Managing Your HMO

Almost as certain as death and taxes is the fact that at some point in your life you will be faced with dealing with a health insurance company. Sometimes the experience is relatively painless, but for many people processing a claim is like competing in a decathlon: only the fittest who can negotiate the complicated obstacle course survive and eventually get their claim paid. Skyrocketing medical costs during the 1970s led to the formation of Health Management Organizations, or HMOs, which promised high quality health care at a reasonable cost. But twenty years later, patients and physicians are wondering who is managing the patient's care, the physician or the insurance company? And who benefits in the end, the patient or the insurance group? This entry from A&E's Investigative Reports series examines the current health system in the United States, and its limitations and shortfalls, introducing viewers to the various players within the system: the physicians who face enormous challenges working within a complicated bureaucratic labyrinth; the patients, who are tired of having to fight for every dime of coverage they receive from their insurance providers; and the lawyers who are trying to make a difference. More of an exposé of the healthcare system than a "how to," the dispiriting bottom line of Managing Your HMO is don't get sick in the first place, and may heaven help you if you do. Recommended. Aud: H, C, P. (L. Stevens)