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Washington Takes Aim At HMOs

People once went to the doctor worried what ailment they might have. But for 67 million Americans enrolled in HMOs, the main worry can be whether their insurance will pay for treatment, reports CBS News Chief Washington Correspondent Bob Schieffer.

As President Clinton heard during a trip to the American Medical Association Headquarters, the worry can be well founded.

"I think the hardest part of my job is facing a patient and telling them your insurance plan has told us you're denied coverage," said medical billing manager Carol Anderson.

On Capitol Hill, it was also a day for HMO horror stories. Dr. John Hankins, an oncologist, told Democrats how an HMO refused to hospitalize a man with lung cancer and then "tried to have the patient travel sixty miles a day to get intravenous injection."

Democrats arranged to air all this because they pushing an election year plan to reform HMOs.

Not to be outdone, Republicans unveiled a rival reform plan at a crowded news conference. Sen. Don Nickels [R-Oklahoma] said the GOP plan would "make sure that patients have their choice of physician, make sure that patients can get in the emergency room, make sure that patients are able to see their OBGYNs and pediatricians without going through a gate keepers."

The Democratic plan covers many of those same points. The big difference is that the Democratic plan makes it easier to sue HMOs.

Most HMOs oppose both plans and are bombarding the airways with commercials claiming reforms would drive up health care costs.

"When politicians play doctor real people can get hurt," says one ad.

However, some of these reforms could actually pass. It's a long shot for sure, but it is an election year and the politicians have discovered that Americans hate HMOs almost as much as they hate the Internal Revenue Service.

Reported by Bob Schieffer
©1998, CBS Worldwide Inc., All Rights Reserved

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