When you come down with a costly illness, such as cancer, it’s not in the HMO’s interest to admit you have it or to treat you effectively. With a terminal disease, the longer the organization delays treatment, the less it will have to pay to care for you. My mother died hideously in an HMO; there was little we could do to help her because my parents did not have thousands and thousands of dollars to take her to competent and caring doctors outside the group. She would have died anyway, but she did not have to suffer the way she did. She should have had palliative care, but that was not forthcoming because her doctors obfuscated, put her off, delayed diagnosis, and did all they could to avoid treating her.

A friend whose breast cancer symptoms were obvious was treated with courses of antibiotics for three months before an HMO doctor got around to ordering a mammogram, giving the disease plenty of time to metastasize. It’s SOP to do a mammogram when a woman has a breast lump and a discharge…unless, of course, you’re cutting corners.

The fact that your health is good today doesn’t mean that it won’t change tomorrow.

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