[Congressional Record Volume 141, Number 188 (Tuesday, November 28, 1995)]
[Extensions of Remarks]
[Page E2240]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         MEDICARE HMO MARKETING

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                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                       Tuesday, November 28, 1995

  Mr. STARK. Mr. Speaker, the Nation's seniors and low-income citizens 
are starting to be hit with a tidal wave of sales pitches for managed 
care health plans.
  Some of the information is helpful. A lot of it is just old-fashioned 
boiler room high-pressure sales pitch.
  I've just received the following letter from Dr. Harley Schultz of 
San Leandro, CA, which explains some of the dangers of this marketing.
  Mr. Speaker, before a lot of seniors and disabled and low-income 
people are hurt by gross sales practices, we need to establish some 
standards so that people can make rationale, careful choices on their 
health plans--after all, it could be a matter of life and death.
  The letter follows:

       Dear Congressman: Recently I had the experience where a 
     Medicare/MediCal patient of ours was marketed and sold an HMO 
     plan. Neither the patient or family understood that the plan 
     resulted in a limitation of their choice of hospital, home 
     health service, would result in a co-payment for office 
     visits, and possibly limitations in service available. The 
     salesman told them that since MediCal patients would soon be 
     enrolled in managed-care plans, that they should sign up 
     early instead of later.
       Several other patients have commented to me that they 
     signed up for various plans because they eventually succumbed 
     to persistent telemarketing, and didn't know any other way to 
     stop the phone calls from coming.
       Many of our elderly citizens are clearly no match for 
     sophisticated insurance salesmen who work on commission.
       Inasmuch as you have a long record of interest in fraud and 
     abuse, I would suggest to you that you may wish to direct 
     some of your attention to marketing practices in the health 
     care industry. Specifically, the Federal Government may wish 
     to set certain guidelines for the plans with which they 
     contract with regard to the information that is presented, 
     the way it is presented, and the amount of aggression that 
     can be used in pursuing a potential client.

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