The inherent meaning of HMO medicine is rationed medicine for whole polulation. As an Internist we hget denial for necessay medicines and services on daily basis. Rationing is there for different level of consumers. Fo rmedicaid pts, rationing is rampant but not so mcuh for Medicare pts. For Medicare advantage rationing is done to make sure there is enough profit for HMOs and IPAs.Le's not be disallusioned that we have the unrationed and uncontrolled healthcare delivery system.When a healthcare deliver is based on profitabilty, then profitabilty depends on rationing.Pankaj Karan,MD
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