HMO POLITICS: Industry Eyes 2000 Elections
The AP/Boston Globe reports that the managed care industry "has quietly crafted a political strategy aimed at improving its image in the next presidential campaign." Led by the American Association of Health Plans, the industry is using "television advertising, networking and sophisticated marketing" in several early presidential primary states, including Iowa and New Hampshire. AAHP's Mark Merritt, speaking of Iowa, said, "This is where the cauldron is going to be. This is one place where voters are going to get the education and we want to be part of that process." AAHP "plans to begin intensive polling in mid-November among those likely to attend Republican and Democratic precinct caucuses" in Iowa, Merritt said. He also said the group will rely on "focus groups" and will attempt to build "networks of 'key business allies.'" In addition, AAHP plans a big TV and radio campaign starting in January that is intended to shape "public opinion by stressing cost increases associated with regulating HMOs." As the 2000 elections near, AAHP will meet with presidential candidates "to convince them the issue of regulating managed care programs is a loser they should avoid." Merritt said, "We are expecting we can turn this into a reasoned debate. We can win when the debate is reasonably level" (10/15).
Last night, ABC's "World News Tonight" continued its weeklong "HMO Nation" series with a look at HMOs and their effect on mental health. ABC's Rebecca Chase reported, "Managed care has had a profound impact on the delivery of mental health services. More people than ever now have coverage. Out of pocket expenses are lower. And there is more accountability. But there is growing concern that people who need treatment are not getting it." Chased noted that the "average hospital stay has gone from 28 days to five" and "the limit for outpatient therapy has dropped from 50 visits to 20, if you can get it authorized." In addition, health plans are putting "pressure" on practitioners "to prescribe drugs in lieu of therapy." ABC's Peter Jennings: "Many people tell us that to get the best HMO coverage, you have to make a lot of noise to your HMO, of course. But also to your employer, who's paying for it. This can be a huge obstacle for people with mental health illness, because they are very often reluctant to let people know that they are sick" (10/14).
Who Should Pay?
CBS Radio Network's Charles Osgood profiled Terry Laftenstager, a 37-year-old Seattle woman "who has a particularly lethal kind of brain tumor." Osgood reported that Laftenstager's HMO, Group Health, denied coverage for a "unique neurosurgical procedure involving radioactive antibodies that is only done at Duke University Medical Center." The health plan based its decision on the fact that the treatment is experimental and unproven. Osgood noted that Group Health's Dr. Hugh Straley "says the patient can appeal" the coverage decision, "but he says, 'The broader question has to do with who should pay for unproven therapies.'" Osgood concluded, "It's not an uncomplicated business, but it's not an isolated question, either. Dr. Straley's question is one the whole country has to ask: Who should pay?" (10/14).
Cleveland Rocks ... HMOs!
In last night's episode of ABC's "The Drew Carey Show," the Carey character is persuaded to stay on at his human resources job after his company's health plan is switched to an HMO. The Carey character remarks that he had fought for years against HMOs and is urged on by his co-workers to switch the coverage back to the non-HMO plan (ABC, 10/14).