Re: Managed Care Organizations - HMO

[Guest guest]

You're absolutely correct in your statement Merav that not all HMOs were

created equal. A good case manager or HMO contract negotiator will tell you

the same. In my company we do have contracts with many of them, and we know

the good ones that will really do their best for the patients, and those

that just want to pinch pennies. We assign the toughest case managers to

advocate for those patients stuck with the lower performers and have to

justify everything, even a Tylenol (maybe not that but most treatments).

Also the ALS are much shorter with those so the review IDT has to be alert

and continue to strive for 24 more hrs if the resident needs it.

In my case I am my own case manager, know what to say and what to do to

obtain the services I need. Additionally with my insurance I can chose the

office out of many where I want to be seen, and as I said, chose it for many

reasons; I knew the MD that started that office as I worked with him in the

past and his son is now the MD, I wanted and Osteopath, not an MD, and I

wanted a young female with more recent degree and some holistic tendencies -

I got it all! Plus, I like the nurse practitioner and for many minor things

I just ask to meet with her and get a same day appointment.

In any healthcare situation we all need to be able to manage the process. I

pity the lay-people or those of a more timid nature, those that are

misinformed, and those that are very ill and have no one else to advocate

for them. Another unrelated comment. I am SHOCKED at what pharmacies are

charging for meds to nursing home residents. I just received my parents'

first bill for a mere 15 days supply, and it's going to cost >$300 each a

month for meds I was providing for them from Canada for about about $200.

Tomorrow I plan to contact the SNF adn find alternative ways to supply for

their meds. They just don't have the funds to pay that much - and they did

not enroll for Med D so have to wait for the enrollment time again. Oh,

and this cost includes my mother who only takes 3 meds a day....

Re: Why socialism won't work -Healthcare bill

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>> > > > comments -can't resist

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>> > > > Okay, can't resist. . . ;-)

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>> > > > Aren't uniforms about equalizing all the kids - those that can't

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>> > > > afford

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>> > > > expensive clothing aren't set apart from those that can. . . a

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>> > nice

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>> > > > socialist

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>> > > > thing. . . equalize all the students/citizenshi p by requiring

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>> > > > uniforms . .

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>> > > > . people judge based on personality rather than clothing. You'll

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>> > > > tend to

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>> > > > strive to become more of an individual.

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>> > > > Your granddaughter already has the capitalism mindset right. . .

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>> > work

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>> > > > hard, pay for what you want - if you want to wear denim, you can

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>> > > > extra for

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>> > > > the right.

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>> > > > The poor kids that can't afford the $5 aren't allowed to wear

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>> > denim to

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>> > > > school. Work hard to get what we want . . . just the exact post I

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>> > > > started out

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>> > > > with!

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>> > > > Jan ;-)

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>> > > > PS. Truly, if you look at the history of the world, socialism just

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>> > > > doesn't

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>> > > > work. Never has. It breeds tyranical governments and limits

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>> > > > individuality.

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>> > > > Think it works? - ask people from China, Venezuala, Cuba or Russia

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>> > > > why they

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>> > > > want to come to the US. Millions of veterans have died

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>> > protecting our

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>> > > > constitution so we wouldn't have to be socialists. But, that's

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>> > > > our

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>> > > > current admin is trying to lead us into. Again, the heatlh care

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>> > > > wasn't about

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>> > > > health - it was about government control of the people. (Talk to

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>> > an

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>> > > > informed vet if you want more details.)

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>> > > > In a message dated 4/5/2010 12:46:19 P.M. Mountain Daylight Time,

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>> > > > mffrd10019yahoo (DOT) com writes:

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>> > > > Diane,

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>> > > > I read that you have taught your children the importance of being

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>> > > > responsible citizens. I taught mine and am very pleased to see my

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>> > > > grandchildren

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>> > > > being given the same messages. My 14 year old granddaughter just

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>> > > > made a

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>> > > > proposal to the Headmaster of her school to allow the students to

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>> > > > wear denim one

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>> > > > day (they wear uniforms) and charge $5 for this privilege with the

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>> > > > money

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>> > > > collected going to help the victims of the earthquake in Haiti.

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>> > The

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>> > > > Headmaster responded that although he was against wearing denim

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>> > > > school he was so

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>> > > > impressed with her proposal he had to agree. 120 students raised

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>> > over

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>> > > > $600.

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>> > > > Gratefully there are future generations who will be at the front

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>> > of

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>> > > > the

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>> > > > line teaching values and responsiblity to those whose parents were

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>> > > > from the

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>> > > > 'me' instant gratification generation and did not have the ability

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>> > > > to teach

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>> > > > their children what you have taught yours.

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>> > > > Madalyn

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>> > > > Jan Patenaude, RD, CLT

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>> > > > Consultant, Writer, Speaker

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>> > > > Director of Medical Nutrition

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>> > > > Signet Diagnostic Corporation

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>> > > > (Mountain Time)

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>> > > > Fax:

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>> > > > DineRight4aol (DOT) com

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>> > > >

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>> > > > " Though no one can go back and make a brand new start, anyone can

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>> > > > start

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>> > > > from now and make a brand new ending. "

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>> > > > ~Carl Bard

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>> > > > [Non-text portions of this message have been removed]

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>> > > > [Non-text portions of this message have been removed]

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