Dumped By The HMO's

Carmen Torres is desperate to find her parents a new HMO after their current provider, Oxford Health Care, dumped them.

CBS News Correspondent John Roberts reports for Eye On America.

"Its just cold-hearted. It s like to me they don't care, this is it, you re out of the plan," says Torres.

Her healthy father could find another provider, but no other plan will take her mother, because she needs expensive kidney dialysis. She could go on traditional Medicare, but unlike an HMOs, it doesn't cover prescriptions.


"Only for medicine I need about $500 dollars a month," says Antonia Torres.

Add to that co-payments for hospitals and doctors and her monthly bills approach $2,000. They can't afford it, but daughter Carmen wonders: What's the alternative?

"I mean, do I let her die?" says Carmen, "I don t think so."

Turning Medicare over to managed care seemed like a good idea at the time--saving patients and taxpayers money. For HMOs, it opened up an untapped market...a market they aggressively pursued with a seductive ad campaign..

"How would you like comprehensive health coverage with no additional premiums for comprehensive coverage....Hey! I like that idea.."said one ad.

But when Congress put an end to years of double-digit payment increases to HMOs to help balance the budget, seniors went from asset to liability.

New York's Medicare Rights Center says across the country, 450,000 seniors are being dumped. Fifty thousand may not find a new provider.

"Congress should have thought long and hard before it allowed the HMOs to come in and enroll a lot of seniors and people with disabilities," says Diane Archer from the Medicare Rights Center, "and then let the HMOs say 'we don't want you anymore--you're not making us enough money.'"

But Karen Ignagni, lobbyist for the HMO industry says budget cuts gave many health plans no choice.

"We were at a point where the payments were not at all covering the cost of meeting the needs, which are very complicated as you know, for this population," says Ignagni.

On one point everyone agrees. Unless Congress comes up with a remedy--and soon, many more seniors will find themselves without adequate healthcare, just when they need it the most.
  • CBSNews.com staff CBSNews.com staff

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