I’ve just signed on to Group Health and my experiences so
far have been good. However a couple of times since doing so, I’ve
heard it referred to as “Group Death”, but was unable to get an
explanation for that. Can someone tell me where this idea
comes from, ideally in such a way that I can look up some articles?
When I was an editor at Health Sciences, I had Group Health Coverage (a
choice between that & Blue Cross, my progressive politics tricked me into
thinking a members coop would empower members the most). This was way back
in their supposed “heyday” of the 1970s, when they were already called
Group Death, already restricted doctors’ prescription options to the
cheapest & often least effective drugs forcing some doctors to send you to
independent pharmacies to pay for it yourself rather than covered as
promised, had “membership” meetings in the Tacoma Dome pretending to care
about “us” for more than our membership fee (which cost the same OR MORE
than any other medical insurance unless ones employer paid the bulk of
it), put you on an assembly healthcare line, with doctors & nurses coming
& going so soon there was very little continuity of care from visit to
visit, some older entrenched doctors smelling like cigars & having the
bedside manner of an Ambrose Bierce, & it was a pain in the ass to
remember to figure out before each vacation where the coverage would apply
if one had an emergency in another part of the world.
I remember an emergency with a friend who broke her leg in the fall in the
forest, & we could’ve gotten to a doctor in a ten minute drive to the
nearest town, but she was so bamboozled & afraid of Group Health’s limited
coverage that we drove for two hours with her foot twisted half off & held
together with the piece of string & two twigs I rigged up so she could
even crawl back up the trail to the car.
Group Death was merely an echo from the future of heartless HMOs whose
bottomline mentality seeks mainly to figure out the ratios between “as
little care as possible vs number of lawsuits for refusing care.” All
Group Death had that later HMOs never had were those mass-meetings at the
Tacoma Dome which was just a trick pony show anyhow.
I often hear about the good ol’ days when Group Health really was a
MEMBERs’ coop. I’m willing to believe it’s even worse now than then, but
it was always rather dreadful & anyone who compared care at Group Health
with care at Mason or anywhere EXCEPT the even worse veteran’s hospital
ended up kinda sad they only had Group Health. And when I stopped working
for the University & unable to afford the high cost of continuing with
Group Death, I had to rely on Country Doc thereafter — that was the first
time I experienced concerned, professional care.
Group Health is alright if you have simple medical problems with simple
solutions, especially when it can be addressed by a nurse practitioner
instead of a doctor. If, on the other hand, you have more complex issues
that requires a considerable amount of time with a real doctor (or worse,
a specialist!), you’ll soon learn where “Group Death” came from.
This isn’t to say that all of Group Health is bad. There indeed some
excellent doctors there. The optometry department and See Center are
quite good.
But Group Health does have it’s problems. Among other things, they are
very fashionably politically correct. A few years ago, they labelled all
their facilities as “gun-free zones”; a harmless bit of silliness except
for one thing. It turned out that some of their patients are hunters with
prescription shooting glasses and scopes, and the doctor needs to work
with the patient and the rifle.
They also get involved with politics a lot, and spend a great deal of
money on political advertising and lobbying.
They are obsessed with using the very cheapest medication. Never mind
that the price differential is inconsequential and the cheaper medication
isn’t as effective. Group Health will switch its formulary to the cheaper
medication and force patients to switch. Then, when the cheaper
medication is proven not to work (and you are forced to stick with it for
some time), you get hit up with the extra charge for non-formulary.
There was quite an uproar when they switched their GERD patients from
Prevacid to the much-less effective Protonix — all to save less than $10
on a $300 prescription.
There is a real problem with getting a problem escalated. If you’re not
the sort who makes waves, you can spend *years* suffering with a problem
because the nurse practitioners will fart around with treatment that isn’t
effective and won’t escalate it to a specialist.
Nurse practitioners certainly can deal with a wide variety of health care
needs. But it’s like always being taught by TAs and never seeing a
professor; after a while you lose something, and after a long while you
lose a lot.
I live on Bainbridge (“brain damage”) Island. Group Health once had a
clinic on the island. They closed it and moved the doctors to Poulsbo (a
good half-hour’s drive away) but let us transfer to the VM clinic on the
island (basically, using Group Health as health insurance instead of as an
HMO). This was a net improvement since VM is vastly superior in every
way. But Group Health got unhappy with the fact that most people on the
island made that choice, and sent everyone a letter saying “you’re going
to have to go to Poulsbo starting next year.” I decided to stay with VM
and thus am no longer with Group Health.