Δαφνη Ευτυχια Αρθουρος

"Here's how life works: you either get to ask for an apology, or you get to shoot people. Not both." -- Dr. Gregory House (played by Hugh Laurie) on the television show House, M.D. (in the episode "No Reason", aired 2006-05-23 [written by David Shore?])

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?)

Guess who just brought me a toy?

I figured something was up when Perrine followed me downstairs but was uninterested in eating while I had my own breakfast. My guess was right: she'd detected something and was more interested in hunting. A few seconds ago she came upstairs and dropped a mouse on the bed, a juvenile with big ears. But this one was stunned or scared enough not to run away when she dropped it and looked away, so I was able to capture it before it reached anyplace that Perrine and I can't get to. *whew*

Now she's distracted by a bird chirping outside the bedroom window.