Two Sides to Health Organization Issue/health Care Industry Moving from a Social Service to Business

Article excerpt

Many thanks to Joyce Ostergren of Excelsior, Minn., for her letter reminding me that there are two sides - minimum! - to every issue. She was responding to my December column that discussed medical care options. In it I wrote about some of the benefits of health maintenance organizations - commonly called HMOs.

Joyce Ostergren writes that the organizations are not always ``dandy.'' She says, ``It all depends on what comes first - money or the individual. Maybe you agree that older people should get out of the way - they cost too much.''

Well, Mrs. Ostergren, I certainly don't feel that way at all. In fact, I believe that any doctor, or HMO, or administrator of any other kind of health care program who feels that way, is out of touch with the real world.

We are becoming a society of older - or shall I say more mature - people. One of every six Americans is over 60 years of age. Every year, 2 million more people turn 60. This constitutes a large - and influential - share of our population, both economically and politically.

Mrs. Ostergren was thoughtful enough to send along some articles and information that present another side of organizations. One was an interview with Dr. Arnold Relman, who has practiced medicine for 40 years and is editor of The New England Journal of Medicine. The good doctor emphasized in the interview that he spoke for himself, not for the Journal.

Dr. Relman believes the health care industry is moving away from providing a social service and toward being a business. As a business, the goal is to make a profit or return a dividend to investors - not to provide the best medical care possible.

Several current issues highlight this new trend:

- One, health maintenance organizations often carefully screen patients to make sure they do not have a serious illness. In fact, the illness doesn't even have to be serious; I recall reading about a man who was rejected because he and his wife had been seeing a marriage counselor. …

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