Do you have an HMO?

Arvon · 10-26-2001, 01:28 PM

I think this will mostly make sense in the US.

Q. What does HMO stand for?
A. This is actually a variation of the phrase, "Hey, Moe!" Its roots go back to a concept pioneered by Doctor Moe Howard, who discovered that a patient could be made to forget about the pain in his foot if he was poked hard enough in the eyes. Modern practice replaces the physical finger poke with hi-tech equivalents such as voice mail and referral slips, but the result remains the same.

Q. Do all diagnostic procedures require pre-certification?
A. No. Only those you need.

Q. I just joined a new HMO. How difficult will it be to choose the doctor I want?
A. Just slightly more difficult than choosing your parents. Your insurer will provide you with a book listing all the doctors who were participating in the plan at the time the information was gathered. These doctors basically fall into two categories -- those who are no longer accepting new patients, and those who will see you but are no longer part of the plan. But don't worry -- the remaining doctor who is still in the plan and accepting new patients has an office just a half day's drive away!

Q. What are pre-existing conditions?
A. This is a phrase used by the grammatically challenged when they want to talk about existing conditions. Unfortunately, we appear to be pre-stuck with it.

Q. Well, can I get coverage for my pre-existing conditions?
A. Certainly, as long as they don't require any treatment.

Q. What happens if I want to try alternative forms of medicine?
A. You'll need to find alternative forms of payment.

Q. My pharmacy plan only covers generic drugs, but I need the name brand. I tried the generic medication, but it gave me a stomach ache. What should I do?
A. Poke yourself in the eye.

Q. I have an 80/20 plan with a $200 deductible and a $2,000 yearly cap. My insurer reimbursed the doctor for my out-patient surgery, but I'd already paid my bill. What should I do?
A. You have two choices. Your doctor can sign the reimbursement check over to you, or you can ask him to invest the money for you in one of those great offers that only doctors and dentists hear about, like windmill farms or frog hatcheries.

Q. What should I do if I get sick while traveling?
A. Try sitting in a different part of the bus.

Q. No, I mean what if I'm away from home and I get sick?
A. You really shouldn't do that. You'll have a hard time seeing your primary care physician. It's best to wait until you return, and then get sick.

Q. I think I need to see a specialist, but my doctor insists he can handle my problem. Can a general practitioner really perform a heart transplant right in his office?
A. Hard to say, but considering that all you're risking is the $10
co-payment, there's no harm giving him a shot at it.

Q. What accounts for the largest portion of health care costs?
A. Doctors trying to recoup their investment losses.

Q. Will health care be any different in the next century?
A. No, but if you call right now, you might get an appointment by then.

10-26-2001, 01:49 PM

Being employed by an HMO I find it ironic that I thought that was quite funny

Personally I think they ought to do away will all medical insurance programs of all types. Make people invest and save for the medical aid they can afford and not have a limitless pool of tax money for giving every tom, dick and sally unlimited treatments....I SAY...LET the Process of Natural Selection weed out the weak

unfortunately that would also weed out the poor too...and then gradually the middle class.....eeep then where would I be??? Forget I said anything

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Disintigration is easy, If you really want to impress me, ReIntegrate it.

Sir Kenyth · 10-26-2001, 03:19 PM

Part of the problem that led to HMOs was the fact the medical facilities were ripping off the insurers. It was the equivalent of going shopping and letting the stores tell you what and how much you need to buy and that the cost doesn't matter. I remember my son getting a dose of liquid sedative once before a procedure. That little paper cup cost $100!!! I checked on the medication name and one hundred bucks could darn near buy a years supply at the pharmacy! There was no competition and the medical community set it's own prices as it saw fit. When was the last time you saw a new drug become over the counter? It don't happen often folks! If the medical community had anything to say about it, you'd need a prescription for an aspirin! Nothing like a 5 minute doctors visit at 60-100 dollars a pop to bring in the cash! I'm not saying doctors don't deserve to be payed very well. I'm saying that things got out of hand with medical costs and now were paying the price as patients while the insurance companies fight back.

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Member of ORT
Master Barbsman and weilder of the razor wit!
Official royal toad! Ribbit! Ribbet I say!

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Silver Cheetah · 10-26-2001, 03:24 PM

Quote:

Originally posted by Sir Kenyth:
Part of the problem that led to HMOs was the fact the medical facilities were ripping off the insurers. It was the equivalent of going shopping and letting the stores tell you what and how much you need to buy and that the cost doesn't matter. I remember my son getting a dose of liquid sedative once before a procedure. That little paper cup cost $100!!! I checked on the medication name and one hundred bucks could darn near buy a years supply at the pharmacy! There was no competition and the medical community set it's own prices as it saw fit. When was the last time you saw a new drug become over the counter? It don't happen often folks! If the medical community had anything to say about it, you'd need a prescription for an aspirin! Nothing like a 5 minute doctors visit at 60-100 dollars a pop to bring in the cash! I'm not saying doctors don't deserve to be payed very well. I'm saying that things got out of hand with medical costs and now were paying the price as patients while the insurance companies fight back.

Jesus. Give me our National Health Service any day. It's not perfect, but at least I can afford to be ill.......

PS I don't have private health insurance!

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Most Ecstatic Mistress of the Illuminati Not to Mention Sensuality Incarnate (if Somewhat Flea-bitten Right Now..)

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10-26-2001, 04:22 PM

Well costs were part of the problem that created the HMO debacle we have now, but it was the government trying to regulate things through the tax code that actually established the first HMO's now the scales have tipped the other way...I still think the process of natural selection is a fine mechanism for stabilizing a population

err wait no, I dont, because in that case being so near sighted that I couldnt see my hand in front of my face (before surgery any way now its 20/20) I would have been the first to get taken by a Cheetah...silver or otherwise

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Disintigration is easy, If you really want to impress me, ReIntegrate it.

[This message has been edited by MagiK (edited 10-26-2001).]

pBluescript · 10-26-2001, 10:20 PM

I belong to an HMO. Never had any problems. Switched doctors twice now. No huhu. Cost me $100 to have the child born and that was with complications. When he needed tubes for his ear infections, no problem, cost me $25 out of pocket. Sure, they take a hefty chunk of change out of my paycheck for the privlige of belonging to the HMO, but its all pre-tax. Have gone to the emergency room twice now, no problem, they have treated me in under 30 min. I'm not saying the system is perfect, but personally, I have not had any problems with it.

10-26-2001, 01:28 PM	#1
Arvon Unicorn Join Date: October 4, 2001 Location: Kingdom of the West,..P.o. Cynagus Posts: 4,212	I think this will mostly make sense in the US. Q. What does HMO stand for? A. This is actually a variation of the phrase, "Hey, Moe!" Its roots go back to a concept pioneered by Doctor Moe Howard, who discovered that a patient could be made to forget about the pain in his foot if he was poked hard enough in the eyes. Modern practice replaces the physical finger poke with hi-tech equivalents such as voice mail and referral slips, but the result remains the same. Q. Do all diagnostic procedures require pre-certification? A. No. Only those you need. Q. I just joined a new HMO. How difficult will it be to choose the doctor I want? A. Just slightly more difficult than choosing your parents. Your insurer will provide you with a book listing all the doctors who were participating in the plan at the time the information was gathered. These doctors basically fall into two categories -- those who are no longer accepting new patients, and those who will see you but are no longer part of the plan. But don't worry -- the remaining doctor who is still in the plan and accepting new patients has an office just a half day's drive away! Q. What are pre-existing conditions? A. This is a phrase used by the grammatically challenged when they want to talk about existing conditions. Unfortunately, we appear to be pre-stuck with it. Q. Well, can I get coverage for my pre-existing conditions? A. Certainly, as long as they don't require any treatment. Q. What happens if I want to try alternative forms of medicine? A. You'll need to find alternative forms of payment. Q. My pharmacy plan only covers generic drugs, but I need the name brand. I tried the generic medication, but it gave me a stomach ache. What should I do? A. Poke yourself in the eye. Q. I have an 80/20 plan with a $200 deductible and a $2,000 yearly cap. My insurer reimbursed the doctor for my out-patient surgery, but I'd already paid my bill. What should I do? A. You have two choices. Your doctor can sign the reimbursement check over to you, or you can ask him to invest the money for you in one of those great offers that only doctors and dentists hear about, like windmill farms or frog hatcheries. Q. What should I do if I get sick while traveling? A. Try sitting in a different part of the bus. Q. No, I mean what if I'm away from home and I get sick? A. You really shouldn't do that. You'll have a hard time seeing your primary care physician. It's best to wait until you return, and then get sick. Q. I think I need to see a specialist, but my doctor insists he can handle my problem. Can a general practitioner really perform a heart transplant right in his office? A. Hard to say, but considering that all you're risking is the $10 co-payment, there's no harm giving him a shot at it. Q. What accounts for the largest portion of health care costs? A. Doctors trying to recoup their investment losses. Q. Will health care be any different in the next century? A. No, but if you call right now, you might get an appointment by then.

10-26-2001, 01:49 PM	#2
MagiK Guest Posts: n/a	Being employed by an HMO I find it ironic that I thought that was quite funny Personally I think they ought to do away will all medical insurance programs of all types. Make people invest and save for the medical aid they can afford and not have a limitless pool of tax money for giving every tom, dick and sally unlimited treatments....I SAY...LET the Process of Natural Selection weed out the weak unfortunately that would also weed out the poor too...and then gradually the middle class.....eeep then where would I be??? Forget I said anything ------------------ Disintigration is easy, If you really want to impress me, ReIntegrate it.

10-26-2001, 03:19 PM	#3
Sir Kenyth Fzoul Chembryl Join Date: August 30, 2001 Location: somewhere Age: 54 Posts: 1,785	Part of the problem that led to HMOs was the fact the medical facilities were ripping off the insurers. It was the equivalent of going shopping and letting the stores tell you what and how much you need to buy and that the cost doesn't matter. I remember my son getting a dose of liquid sedative once before a procedure. That little paper cup cost $100!!! I checked on the medication name and one hundred bucks could darn near buy a years supply at the pharmacy! There was no competition and the medical community set it's own prices as it saw fit. When was the last time you saw a new drug become over the counter? It don't happen often folks! If the medical community had anything to say about it, you'd need a prescription for an aspirin! Nothing like a 5 minute doctors visit at 60-100 dollars a pop to bring in the cash! I'm not saying doctors don't deserve to be payed very well. I'm saying that things got out of hand with medical costs and now were paying the price as patients while the insurance companies fight back. ------------------ Member of ORT Master Barbsman and weilder of the razor wit! Official royal toad! Ribbit! Ribbet I say! The true secret to happiness is not having what you want, it's wanting what you have!

10-26-2001, 04:22 PM	#5
MagiK Guest Posts: n/a	Well costs were part of the problem that created the HMO debacle we have now, but it was the government trying to regulate things through the tax code that actually established the first HMO's now the scales have tipped the other way...I still think the process of natural selection is a fine mechanism for stabilizing a population err wait no, I dont, because in that case being so near sighted that I couldnt see my hand in front of my face (before surgery any way now its 20/20) I would have been the first to get taken by a Cheetah...silver or otherwise ------------------ Disintigration is easy, If you really want to impress me, ReIntegrate it. [This message has been edited by MagiK (edited 10-26-2001).]

10-26-2001, 10:20 PM	#6
pBluescript Dungeon Master Join Date: October 25, 2001 Location: Winston-Salem, NC USA Posts: 77	I belong to an HMO. Never had any problems. Switched doctors twice now. No huhu. Cost me $100 to have the child born and that was with complications. When he needed tubes for his ear infections, no problem, cost me $25 out of pocket. Sure, they take a hefty chunk of change out of my paycheck for the privlige of belonging to the HMO, but its all pre-tax. Have gone to the emergency room twice now, no problem, they have treated me in under 30 min. I'm not saying the system is perfect, but personally, I have not had any problems with it.

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