HMO Books

One family's fight to reform the medical system is documented in this excellent, but gut-wrenching book. The author, Dorothy Cancilla, a bright and feisty woman, who learned the hard way how callous and incompetent some medical providers can be. Death by HMO documents her daughter Jennifer's eight years of painful illness that eventually led to a premature and avoidable death. Jennifer died four days before her 30th birthday.

I'm amazed at how much information and detail is compiled into this 132-page book. The reader gets an education on the human body, and the tragic errors made by doctors at every turn become very clear.

Jennifer's problems began with frequent abdominal pain and vomiting. While doctors debated about the cause of her suffering, she trusted her doctor who literally butchered her by removing her pancreas, instead of her gallbladder. Jennifer, who was somebody's mother, wife, daughter and sister, tried to live a normal life around many hospital stays and surgeries. Cancilla portrays her youngest daughter as heroic. Anyone reading this book will fall in love with Jennifer, but what pulls at my heart is Cancilla's loss--a mother's loss--that never goes away. She honors her daughter and family by writing this book.

People need to know what can happen to any of us once we put ourselves in someone else's hands. We must advocate for ourselves and our loved ones. We cannot assume that the doctor is always right. We have to keep in mind that the only body we have has to last us a lifetime. We are the ones who are affected by wrong decisions. Ultimately we must consider the medical professionals as part of our team. They are expert consultants and sometimes gifted surgeons. But even the most dedicated doctors are imperfect, not God-like. Even decent medical people may be cajoled into betraying their patients by the HMO who pays their salary.

Death by HMO will surprise and dismay you. But you will be inspired by the courage of Dorothy Cancilla and her family. This story has all the elements for a great movie.

> This is a very well written and documented story of a family trying to get professional medical care for their daughter (Jenny) at Kaiser Hospital...

> Jenny's family took it for granted that all Hospitals were "100% Dedicated at Maintaining a Very High Standard and keeping all of their patients in Excellent Health"...

> Without going into detail their daughter who was in her early 20's had a medical condition that seemed to be getting worse...

> This family was in for a Rude Awakening when they took Jenny to Kaiser Hospital to be diagnosed and treated...

> What they found out is that Kaiser Hospital did not want acknowledge or admit anything was wrong with "Jenny" and Refused to provide the Correct Diagnostic Tests that "would or would not" verify that she had medical condition that needed treated ASAP...

> Jenny's family spent the next "8" years trying to have their daughter Correctly Diagnosed and Treated at Kaiser Hospital with the end result being that the only thing "this hospital" had to offer them were Lies, Deception and Denial by repeatedly telling them that their daughter "did not" have any medical problems at all...

> What was found out later in Court by Professional Medical Experts and Doctors was that Jenny was provided with "100% Extreme Sub-Standard Medical Care" at "this HMO" starting with her very first visit...

> To put it simply: This young lady could have been Diagnosed - Treated and Cured by the Lowest 10% of the Graduates fresh out of Medical School because as it turned out Jenny had an Elementary Medical Condition that could have been Easily Diagnosed and Cured with Proper Professional Treatment...

> After Eight Years of "Extreme Sub-Standard Medical Care" at Kaiser Hospital and combined with Six Un-Needed Operations: Jenny Died a Horrible Death at the young age of "29 Years Old"...

***** THE FOLLOWING IS WHAT "YOU WILL LEARN FROM THIS EXCELLENT BOOK":

#1 The Red Flags that will tell You to change Doctors or Staff and get an Outside Second Opinion...

#2 To be able to Locate the "Many Great Doctors" that are available at Kaiser Hospital...

#3 To Understand the Fact that you have Zero-Support from some HMO's...

#4 I know that it is a "Known Fact" that there are some "Doctors and Staff" at "This Hospital" who Do Not care at all if you Die or Severely Damaged by their Major or Minor Medical Malpractice Mistakes and they will do nothing at all to save you - Rather than admit they made a Serious
Mistake and Save You - They will keep this a Complete Secret...

#5 Also Keep in Mind that there are "Many Great Doctors and Staff" at Kaiser who have Perfomed Miracles and saved patients who had almost no chance at all of Surviving and / or perfomed Incredibly Complicated Operations or Treatments with Fantastic Results...

#6 It is a "Known Fact" that some very "Unqualified Doctors or Staff" at Kaiser who will: Lie, Destroy and / or Lose Critical Medical Records, XRAYS, Radiology Reports, Dr's & Nurse's Notes, and any Info. that would Show or Prove they Commited a Major or Minor Malpractice Mistake that Killed or Severely Injured You...

#7 You may think so but you WILL NOT get any Support from "Some" Outside Medical "Watchdog" groups that you are told watches out for Sub-Standard Medical Care - This gives some people a Job to get Paid to Do Nothing and they are paid by you the tax-payer...

#8 The Exception to #7 is MEDICARE - "They do an EXCEPTIONAL JOB" at making sure you are OK... >>> BUT YOU HAVE TO LOOK OUT FOR THE RED FLAGS
YOURSELF BEFORE IT IS TO LATE...

#9 Before it is to late this HMO will have to Re-Evaluate their Game-Plan and put their Members & Patients in Priority Position #1... Income and Profits should be Priority Position #2... And #3 Should be to Weed-Out Any and All Unqualified Employees and Staff and hire Only Qualified and Professional Employee's who Desire to be the "Best of th Best" in the Kaiser Hospital System...

#10 If I had to make an Evaluation of the Kaiser Hospital HMO at this time after reading this excellent book and also being a past member of this this HMO - The Words that Clearly come to Mind Are:
***** THIS HAS TO BE THE MEDICAL SCAM of the CENTURY *****...

If Denzel Washington Touched Your Heart in The New Movie "John Q" Than read.....Jennifer's Story...DEATH BY HMO...A Real Life Tragedy.

This book is much much more than one which relays the horrible medical treatment that Jennifer received "While In The Hands of Kaiser" which resulted in her death.

This book is also about an organization that is more concerned about profit and image than the lives of any of it's patients. They will lie, they will trick, they will deny care in any manner possible until it is too late to save the patient if a patient is no longer profitable to them in the long run.

President Nixon when he was considering allowing the creation of the HMO Act was advised by Mr. John D. Ehrlichman who had received information on how Kaiser is run from the then CEO of Kaiser - Edgar Kaiser. Mr. Erlichman stated "...the less care they give them, the more money they make" and that just about sums up everything about this company.

Jennifer was tortured and abused by this corporation and like countless others she and her family found the inconceivable taking place right before their eyes. Medical personnel were not performing their prescribed duties in a professional nor competent manner. The medical staff with their conduct appeared to be a bunch of bumbling fools.

The Kaiser system is intentionally set up so that the patient and their family will choose to believe that a series of errors or incomptent events is taking place. These are really premeditated actions by a corporation that has put in place a system intentionlly fraught with systemic problems to delay treatment until the patient goes away one way or another.

For anyone that would question that statement how else can you explain how a doctor that goes to school for a decade to learn to be a physician and then passes a test to get a license could be so clueless over and over again.

It simply costs Kaiser less to settle an arbitration than it would to provide proper medical care in the long run.

Jennifer's family should be praised. They had the courage, the fortitude and the belief in themselves to put aside their pain and to focus their thoughts so that the public would have the opportunity to learn and avoid the never ending nightmare that they were all forced to endure by Kaiser and the for profit Permanente Medical Group.

This book is must reading for all people. If you must do business with Kaiser then at least be aware of what their business practices are so you can avoid the eternal suffering that Jennifers family must go through.

Jennifer's death was not in vain. She has lived on in this book to tell the story of what happened and to light the way for those that will listen.

This is a very disturbing indictment of modern health care. Dorothy Cancilla exhibits an extraordinary amount of restraint in recalling the preventable death of her daughter at the hands of inept doctors and an unforgiving system.

It's ironic that a organization whose charter is to maintain people's health can actually compromise their lives when the bottom line might be in jeopardy.

Kudos to Mrs. Cancilla for having the courage to face her demons by sharing them with others.

My 85-year-old mother recently fell and severely fractured her hip. Unfortunately, she belongs to a Medicare HMO based in Southern California. Because of the nature of her fracture, she required pinning of her femur, a more extensive procedure than the usual treatment for hip fractures. The HMO which was contractually responsible for her care denied payment to the Skilled Nursisng Facility after l8 days, in spite of written reports from her physical therapists and her doctor detailing the remarkable progress she was making. Thanks to this book, we were able to appeal the HMO's denial, which was immediately again denied by the HMO. The appeal then went on to HCFA for review and the denial was reversed. This has saved my mom thousands of dollars. It should be required reading for anyone involved with HMO's!

Don't Let Your HMO Kill You is an invaluable resource which every family should have. It empowers the consumer to take charge of their and their family's health care. Drs Theodosakis and Feinberg bring both insight and useful advice to help the patient make the most of managed care. From better organizing your doctor's visit to learning how to successfully appeal a denial from your HMO, there is something for everyone in this powerful book.

Read this before you go to the doctor! It explains how to work with your doctors, rather than against them, to get the care you need. It points out why the red tape exists, why the doctors are bound by it, and how the two of you can get around it. This book should be issued to every patient. It will benefit doctors and patients alike.

This book is full of great advice for all of us who have been frustrated by dealing with an HMO. It lays out the reasons why managed care has problems, and then explains in plain language how to get good health care from a system that isn't set up to be patient-friendly. There are really good tips on how to get the most out of your plan. Instead of focusing on what's wrong, Drs Theodosakis and Feinberg tell you what you can do to make it work. They are especially good on telling how to build good relationships with the health professionals that you have to depend on within the HMO system.

As a physician who has dealt with many HMOs, I believe this will become the premier guide for people to get the best care out of whatever system they're using. It is about time someone put all of the secrets and resources in one place. Medicine has changed significantly in the last few years - right under the noses of most patients and doctors. It's caused frustration as quality care has diminished. This book will help you get back in charge. I think it should be given out by insurance plans as a guide to how patients should use the system. Congrats to the authors!

This book is a page turner. The author's story is one of courage and determination. Not only is he told he is seriously ill, but he finds his HMO offers no help. As his battle with his illness and insurance company unfolds with the pages, the reader is drawn into its intensity and overwhelming obstacles. I was amazed at the bravery of this man. He accomplished a feat few people in his situation would be willing to face. In my opinion, he is a hero. Read this book! You will find it fascinating.

Scribner's "Finding Hope" is a descriptive narrative which begins as the author is diagnosed with a rare and aggressive cancer. The reader climbs aboard an emotional roller coaster ride which makes this book difficult to put down; you'll find yourself reading it at every opportunity. Throughout the narrative, Scribner shares the difficult lessons he learned in his fight with HMO Medicine, even explicitly labeling some valuable lessons as "advice". Scribner battles the disease on any and all fronts. By "getting it together" on the physical, psychological, and spiritual fronts, Eric discovers a better way to live each day. We can all benefit from his learning and the joy he discovers in this amazing journey.

This is a warm, comforting book with gently taught lessons on how to manage with a rare cancer. The importance of finding expert doctors is gently but unforgettably remarked upon. The man has a generosity of character and spirit that makes reading this book a calming as well as an educating experience. He demonstrates by example an exemplary way of dealing with cancer, its many setbacks, and its many frustrations. WELL WORTH READING. Beg, borrow or steal a copy.

This is a warm, comforting book with gently taught lessons on how to manage with a rare cancer. The importance of finding expert doctors is gently but unforgettably remarked upon. The man has a generosity of character and spirit that makes reading this book a calming as well as a learning experience. He demonstrates an exemplary way of dealing with cancer, its many setbacks, and its many frustrations. WELL WORTH READING. Beg, borrow or steal a copy.

I highly recommend this book this book to all readers, whether ill or healthy. Mr. Scribner's true story will touch you deeply. He has the ability to draw you into his life with the written word. I actually felt I was present in many of the situations. The book is excellent and extremely informative. His factual account is awe-inspiring and offers encouragement to those who are battling their health insurance carrier as well as a lifethreatening disease. His courage in the face of overwhelming odds literally does give one "hope" when it seems there is none.

A Young Surgeon joins forces with the twentieth century's boldest industrialist in "Courage to Heal". Paul Bernstein, MD lends his medical expertise to his this medical thriller novel set in the Great Depression of one determined doctor to provide the best medical care he could in the face of a paranoid government. Enthralling from the first page to the last, it's highly recommended for fiction fans in general and any community library fiction shelves.

(Disclaimer: I am a former colleague of the author, and worked in the Kaiser Permanente system for most of my career).

Having been a Permanente physician since the days when we were close to being "persona non grata" in the local medical community, I was somewhat familiar with the history of the Medical group, but Paul Bernstein has made its humble beginnings spring from the page with a living and exciting narrative that takes the reader into the very soul of Sydney Garfield, whose name I knew as our founder, but not much else about him. Henry Kaiser is also brought into the mix as a larger-than-life industrialist who believed in what Garfield was doing and provided the capital and know-how to build the prepaid system that spans the country today---though still heavily weighted on the West Coast. I heartily recommend this book to anyone trying to fathom today's health care controversy. When you finish this book, pick up "Overtreated" by Shannon Brownlee, for a fascinating look at what has happened to American medicine, and suggestions for reform. Not surprisingly, she holds Kaiser up as an example of how things could work. And Sydney Garfield is the reason. Good work, Paul!

Who would suspect that a book about the creation of an HMO could be so captivating? I started reading at bedtime and just couldn't stop. The author skillfully weaves together fact and fiction, vividly describing scenes and characters, keeping the reader constantly in suspense. The historical images of the times before, during and after WWII are particularly striking to those of us too young to remember things like the polio epidemic. The plot conflict about health insurance is as timely now as it was then, with millions of Americans still without coverage.
This is my favorite kind of book: it is great reading for entertainment alone, and informative and thought-provoking at the same time!

This is a fictionalized account of the creation of Kaiser Permanente, the granddaddy of HMOs. Dr. Bernstein has told a fascinating story of its creation and successful rise in the face of resistance from the medical establishment. Highly recommended.

The courage to heal reads more like an adventure than a biography. Sidney Garfield, like all great pioneers, is single-minded in his quest to bring affordable health care to the people. I found it interesting to see how the concept of prepaid medicine evolved and particularly the resistance they met from the medical establishment. I particularly enjoyed the historical setting in the thirties, forties and fifties. Bernstein brings us into the dramas of medical emergencies. We get a glimpse into what that world was like when polio was rampant and antibiotics were still a novelty. This book seems particularly relevant today with so many people without access to medical care due to deficiencies of the fee for service system. I recommend this book highly.

It is obvious from the moment you begin the book that Dr. Steinberg cares about his patients and their health, and after reading his book I feel I understand how to get the most out of my HMO. Thank you Dr. Steinberg!

This is an excellent exploration of the HMO system that is taking over American health care. If you belong to an HMO, you MUST read this book -- it could literally save your life, as the many case studies of unfortunate dead patients make clear. The author gives solid, practical advice about how to get the most from your HMO. I'm not in an HMO, but I still found the discussion of the history and workings of HMOs fascinating.

My husband didn't like "the work" of wading through the information his company provided when it came to choosing a health plan, so he left the decision to me. I was overwhelmed by the information and jargon in the company packet so I was desperate for help in sorting through it. This book was the answer to my prayers. It provides the most thorough, objective information on managed care I've found without resorting to the scare tactics in most other books or articles on the subject that I've read. It really helped me understand what I was doing in choosing from the options given to us by my husband's employer. The section on comparing benefits was especially a great help. I highly recommend this book to anyone who plans to join an HMO and wants to make a good choice; or even to those who already belong to one who want to understand their plan better.

I first met Dr. Mayes during one of my visits to USA, and I had the honor to get in touch with his book "Dental Benefits" when it was still being prepared in his office in Hershey,PA. That time he told me the book will focus also the Dental PPOs, considering the exploding grow on the last years. When finally the book came published, I could confirm not only that PPOs were there, but the were many other interesting subjects related to all the business of Dental Plan in USA. The book is so completed that we invited Dr. mayes to visit Brazil and share your temendous knowledge and experience in Dental Benefits with our local market key executives. The firt Seminar of Dental Plans Management took place at American Chambers of Commerce of São Paulo, 26th and 27th of September 2002 and his book "Dental Benefits" were included for each participant of the Seminar. Since then the wook is largely used for many people, including the Agencia Nacional de Saúde Suplementar(ANS), the federal government agency for dental and health plans regulation. A significant part of Dr. Mayes book was also translated and used by ANS in the Referral Material in their first publication on Dental Plans - "Planos Odontológicos: Uma Abordagem Economica no Contexto Regulatório".
This and many other facts prove that Dr. Mayes book is not applicable for the "American Dental Benefits" , but for "World Dental Benefits" . Certainly it has a great value for the brazilian Dental Market at the present "growing" moment.

I knew afer about page 30, that Dr. Lesser had the right approach and outlook for me. His book is so insightful, he nails the problem with regards to modern-day practice of western medicine and then offers alternatives. And not from some new age nonsensical perspective, but from a lifetime of successful medical practice. I need to read it again after I read his now out of print "Growing Younger."

As a journalist, not a health service provider, Mr. Anders brings credibility to his examination of our current health care system. His matter-of-fact style and even-handed presentation of the abuses of the traditional, fee for service model, the positive strengths of managed care, and the responsibility of the consumer in building a workable system further enhance his credibility. In this broad review of health care, Mr. Anders points out that the initial goal of managed care was to secure high quality, affordable, efficient health care by making sure patients received the right treatment by the right provider at the right time. He credits HMO's with redirecting medical priorities to preventive care away from costly, late-stage care. Mr. Anders discusses how the well-intended but inappropriate application of traditional business practices accidently created powerful loopholes and incentives for abuse, in part, because consumers and purchasers were naive about the great potential for unethical profiteering by managed care. The organization of the book makes the complicated issues in health care more understandable. Complex issues are discussed in separate chapters organized by topic areas such as emergency care, medicare and mental health care. Mr. Anders combines factual technical information with evocative personal testimonies from patients, providers, managed care executives and others. Mr. Anders' bottom line is that truly sick, vulnerable or atypical patients are poorly served by for-profit managed care. While Mr. Anders mainly focuses on the dark side of managed care, a great strength of the book is that he does not leave the reader feeling hopelesss or overwhelmed. In his final two chapters, he addresses quality and gives specific suggestions for building a balanced, better system. This easy read is an indispensible resource for those interested in promoting a health care system characterized by compassion, competence, and cost-effectiveness.

As a legal advisor to a Section 501(c)(3) hospital who is not a dyed-in-the-wool tax expert, I have found this book to be of immense help. It is well-written and the examples are chosen carefully.