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A Times Editorial

Time for consumers jilted by HMOs to organize

© St. Petersburg Times, published July 21, 2000


If you're one of the 9,800 people being abandoned by one of two health maintenance organizations who no longer want to do Medicare business in Hernando County, you probably have plenty of questions about how you'll receive HMO services after the first of the year.

You also may be compelled to express frustration at, in no particular order, the insurance companies' money-motivated coverage areas, their unwillingness to accept clients in less-populated counties in Florida, or the reluctance of the state and federal governments to undergo meaningful reform on this very complex health-care issue.

But unless you have very specific questions about what medical procedures are covered under Medicare A or Medicare B, you probably shouldn't show up at the Hernando County Fairgrounds today expecting to get any answers, or satisfaction from venting, about AvMed Health Plan's or Humana's decision to drop clients in Hernando County.

At 2 p.m. today, representatives of SHINE (Serving Health Insurance Needs In Elders), which is a volunteer group under the umbrella of the state Department of Elder Affairs, will host a meeting to disseminate general information about Medicare HMO rules and coverage. It is the second such meeting in the past week. The first was held last Friday at the Spring Hill Enrichment Center on Mariner Boulevard, and it unexpectedly turned into a rally of about 200 people who were angry they could not get more specific answers about the impending loss of their Medicare HMO coverage.

Some folks in the emotionally charged crowd took out their frustrations on the SHINE volunteers. While understandable, it was inappropriate for them to misplace their anger at a handful of people who were simply trying to help their neighbors navigate the bureaucratic abyss of Medicare.

Those who attend today's meeting should not repeat that bad behavior.

Nonetheless, that doesn't mean jilted consumers, or anyone else who is fed up with inaction by their elected officials on this issue, shouldn't attend the meeting. At the very least, it will be an opportunity for people with common problems to meet and compare notes on the subject. At least one newly formed group, Florida Citizens to Keep HMOs, will be at the fairgrounds today collecting signatures on a petition that will be forwarded to state and federal representatives. The group also wants to work with people in other counties where Medicare HMOs are pulling out.

There are no simple answers to this national dilemma, or quick solutions to responsibly regulating the widely inconsistent reimbursements from the federal government.

But there is nothing to prevent taxpayers from insisting that Congress accelerate the debate. And, because this is an election year, it gives voters even more leverage to force the discussion.

The almost 10,000 people in Hernando County who are losing their coverage have the opportunity to help shape the debate.

They should do so thoughtfully and with determination, beginning with a forum with representatives from the HMOs, the federal government, area doctors, the state Insurance Commission and the governor's office.

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