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Created: September 8, 2003
Latest Update: September 8, 2003
jeannecurran@habermas.org
takata@uwp.edu

When HMO's Practice Monologic Non-Answerability

Site Copyright: Jeanne Curran and Susan R. Takata and Individual Authors, September 2003.
"Fair use" encouraged.

On Sunday, September 7, 2003, Jacqueline Jones-Lee wrote:

Hi Jeannie,

My name is Jacqueline Jones-Lee, and I have been reading our text Reframing Organizations. I also have enjoyed your lectures. However, Friday I had a conversation with my insurance company Health Net (HMO). My son was diagnosed with diabetes in July, and he was having low blood-sugar reading. My son (Kendric) has been testing his Glucose levels quite often. He ran out of test strips, and when I called in for a refill, the pharmacist told me it could not be refilled until a week later. Therefore, I called Health Net and had a huge argument over the fact that I pay for Insurance and I expect it when I need it. The representative stuck by the policy “they would only authorize 100 strips a month” if I needed any more I would have to pay full price," was her response. Jeannie, it was the Representative for the Ins. Co. with answerability, right? It is Health Net's responsibility to insure the health of my child as far as medical supplies. “I” the patient, am stuck with non-answerability unable to change their policy. How can I win?? I am looking forward to show and tell on Tuesday.

On Monday, September 8, 2003, jeanne responded:

Yes, Jacqueline, you're right. The Health Net representative was taking a monologic non-answerable perspective. But in California there is an agency to help you in dealing with complaints with your HMO.

I think you should argue specially that your son, Kendric, needs time to learn to adjust his blood-sugar readings, and that the HMO should take responsbility for that learning period. Diabetes is a very difficult and frightening disease, especially the kind your son has, which is the Type 1 of early onset. Ask the agency to help inform you about counseling and help for your son.

Have a Problem With Your HMO? Get Help Provides telephone numbers to contact the state agency for help, and explains the complaint process.

Good luck. jeanne