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An HMO Denies Payment, Not Care

October 15, 2001

I would like to respond to words used in "Consumer Group Sues Agency" (Sept. 17). As a family physician, I have fought many a battle about--and am constantly frustrated with--the denial of coverage by insurance plans. The article referred to disputes in which patients have claimed "that their HMOs delayed or denied necessary medical care."

This way of looking at health care always makes me angry. Although I am a strong patient advocate, an HMO does not deny care but, rather, denies to pay for the care. This is a very strong difference. A patient can always pay out of pocket for whatever the patient and physician decide would be best. If a medication is not paid for by the HMO, the patient always can pay for the medication they so desperately want. A medication is never denied, as long as a doctor writes a prescription. It all boils down to who will pay for the medication.

DR. MARK DRESSNER

Long Beach

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