Local Groups’ Behavior Not ‘Good Care’
Investor-owned health plans aren’t the only insurers shortchanging patients, charges one of the co-authors of a new study critical of managed care.
Under intense cost-cutting pressure from for-profit operators whose shareholders clamor for higher returns, managed care plans of all types are scrambling to downgrade services and pare costs, according to Dr. Ida Hellander.
While her research shows the quality of investor-owned plans is markedly inferior, “Nonprofits increasingly are being forced to mimic the for-profits,” she said in an interview. “It’s time to end our race to the bottom in health care, and implement nationwide quality improvement and universal coverage through single-payer national health insurance.”
Hellander also is executive director of Physicians for a National Health Program, a Chicago-based advocacy group pushing for universal coverage. The doctor phoned me to offer her personal perspective on the study, published last Tuesday in the Journal of American Medicine Association, and she had harsh words for Medicare insurers abandoning Inland Northwest seniors.
Thousands are being stranded by PacifiCare and Group Health Northwest, which notified Medicare clients in Eastern Washington and North Idaho that they will be dropped Dec. 31.
Group Health enjoyed a position of trust in the community for decades as Spokane’s home-owned cooperative. But when push came to shove, the local co-op pulled the plug on old folks. “That’s certainly not good care,” observed Dr. Hellander. “These folks are hurting.”
State Insurance Commissioner Deborah Senn voiced concern at a clinic last week to help displaced seniors figure out their next move. “I understand the anger and frustration you are expressing toward Group Health and PacifiCare,” said the commissioner, “but they are part of a larger national problem.”
The lone Medicare managed care plan left in Spokane is MSC/Premera. How long it accepts new enrollees is anybody’s guess.
Meantime, seniors are advised not to disenroll from the plan that will disavow them Dec. 31. Those who do risk losing the guarantees of coverage for pre-existing conditions and nondiscrimination in premium pricing. The safest bet is to sign up with a new plan in the next few months for coverage effective Jan. 1, 2000.
Senior Try-Its Week kicks off Friday with lawn bowling, racquetball and tennis, followed by pocket billiards, dancing and lawn bowling again on Saturday.
The action switches to indoor bowling Sunday. Darts, bridge, horseshoes, shuffleboard, ping-pong, badminton, golf, track and field events, pickleball, and softball round out activities during the week.
It’s all free, thanks to the Senior Assistance Fund of Eastern Washington, producer of the upcoming Washington State Senior Games.
A schedule of activities for Senior Try-Its Week is included in registration packets for the State Senior Games Aug. 12-15. There is a $22 registration fee for the Senior Games. That covers the first event, event program and check-in bag. Sign-up continues through July 30. Registration materials are available at 24-Hour Fitness locations in Spokane and Post Falls, and at HealthSouth in Washington and Idaho.
A new Web site boasts one-stop shopping for senior services available from the federal government.
Hosted by the Social Security Administration, www.seniors.gov offers an array of information and services, including data on Medicare, nursing homes, HUD housing and VA benefits.