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Let's Have Some Fun With H M Os
A satirical look at the dismal state of healthcare today.
I'm a freelancer currently living in North Carolina. Prior to relocating, I wrote a book review column for "Southeast Florida Lifestyles"
|AUTHOR'S OTHER TITLES (2)
A Guy Thing (Essays) It isn't always the earth-shaking things that change the course of one's life. Sometimes it's something as simple as a phone call... [678 words] [Drama]
South Florida Memoirs (Essays) The recent election fiasco in Florida didn't surprise me a bit. When I lived there, I came to realize the whole state operates under Murphy's Law. [565 words] [Humor]
Let's Have Some Fun With H M Os
Following is an interview I never conducted with the non-existent CEO of a healthcare company that, in keeping with the focus of the article, also does not exist. Or does it??
Me: You were recently quoted in the media as stating that the Healthbiz HMO, of which you are Chief Executive Officer, must raise its premiums again, as it is losing money. Records show that premiums have been raised for the past five years, yet the payout for claims is at an all-time low. Your current salary is $10,000,000 per year, not counting bonuses. Do you see any correlation between your salary and the HMO's lack of funds?
CEO: No I don't.
Me: It has further been reported on national news that while the denial rate for claims is at an historic high, Healthbiz has made millions of dollars in contributions to recent political campaigns. People are wondering if this is why the issue of healthcare reform is not being addressed more aggressively by the current administration and in congress. If this is the case, aren't the contributions akin to "hush money?"
CEO: Ha ha. We prefer to refer to the contributions as simply, "Insurance for the insurers!"
Me: An anonymous tipster, formerly an employee of Healthbiz, has stated that your Medical Claims Reviewers are given orders to unequivocally deny a certain number of claims per month, regardless of the validity of the claim. This person further stated that your reviewers use computer software specifically designed to find additional loopholes in policies already so obscure as to make claim payment next to impossible, in order to deny legitimate claims. Is this true?
CEO: Actually, we don't deny claims. We prefer to say that we fail to approve them.
Me: But isn't that the same thing?
CEO: (Cough, cough)
Me: Would you like to answer the question?
Me: We were also told by the former employee that your Claims Reviewers are known by company insiders as "The Grim Reapers," and that they wear hoods on the job. Is this true?
CEO: Ha ha. Good one.
Me: So, is it true?
CEO: (Ahem. Cough, cough.) What's your next question?
Me: We have interviewed several doctors who accept patients covered by Healthbiz. These doctors have stated that you have "Field Representatives" who routinely visit their offices in order to explain new Healthbiz HMO policies. These doctors have said some of those policies seem somewhat unreasonable. One example cited was that combination multiple-amputee/quadruple heart bypass surgery is now considered to be an outpatient procedure and should, in fact, be performed in the doctor's office. Would you care to explain how your organization came up with this policy?"
CEO: No, I would not.
Me: Our anonymous tipster/former employee also stated that on Friday afternoons, your supervisors routinely go through the claims reviewing department, picking up unopened claim files and throwing them in the trash. Would you care to comment?
CEO: That's preposterous! Completely untrue!
Me: So you're saying that Healthbiz Supervisors do not throw claim files in the trash.
CEO: Of course not. That's what shredders are for.
Me: I see.
Me again: Are you and your family enrolled in the Healthbiz HMO?
Me: I asked if.....
CEO: I heard you. That's a very good question.
Me: And your answer...
CEO: As I said, that's a good question.
Me: Have you ever considered getting into politics?
CEO: I'm afraid that I'm going to have to terminate this interview. I'm running late for a Board of Directors meeting.
Me: Oh, may I sit in?
CEO: That would be impossible.
CEO: It's in Switzerland.
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"I thought this essay was hilarious. It was even more so since I worked with HMO's on a regular basis at a previous employer. I really thought it was entertaining and I am going to show this to some friends to look at also." -- Emcee Teacup.
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© 2001 Georgia Kraff
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