Many Share Frustration With Health Care

Re: “When Did They Take the ‘Care’ Out of ‘Health Care’?” (April 6): What a sad state of affairs when Leisure World has to hire an advocate to get people appointments with their HMOs.

Recently, I was one of the thousands of people a day having to fight my way through my HMO’s bureaucracy in order to get care. I had a broken blood vessel with severe hemorrhaging from my nose for several days. My general care physician said that I needed a specialist because she was not equipped to treat me. She could offer me no help in getting an appointment with someone either. It took three days, five phone calls, and three voicemail messages before I received an authorization to see a specialist. Only because I’m persistent and feisty was I able to wrangle an authorization code from her. Why should I have to fight for health care I pay for?

Fortunately there is a bill that passed the Assembly Health Committee on April 8 that would address this problem. AB 497, authored by Scott Wildman (D-Glendale), would guarantee patients timely access to health care. It regulates how long HMOs can keep you waiting on the phone and guarantees access to specialists in a timely fashion as well as other key response times. Let’s hope this bill makes it all the way through the Legislature before we all have to hire intermediary advocates to get appointments with our HMOs.

KAREN FATTA

Los Angeles

*

Lynn Smith’s frustration with health professionals I am sure is shared by the majority of patients and the caregivers of the patients who have been thrust into the HMO system of “health care.”

I agree the system isn’t working. While reading about Smith’s mother’s illness, I had the unsettling vision of just what she described happening in my office.

I am trying to see more patients per day than I ever have before in my 23 years of practice while deluged with forms, rules, reports, restrictive formularies, guidelines, authorizations, authorization denials, and complaints (“even the smallest”) to respond to “in writing within five days.” I never leave the office before my family has already had their dinner. And, I am certainly not unique.

Physicians, nurses and pharmacists are the same professionals who have been trusted for many years before HMOs came along. “Care” is under the rubble of the HMO system, where we “providers” have allowed ourselves to be buried.

DR. DAVID ABRAMS

*

I can share Lynn Smith’s frustration. I manage a company that specializes in wound-care treatment, and we must deal with managed-care companies daily to get approval to treat this predominantly elderly population of patients who have chronic non-healing wounds.

We have data to prove that we have saved hundreds of patients’ limbs from being amputated due to our treatment methodology. It is sad, but true, that in many cases we are denied access to these patients and they end up losing a foot or leg. We are told that it is cheaper to go ahead with an amputation then to try and heal the wound, in spite of all our supporting data to prove otherwise. It is frustrating to see this happen and we must live with this daily.

As Smith pointed out, the elderly are hurt the most. They are afraid to ask for the proper treatment and grew up trusting the medical profession to do what was right.

GEOFFREY MOSDALE

Santa Barbara

*

At my doctor’s appointment yesterday, I brought up Lynn Smith’s article. The doctor chuckled and said, “Did you hear the one about CIGNA? Stands for ‘Call In Get No Appointment.’ ”

Assembly Bill 497 would force HMOs to respond to phone calls and give appointments to specialists in a timely fashion. So call your state legislator and let them know how fed up you are.

JOAN PIRKLE SMITH

Los Angeles