I'm a member of HMSA, but I don't approve of some of their tactics. They've demonstrated a measure of sneakiness or worse far too often, such as their optional "confidential" surveys of physicians...

and there was Dave's quote of the week (March 7, see link on bottom):

… "from state Rep. Josh Green on HMSA boss Robert Hiam's $35,000 pay raise and $503,511 bonus last year even as the medical insurer lost $22.6 million:

"HMSA's list of excesses is long and disturbing: inflated executive salaries and bonuses, big spending on advertising, lobbying, and government relations, an under-funded charitable foundation and investments in for-profit enterprises with tax-free income."

With flak like that, lucky for Hiam that rolling in dough is a great stress reliever. "



P.S. Nice to see that Jennifer Diesman is a registered lobbyist- so that's what they do!

http://blogs.honoluluadvertiser.com/volcanicash.php?blog=10&page=1&disp=posts&paged=3
http://www.state.hi.us/ethics/noindex/lljan08.pdf

Seriously. Green needs to get off his high horse with the mentality that HMSA is the root of all evil and that if he can make them pay him--I mean doctors--more then voila! medical "crisis" solved! get real buddy.
Sure he'd rather HMSA go talk to him about healthcare issues but have you seen this guy?! It seems impossible for HMSA to have a civil conversation with him because all he does is raise his voice and call names and by returning a gift he is just showing his lack of class. It's not like HMSA hand-picked his name and said "hmm today let's just send this cooler & plant to Green." NO! a lot of people got it! get over yourself.
In regards to the above post about "confidential" surveys, how is that being sneaky? If a vast majority of patients have issues with a physician wouldn't you want to let someone know so something could be done? wouldn't you want to make sure that the physician is meeting the standards required to be a participating physician? I know I would.
And for crying out loud would they stop trying to make it seem like executive salaries are the reason doctors don't get paid what they could be making if they were in the mainland? Anyone who has been following this situation would know that the Hiam's salary is paid from the reserve;money that HMSA has accumulated through investments which has NOTHING to do with member dues or causing the healthcare problems we face.
Enough already!

Senator Green is right on! HMSA is the root of all evil. If you're not a doctor, you simply do NOT know. Most lawmakers are NOT doctors and do not know the intimate on-goings in running a private practice or a medical institution. They monopolize Hawaii's doctors by keeping them hostage to their low fee schedule, optional confidential reviews, have the audacity to dictate what is covered/apyable and what is necessary for patient care and to PAY their execs half a million dollars and still claim a loss? Reserves or no reserves...use THAT money for advertising, not 'our' investment into our insurance. Whatever!

Because of this, docs are either leaving, packing their bags, or choosing to opt out of insurances and take cash only. We doctors sometimes wait more then 60days to get paid by insurances... including HMSA as they are the state's largest provider. Actually, for the last decade AMA has been fighting Capitol Hill about Medicare reduction of fees by 5%. Umm...hello? Inflation? We are overworked and underpaid already, and you want to CUT our pay? I don't think so. Good doctors will continue to dwindle, and international doctors will come in and take whatever the pay they are giving.

So, Mr. GetOverYourself, until you know what it is like to be told what to do by some telephone person with a high school education on how to treat a child with cancer or get paid 6months after a surgery you performed, and still get sued for... it simply is NOT right.

The hay days of doctors being paid well have been long gone. My patients realize that we make peanuts and risk plenty, and are very sweet to bring treats and gifts to lessen the burden. Guilt felt, they should NOT have to...they are indirectly paying for a service.

In the 90's, docs were considering the unthinkable - a 'union' for doctors. Could you imagine docs going on strike and refusing to treat a sick person? That goes against our Hypocratic Oath. But what is this capitalist country doing to us?

There simply needs to be a compromise in TORT reform and fee schedules. (Rep. Waters?)
The biggest problem is business is business. How to buy good health?

The phrase "holier than thou" keeps running through my head...

Yes, HMSA is the cause of all our doctors' woes. Unless it is high malpractice insurance premiums. Or low Medicare/Medicaid reimbursements. Maybe drug prices. Still, HMSA should be lowering premiums instead of wasting money on all those basil plants.

I'd love to walk through Dr. Green's office to see if he has any of those cool pens, magnets and post-it notes with drug names on them. Or is it okay to take freebies from pharmaceutical manufacturers, just not insurance companies?

DrP,

I beleive that everyone at some point HAS had someone with "a high school education" tell them what to do. If I call a customer service line regarding my computer I'm lucky I get someone who speaks English well let alone have advanced education. You mention being told what to do by these people and how to treat a patient but shouldn't that be decided by the patient & doctor?
Getting sued and being slapped with malpractice suits are an unfortunate thing especially considering the amount of work, knowledge, skill and time that our doctors put in for each of their patients. That's why tort reform would be a good thing and would probably help with the retention of doctors here as well. NOWHERE in my post did I say that getting sued was right so please, do not imply that I said so. The legal issues also have nothing to with HMSA and the member dues. Whether HMSA pays doctors 110% or 10% will not stop the patients from doing what they will do.
My point is that the price of everything is going up whether we like it or not. But supply and demand; if we need a certain drug we have to buy a certain drug and it's not any one person's fault that it costs more now than it did in the 90's. Anyone who decided to become a doctor for the money (in my opinion) did it for the wrong reason. It's easier to point fingers and say that since the insurance company pays the doctors when services are used, it's the insurance company that is at fault for the doctors not making what they could in another state. Everything is going up except for the salaries of the working class but Green has taken this to a whole new level and when viewed from the eyes of the public, his behavior comes across as ridiculous and uncalled for.
Hopefully some sort of compromise can be made because it would be very unfortunate to lose much-needed doctors based on pay. But let me tell you I don't believe that this is an issue just between HMSA and doctors, it has to go much higher.
And it's the Hippocratic Oath, not hypocratic.

I appreciate DD's blog and each of the coments... but it is really quite simple.

Everyone involved in healthcare in Hawaii, including each hospital, virtually every provider, the other insurers and too many patients, know that HMSA bullies everyone financially and from a policy standpoint.

This is why as Health Chair I decided I had to stand up to them.

If I sometimes sound angry it is because I know the tragic and personal stories of patients, as a doc and as a legislator, first hand. In many cases a more responsive HMSA (who rules Hawaii's market) could have helped these people greatly.

They do many great things at times - and they also display terrible excesses too often.

In the end, I hope that they will step up to the plate and help rather than hinder the necessary changes that could be enacted to improve healthcare in Hawaii, esp. on the neighbor islands.

Sincerely,

Josh Green M.D.

Oh, I know its the HIPPOCRATIC OATH by Hippocrates during times of ancient Greece. I took it passionately, and perhaps too seriously.

I simply addressed you as you seem to disrespect the motive of Doctor Green, but after your explaination, you were disagreeing with the tactic of Dr. Green the Senator.

But I meant what I said, hypocritical oath... as in HYPOCRISY.

The "Oath" is an oath that many of us have taken pertaining to the "ethical practice" of keeping people alive and well, however, business as usual has turned this whole business of keeping people alive and well a hypocrisy. We don't get paid to take call, we get called at all hours of the night, we get paid 40% of our charges on an average of 3 months later. All because these health insurances claim bundling charges, missing a decimal point, etc. Who would take on such a job anymore? Because of the "oath" we continue to see patients even though we're not getting paid. We continue to lose the battle against inflation. We continue to risk our necks for a lawsuit. We continue to struggle as a profession.

We continue to live the hypocrisy, as we try to better the health quality of the lives of those we treat while we struggle to keep our business' afloat. Think about it, in these hard times, would anyone in their right mind would take on a job, knowing that they'd have to wait 3m+ to get paid.

We love what we do, but it shouldn't have to be a cross to bear! That is why so many of my colleagues have left anymore!

Err - correction, I meant Representative Green