Re: Harry & Louise Part IV

[METRA1001@aol.com]

Whistle-

Now there is a real non-sequiter for you. 'Care Manager'. Sort of like 
'Military Intelligence'. A contradiction. An oxyMORON... I guess that (care 
manager) is a spin-doctored "Gate Keeper" except, instead of a doctor 
blocking your way, i guess you get a person with a high school degree, a 
clerk, or a history major, as your gatekeeper for helthcare, OH JOY! AND they 
want to know ALL about you. How delightful. Telling an unknown stranger with 
no hippocratic oath ALL your troubles, so  you can get in to see a shrink. 
That'll be the day. I don't know about the rest of you, but I am tired of 
being treated as though I am 8 yrs old, have an IQ of 50, and cannot SEE what 
is going on! This is gradualism, breaking straight out to absurdity. 

Care Manager. In other words, some nice person who comes on as YOUR specific 
liaison to tell you exactly WHY you cannot get access to whatever specialized 
care you need. Just what we need. Another title. By the way, have you seen 
the latest anti-patient rights ads? They are lean, mean, and aim below the 
belt, right for the 70 or less IQ lot, (THE EMOTION CROWD) pressing all the 
HOT buttons, promising that anyone who does not call their congressman or 
senator and demand they vote down patient rights, makes themselves A DIRECT 
target for the loss of insurance, if patient rights (and the right to sue) is 
passed into law... 

I guess they presume that most people are not bright enough to know that when 
all of us are paying 7 thou to 14 thou a year for insurance, and are blocked 
from access to specialists, and get repeated denials, for treatments, that 
essentially means WE ALL ARE ALREADY LOSING our insurance (even though we are 
still paying for it) RIGHT NOW. 

I still recommend "Changing HealthCare" by Ken Jennings (produced by AAHP) a 
REAL exercise in manipulation and propaganda by AAHP; what a wonderful world 
it portrays, having UNIQUE, benevolent, healthcare providers ANTICIPATE 
beneficiaries needs, before the patient needs it, and providing it, before 
the need is even detected by the patient. I maintain that you have to be 
NORMAL before you can be unique. And our current managed care system is 
anything but normal. 

How can you advertise you CARE about outcomes, when you blatantly deny 
anything and every claim that comes your way, limit access, deny claims, lose 
claims, lose specialist referral numbers, (you know the regular paper games), 
if you really CARE what happens to a patient. Forget what they SAY. JUDGE BY 
WHAT HMO'S DO. And how they behave. That's where they fall down. When it 
comes time to produce, that's when their true colors come out. Anyone ever 
read 1984 by George Orwell? Well, this is the Party line, the little lies. 
And you little sheep out there, peddle the party slogans with Newspeak: 
Repeat after me: War is Peace. Freedom is Slavery. HMO's are caring insurers. 
Care Managers are your friends. Patient Rights is HERESY. We VALUE YOU, the 
customer. You can trust US. You know the rest... 

Al

In a message dated 8/25/99 1:17:18 PM EST, weeethistle@yahoo.com writes:

<< Subj:     Re: Harry & Louise Part II
 Date:  8/25/99 1:17:18 PM EST
 From:  weeethistle@yahoo.com (Whistle)
 Sender:    med-privacy@essential.org
 Reply-to:  med-privacy@essential.org
 To:    med-privacy@essential.org (Multiple recipients of list MED-PRIVACY)
 
 Dear Al and Peter and all --
 
 Have you heard of a "Care Manager" for services such
 as mental health outside of HMO plans?  Evidently the
 Care Manager has left the umbrella of the HMO and
 moved into all health insurance policies available in
 NJ.  In NJ the insurance industry has segregated out
 mental or emotional illness from physical illness and
 has made it mandatory that a patient's physician can
 no longer make decisions about the care of their
 patient.   "Care Manager manages, assesses,
 coordinates, directs and authorizes a Covered Person's
 Treatment..."and Horizon will provide Network level of
 benefits when treatment is "Medically Necessary and
 Appropriate -- not as recommended by the physician but
 by the Care Manager whoever that person is.  There is
 no explanation offered as to the education,
 qualifications and experience of the Care Manager.  I
 am not sure what "parity" means in New Jersey but it
 obviously does not extend to the patient's right to
 equal treatement by a physician.  
 
 I checked with my benefit negotiator and he said that
 this "RIDER" is now part of every policy written in
 the State of New Jersey, for all insurance companies
 and is not limited to HMO companies.
 
 I find this alarming because obviously we want
 physicians to be the people we turn to when we are
 sick or need medical help.  It is extremely arrogant
 to expect consumers to talk on the telephone to an
 unknown person about their most personal problems not
 knowing anything about the person on the other end of
 the telephone -- it requires that we give up our
 privacy and confidence to strangers.  >>