp. v
Introductionp. 1
1. The End of Health Care Who Plays God in a System Bent on Profitp. 6
2. A Deadly Fraud Behind the Caring Image of HMOs and Managed Care Companiesp. 40
3. The Death of Community Health Care and Hospitalsp. 70
4. The Financial Sting--Paying More for Lessp. 99
5. Getting Away with Murder Why You Can't Sue Your HMOp. 120
6. The Battle to Make Health Care Workp. 153
Appendix 1 HMO Patient Self-Defense Kitp. 178
Appendix 2 State Regulatorsp. 189
Appendix 3 Consumer Resourcesp. 197
Notesp. 201
Indexp. 222
About the Authorsp. 231
Stay Involvedp. 232