eftychia: Photo of clouds shaped like an eye and arched eyebrow (sky-eye)
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posted by [personal profile] eftychia at 09:42am on 2006-06-14 under

Yesterday I was thinking about the difference between how I'm treated at the city-run free clinic and how things were at the HMO that I was a patient of back when I still had health coverage. I remembered that the HMO raised the monthly premium at the same time they declared we could no longer get prescriptions filled at our neighbourhood drugs stores, but had to go to the HMO's on-site pharmacy instead. (I never did figure out what the "for your convenience" phrasing was doing in that announcement.) I remembered when they raised the monthly premium at the same time that they raised the copay for office visits. I remember when they raised the montly premium at the same time they put an annual cap on the prescription drug benefit, and again when they lowered the cap, and raised premiums again when they switched from filling two or three months worth of a prescription at a time (depending on whether it was brand name or generic) for a single copay to only filling one month worth at a time. I remember thinking, time after time, "shouldn't they be making this change or raising our premiums, not both?" And I remember how long one of the nurses, and then my doctor, was on the phone to headquarters to get them to authorize the only antihistamine that actually worked for me at the time (because HQ insisted that all antihistamines were interchangeable and therefore I could just take something cheaper).

And I started wondering whether there are organizations that are to HMOs and insurance companies as credit unions are to banks: where the patients are also all part-owners, and the organization exists to serve their needs, not primarily to make a profit for investors who aren't its patients.

Not that I could afford to buy in, but I'd like to know whether such a thing has been tried, and if so, how well it works. What would that type of organization be called, as a class? (Or was that what HMOs started out as and then drifted from?)

There are 5 comments on this entry. (Reply.)
 
posted by [identity profile] persis.livejournal.com at 02:21pm on 2006-06-14
Can you send me your snail address again?

*hugs*
dsrtao: dsr as a LEGO minifig (Default)
posted by [personal profile] dsrtao at 03:10pm on 2006-06-14
I've seen a couple -- usually called a health cooperative. It generally resembles a small group practice crossed with a mutual insurance company crossed with an HMO...

See http://www.ghc.org, which seems to have started that way.
 
posted by [identity profile] realinterrobang.livejournal.com at 03:45pm on 2006-06-14
That is an interesting idea. I think that would be a system I'd be most comfortable in, should I for some catastrophic reason have to give up my OHIP...

Speaking of cooperatives and suchlike, why hasn't the caisse populaire spread to Israel? One would think that Mr. Desjardins' invention would find fertile ground there. Perhaps when I'm a NIS millionaire, I'll move there for a while and start one.
 
posted by [identity profile] dianec42.livejournal.com at 05:48pm on 2006-06-14
It's an interesting concept. Unfortunately, while I can see what the profit model is in a credit union, I can't see what it would be for health care.

On the other hand, you could definitely get a bunch of like-minded people to club together and try to get a better deal. (Of course, I think this is how our current system started out...)
 
posted by [identity profile] aliza250.livejournal.com at 03:51am on 2006-06-15
I use a not-for-profit health-care group practice. http://www.caminomedicalgroup.com/

However, my health-care premiums go to a standard HMO.

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