MANAGED CARE INSTABILITY: Bee Laments Doctor ‘Chaos’
An editorial in yesterday's Sacramento Bee says that a "bedrock principle of managed care is supposed to be stability," but the "shark-like" atmosphere of the health care arena is depriving patients of enduring relationships with doctors. The Bee notes that locally, the "wildest roller coaster involves the 30-some local doctors once employed by the Foundation HMO." In 1993, Foundation decided to hire doctors to staff its own clinics to save money. However, "[a]fter losing more than $88 million on the venture, it sold the medical group to FPA Medical Management." But when "financial troubles caught up with FPA ... it threaten[ed] to fire all its Sacramento doctors." At the same time, "Blue Cross has the opposite problem." Its returns have been so good that "Wall Street expects more of the same." So the insurer "fiercely negotiates what it will pay local doctors and hospitals who care for its" enrollees. However, providers are now fighting back and "Sutter Health has announced that it will stop caring for Blue Cross members except in emergencies, displacing 180,000 enrollees throughout Northern California." Mercy Healthcare has threatened to do the same, which could displace another 8,000 Blue Cross enrollees. The Bee concludes: "No wonder many Californians are fed up with today's health care system. Nobody -- the HMOs, the doctors, Wall Street or the employers -- is an angel in this fight. Until they manage to allow managed care to evolve in a less disruptive manner, the cynicism will only get worse" (5/28).
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