Health Maintenance Organization News
"The Civil Rights Movement of this decade is Mental Health Care quality and equality."
-- Updated November 15, 2003 --

      Welcome! 

    The mission of this page is to provide links to news and information about health maintenance organizations and health insurance.

    If you want to read about single-payer or universal health insurance issues, please go to our Universal Health Insurance Web page.

      The Individual Insurance Market is Rough and Tumble.

    If you are a full-time employee, you have many more options for healthcare coverage. For the self-employed and the unemployed, the process of obtaining healthcare coverage is daunting and full of challenges. Below are a few links to information and resources regarding the individual insurance market and the so-called "high-risk" pool.

    Haven't heard of the "high-risk pool"? In Dr. Sterling's opinion, the term "high-risk pool" is very misleading. When people who score 283 on an extensive health questionnaire are lumped in with people who can score as high as 2,000 points or more, the term "high-risk pool" is much too broad to be representative of "high" risk.

    The fact is that the current high-risk pool scoring includes mild risk, moderate risk, and high risk. The bar has been set so low for so-called "high risk" that the whole classification procedure smacks of a process highly-biased to allow insurance companies to maximize profits at the expense of consumers. Dr. Sterling sees such a biased classification process as a form of corporate welfare. It is Dr. Sterling's hope that a coalition called "Fair Play in Health Assessment" will target this practice of "cherry picking" and push for a fair classification system that includes mild risk, moderate risk and high risk pools having different and appropriate coverage premiums.

    Some links to articles that spotlight the controversy:

    Some links to Washington State health care insurance resources:

      News Reports and Articles.

    We cannot guarantee that our list of links will always contain the very latest news about the health insurance industry or health maintenance organizations. If you want to do more research and find more articles about health maintenance organizations, we recommend that you visit the Google News Search Engine page and type into the search box the words "health maintenance organization" or a similar search phrase. You will get a comprehensive list of the most current articles from a large number of publications.

    • Washington Post article posted January 15, 2003 -- Court Hears Arguments on Kentucky HMO Law. At issue in this case is a Kentucky "any willing provider" statute, which, like similar laws in more than a dozen states, requires HMOs to let patients see any doctor willing to meet the health insurer's conditions for participation in its network, whether the HMO selected that doctor for the network or not.

    • AMA News article posted January 15, 2003 -- Managed care easing gatekeeper hassles. Thanks to physician and patient pressure -- and the realization it wasn't saving money -- some plans stop requiring patients to get referrals before seeing specialists.

      Thank You for Stopping By!

        - Best wishes, Ron Sterling M.D. (Seattle, Washington, USA)


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RON STERLING, M.D.
Phone: 206-784-7842


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