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November 14, 2009

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Letter: Public deserves more oversight of state HMOs

Sunday, July 2, 2000 | 10:45 a.m.

Within an HMO, the poor patient does not have a fair appeal process, which is one-sided, contrived and heavy-handed. HMOs put the burden of proof on the member.

It is hoped that the Consumer Health Assistance office, under Laurie England, can focus on this and act as an appellate czar. Unfortunately she will run into HMO lobbyists and politicians who are directors of HMOs and who also have the governor's ear.

It also is heartening that the state insurance division is active here. The licensing people should also be involved in checking on shoddy medical record-keeping by HMOs. The HMOs are not self-regulating when it comes to members' rights and will rule against their own members in the majority of cases. Ms. England's office could be a breath of fresh air, if it is not subverted politically.

GEORGE P. DIX

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