THE FUTURE: ‘Father of HMO’ Sees New Era of Patient Power

      "The stage is set to shift from a health system dominated by employers and government purchasers to a system responsive to patient power at the individual provider level," Dr. Paul Ellwood, Jr. said Tuesday. Often acknowledged as the "Father of the HMO," Ellwood told the National Association of State Comprehensive Health Insurance Plans that HMOs have grown to value cost over quality, noting, "At this stage, for most managed care organizations, the balance has shifted too much toward insurance. Quality shopping, based on health outcomes, has been stuck, and with it, the core of our original health maintenance strategy." A failing managed care system, characterized by "rising medical inflation, consumer distrust, provider hostility and political opportunism," will likely give way to a new era of consumer power, he said (Minnesota Comprehensive Health Association release, 11/16).

Absolute Power?
      Meanwhile, Massachusetts HMOs are predicting doom -- if a proposal to mandate statewide universal health coverage is approved by voters. The plan also would authorize HMO patients to visit any doctor they choose and would bar not-for-profit HMOs from converting to for-profit status. "This really guts the concept of HMOs," Rick Lord, executive vice president of the Associated Industries of Massachusetts, said, adding "Our concern is that it makes a promise that is very hard to deliver." Advocates from the Massachusetts Nurses Association, the Massachusetts Public Interest Research Group and the League of Women Voters say they have collected more than the 57,100 signatures required to put the issue on next November's ballot (Heldt Powell, Boston Herald, 11/16).