01/09/1998

Health Maintenance Organizations (HMO) in the U.S.

Hirosuke Iwasaki 

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Introduction

In a telling scene from the movie As Good As It Gets, Helen Hunt portrays a single mother whose son has frequent seizures. To spare her the agony of rushing to the emergency room each time, an interested suitor played by Jack Nicholson hires a doctor, who does some simple tests on the son. When the son turns out to be allergic, the doctor asks the mother why the tests were not done earlier. The mother angrily replies that her HMO would not pay for the tests.

HMOs are a type of private health plan that has grown rapidly due to their relatively low premiums and high quality of care. But as the movie suggests, HMOs are not without problems.

In this paper, we look at medical insurance issues in the U.S., the advantages and disadvantages of HMOs, and pending legislation in the U.S. Congress to regulate HMOs.

Hirosuke Iwasaki

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