Psychiatric News December 19, 2003
Volume 38 Number 24
© 2003 American Psychiatric Association
p. 25
Profits Matter, Not Quality
Scott D. Mendelson, M.D., Ph.D.
Roseburg, Ore.
It makes my stomach turn whenever I hear an HMO medical director such as Alan Muney of Oxford (Psychiatric News, November 7) say that the company’s main concern is quality of patient care. The only thing HMOs care about is minimizing payout and maximizing profit. The perfect example is the enormous profit being made in the multibillion-dollar merger of Anthem and WellPoint Health Networks. The November 3 Modern Healthcare reported that one of the CEOs will pocket nearly $335 million in the deal!
It makes me furious to think of all the medicine, drug rehabilitation, home health care, and other essential services that this one-third of a billion dollars could provide customers.
The HMOs make money by giving incentives for withholding care. They make money by coercing physicians to write preauthorizations for drugs that they don’t want to pay for, until it becomes so burdensome that we simply don’t prescribe them anymore. They make money by demanding exhaustive documentation to prove to their satisfaction that we are providing certain services, while knowing that we often have to forego the time-consuming extra documentation and accept lower payment so that we can use the time to ease the suffering of our patients.
We need to get these corporate leeches off our backs and the backs of our patients. We need a single-payer system.
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