HMO? HMP!

It's that time of year again. The time of the year when the company that I work for needs to renew its sanitary permit with the city government. Not such a big deal, really, considering that all they usually need done is a chest x-ray. I'm not sure if they're looking for tuberculosis or pneumonia or what, but so far, I haven't encountered any real problems associated with HIV. So why exactly am I blogging this? Let me tell you why.

This is also the same time of the year that the company chooses to have us, its employees, go through our annual physical exam. The APE is actually part of the benefits we get from our Health Maintenance Organization, or HMO.

Considering my fear of needles, I never really got to go through an APE. The pre-employment medical exam, yes. But the APE, never. Not even before I found out I had HIV. I would always rather go to a private clinic and have to pay P200+ for a chest x-ray, just so I wouldn't have to go through the rest of the tests involved in the APE.

So you can imagine, all the more now, that I know what I have a gang of STDs, I will do absolutely anything to get out of having to go through an APE. I know, I know, R.A. 8504 protects me by prohibiting mandatory HIV tests. But that’s all it does. When it comes to my hepatitis B and my syphilis, anything goes.

I’ve actually sworn off accessing my HMO benefits altogether, until such time that I absolutely no longer have a choice. Why so? Am I wasting the freebies that I might possibly be entitled to? For now, I choose to waste them.

You see, part of my work has me involved in some administrative functions in the office. And part of that entails handling transactions with our HMO service provider. Not everyone may know how the HMO system works. I’ve been fortunate enough to.

HMOs charge a monthly health insurance fee per employee. A fee which, in my case, is shouldered by our employer. Up for annual renewal, the fee paid for health insurance gets recomputed, based on the previous year’s usage of benefits. Ergo, the more health insurance benefits that the company’s employees avail in the previous year, the higher the health insurance premiums charged for the following year. It’s a business, after all. They need to make money.

As part of this reassessment of their services, HMOs send a summary of usage to the administrative unit of our company. It’s a summary, but it’s detailed. Complete with the names of employees who availed of medical benefits, dates, consultations, and findings. Now if you’ve got nothing to hide, then all is good. But for me, I’d rather not be prematurely and unnecessarily disclosed for needing to consult my posse of STDs.

Basically, there’s no fine line dividing the transparency between the HMO and the company as client and service provider, and the medical confidentiality between doctor and patient. A line, or the lack of one, which not everyone may be aware of.

Now if you’re paying for your own medical insurance, then it’s fine. But in some cases like mine where the employer pays for the medical insurance of the employee, then they become part of the equation. Of course, I’m not saying others like me should forego medical insurance benefits. Just consider yourself more equipped to make an informed decision. My personal opinion? HMO? HMP!

Alright? Ok, you can lighten up now. Just stay healthy, my friends.