Letters To the Editor

How Aetna US Healthcare became Godzilla

After reading "Aetna US Healthcare: Godzilla or Barney?"[Aug. 9], I see that the company's corporate officers are still denyingthe problems they've created.

I recently reviewed a new Prudential contract that contains Aetna's changes.The contract states that if a provider drops one Prudential plan, he mustdrop all other Pru HMO and PPO plans. It also says that if a physician hasa dispute over reimbursement, Prudential gets to decide what the reimbursementwill be. In essence, doctors have to sign a contract that does not stipulatespecific reimbursement rates, so they cannot dispute the reimbursement later.It's hard to believe this is legal.

If all doctors refused to sign such contracts, then Prudential (reallyAetna) would have to change them. But as long as we acquiesce to their unfairdemands, HMOs will get their way.

Nick Padron, MD, Dallas, padq@aol.com

Who are Aetna's officers trying to kid? All this nonsense about publicresponsibility is just a smokescreen to cover their real agenda: profits.

Edward Gold, MD, Westwood, NJ, molten@ibm.net

Aetna CEO Richard Huber misinterpreted the AMA's view in stating that "even the AMA has admitted that our new contract is, if not wonderful, much better than the old one." This is misleading.

While Aetna has made some improvements, the AMA is on record—with Aetnaand the public—as having significant concerns with the insurer's contractingpractices. These practices include a "take it or leave it" attitudetoward physicians, and an insistence on the all-products policy. Aetna alsoreserves the right to unilaterally amend any and all provisions in its contracts.

Given these and other significant matters, Aetna has many more improvementsto make before Huber can reasonably cite AMA support for his company's efforts.

Thomas R. Reardon, MD, President, American Medical Association, Chicago

I was disgusted by your powder-puff interview with Aetna's officers.It was obvious that their purpose was not to explain their policies, butto propagandize them—and you let them get away with it!

For instance, when asked about the all-or-none approach to contracting,chief medical officer Arthur Leibowitz replied, "We're not the onlyones with this policy." Any competent journalist would have asked him,"Does that make it right?" And when he said Aetna needs "consistentcontracting," he should have been forced to explain the term and whyother insurers don't need it.

When the director of quality health analysis, Carol Diamond, assertedthat Aetna's disease management program will "ultimately improve quality,"why wasn't she asked to produce one unbiased study that could support thatassertion?

I'm sick of journalists asking questions about issues they don't understand,and respondents getting away with answers that are half-truths or outrightlies. The next time you interview an HMO representative, why don't you askadvice from those of us who've had to deal with these people for years?

If I had paid for my subscription to Medical Economics, I'd be askingfor my money back.

Jack J. Stein, MD, Phoenix, holdemjay@aol.com

Your article was a lightweight piece of fluff. Aetna's execs brushedaside criticism of their company with pat answers.

While they claim that patients must understand that there are limitsto what their insurance will provide, they don't afford physicians the samerights to choose what they feel are feasible products for their practices.

It's rather ironic that in the same issue, you published an article aboutSan Mateo County IPA's problems with Aetna ["Say No to health plans?These doctors did"]. Those doctors seem to have the exact problemsthat Aetna claims don't exist. Which way is it?

Debbie Roseman, Practice Manager, Orchard Medical Group Skokie, IL

Of all the HMOs and PPOs I've dealt with, Aetna is by far the worst.I've been an FP for 38 years.

I'd be terrified to see Aetna merge with yet another large insurer becauseof the danger it would pose to medicine and patients' rights. Despite whatits officers say, Aetna is abusive to doctors and insensitive to patients.

William A