October 14 - 21, 1998

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Senior Scene

By Ethel M. Austin

Although "I told you so" is the classic expression to use when things go sour, there is no joy in me to read day after day in the papers or hear on the TV or radio about the plight of HMOs. Whether it is the sad tale of those who bought out healthcare portions of reliable insurance companies for astronomical sums, are paying their executives astronomical sums to run the HMOs, or how dissatisfied the medical profession is with the interference of non-medical personnel telling them how to advise or treat their patients, I'm not happy.

From the very first I doubted how any company could pay for healthcare claims without any premiums. Since the day that Lloyd's of London insured ships cargos, it has always cost something to be able to do this. It wasn't termed a premium then, but the principle was the same. The payee gambled that the ship would arrive safely and the money paid in to supply any loss would be returned with a bonus because the money was invested in other British markets.

While today's insurance companies work on a similar premise, the HMO's have taken a part of the Federal Medicare premium and assured everyone that they would replace Medicare for seniors, give them more benefits and everything would be rosy.This low amount HMO's are getting from the government is much lower than the claims they are paying.

From the start I advised clients to hold on to their Medicare, take out a Medigap policy, join ConnPACE for medications if eligible and to readjust their budgets to make this possible. For all the coverage one can get, there is still a need to "put a little each month aside" because an illness always costs more than one imagines.

Having spent part of my working life in an insurance company, it seemed to me that those on HMO's could not benefit for long, as the negatives were against them. I was amused when I saw a cartoon which said HMO means Healthy Members Only, and while these policies do fill the gaps for seldom ill (but occasionally injured skiing, or driving or swimming) younger members, we third age members, with multiple ailments, many controlled by high medication costs, were just not really covered. In addition, many had to give up long time physicians, sometimes family members who charged them little or nothing, and had to run all over the place for pharmacies, blood labs, X-Rays or other tests they formerly had right in the office, or in the building where their long term doctor had his practice.

For those with transportation on Dial-A-Ride limited to one ride a day, these and other tests required for the doctor to make a sensible diagnosis, became a major problem.

For those who found that retirement income was even further limited by rising medical costs and who changed to HMOs now find themselves unable to get back on their old policies because they have developed serious health problems which are uninsurable.

For all these reasons, I take no joy in saying "I told you so" but certainly will help in any way I can to solve individual problems. I am available at the Salvation Army Senior Center after my vacation is over on October l9, for you to come in to see me, because each problem is different. I do not make appointments but am frequently away from my desk, so you can call after the l9th to make sure I am there when you can get to me. I hate to disappoint you, or to have you make a trip to no avail. Call 543-8405 Xl68.

Also standing by to help anyone who is dropped from a company or whose doctor drops out of the HMO and leaves them stranded, is the North Central Area on Aging Agency at 724-6443. Ask for the Choices Dept.

We both can also help those who have no health insurance at all but feel they need to look into it. Those about to retire need to explore this area carefully to make the right choice as third age members, those over 65, have a possible 30 year life span to cover.

The AARP Hartford Chapter meets next Wednesday, October 2l, at 1pm at the American Legion Post, 2121 Main Street, Hartford. Each paid up member is requested to bring the name and address of elderly shut-ins for the Holiday Season mail list by the Cheer Fund. Hartford and Bloomfield residents are the sponsors of this Hartford Chapter.
New members from these communities are invited to join. For more information please call 249-0056 or 728-339l. Also call one of these numbers if you cannot make this meeting to give them your list of shut-ins.

Talk with you next issue.

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