Capitation and HMOs

Capitation and HMOs

“Managed care, as we know it, is inherently unethical in its organization and operation. We have an industry that can exist only through flagrant ethical violations against individuals and the public."
- Dr Linda Peeno, May 30, 1996
Such harsh words may seem appropriate and expected coming from a vehemently anti-Managed Care activist. But they transform into a powerful indictment of the HMO industry when it comes from an insider. Dr Linda Peeno gave this statement as a part of her testimony before the U.S. House of Representatives Committee on Commerce on May 30, 1996. She had worked as a medical reviewer at Humana, as the medical director of a 35,000 member HMO, a medical director at a hospital, and as a physician executive at Blue Cross/Blue Shield of Kentucky. In her own words, "Whether it was non-profit or for-profit, whether it was a health plan or hospital, I had a common task: using my medical expertise for the financial ...