Before all the HMO-PPO alphabet soup, health care insurance was fairly easy to grasp, like quantum physics. Now, it’s really complicated, so I decided to seek enlightenment for my readers.

To research the subject, I sought informed and reliable sources. The internet is widely known for its authoritative information---for example, chat rooms for alien abductees---so I searched the web and immediately scored with an exclusive interview. Then I borrowed some questions from an anonymous internet source and I was ready.

The exclusive chat room interview was with John Brown, a knowledgeable CEO of a well-known HMO, and the following is the transcript.

Me: What does HMO stand for?

JB: The acronym is for Healthy Men Only. The genius who dreamed it up knew that women demand too many health care services, and dang it, they live longer, too. But, since so many men have wives and daughters, it was later deemed necessary to cover females despite the cost.

Me: Now for some details. Do all diagnostic procedures require pre-certification?

JB: No, only those that are actually useful in diagnosis.

Me: What is pre-certification for exactly?

JB: It reduces costs for our members. Studies show that most people would rather suffer without costly treatments than endure the hassle.

Me: What’s involved for the health care provider?

JB: They fill out the standard 25-page questionnaire and drive to our corporate offices for further illuminating questions.

Me: Why not use a phone?

JB: We can’t shine the illuminating light in their eyes unless they come in person.

Me: Oh. Do you handle any pre-certs over the phone?

JB: In rare cases, we accept the 50-page questionnaire in lieu of interrogation. They can fax it in and wait on hold to speak with our pre-certification representative. He’s on duty two days a week after buffing the floor.

Me: If I join a new HMO, how difficult is it to choose the doctor I want?

JB: It’s as easy as choosing your parents. Your HMO will provide you with a book listing all the physicians who were participating in the plan as of the print date. These doctors fall into two categories---those who no longer accept new patients and those who’ll see you but are no longer participating in the plan.

Me: What did you think of Hillary Clinton’s government health care plan?

JB: Not much. Our plan is member-friendly; theirs was really complicated with lots of rules and restrictions. I did like their ten-tier gate-keeper idea, though.

Me: Can I get coverage of my pre-existing conditions?

JB: Absolutely, as long as they don’t require treatment.

Me: What if I want to try alternative forms of treatment?

JB: You mean, like, a stay in a hospital?

Me: No, I meant experimental drugs, chiropractic care and so forth.

JB: You’ll need to find alternative forms of payment for those.

Me: What happens if I get sick while traveling?

JB: Try Dramamine.

Me: What I meant was, what if I’m away from home and get sick?

JB: We don’t recommend it. Your primary care physician probably won’t make an out of town house-call. It’s best to wait until you return home to get sick.

Me: What if my doctor won’t refer me to a specialist when it seems appropriate? Can a general practitioner really perform spinal surgery in his office?

JB: It depends, but given the cost difference, why not let him take a stab at it?

Me: Will health care be any different in the next century?

JB: No, but if you call right away, you might complete the pre-cert screening by then.

The interview was interrupted by some guy looking for the alien abductee chat room. Amazingly, Mr. Brown knew the URL address.

If you need further information on HMO’s, you can reach him by email at [email protected].

Copyright Ó1998 Steve Scroggins - All rights reserved.