I understand the need to join an HMO if money isn't available to pay the high premiums for health insurance that allows you to chose your own doctors. However, if money is available to pay for health insurance outside an HMO, you certainly can get better care if you can select your doctors. If one doctor is unsatisfactory, you can find another doctor who meets your particular needs or problems. Being limited by an HMO to just their doctors can be a major problem. Let's say that an HMO is your only choice because of the difference in cost. If this is the situation, you MUST learn to be assertive. If a nurse practitioner is the only one to take care of you, that is not acceptable. Yes, they can do Pap smears and procedures, but what if you have a pelvic mass that is missed? Certainly an M.D. can miss things, but the many, many more years a doctor has of training than a nurse practitioner gives you a better chance of problems being found. If you cannot be assertive with a physician or insist on being seen by an M.D. and having your questions answered, then take along someone who can be assertive. One woman told me she takes a list of questions and gives the doctor a copy. She insists that the questions be answered and she gets the care that she needs.
Now that it is extremely likely that the Supreme Court will call the Affordable Health Care Act unconstitutional, purely on political lines, patients are going to have to be even more assertive to get good medical care. 32 million people will not have any health insurance, pre-existing conditons will not be covered, insurance will be canceled if too much money is spent on a patient and the insurance companies will be in total control. Those in the Tea Party who have rallied against President Obama are goong to find out they will be in big trouble when their insurance rates skyrocket, Medicare is eliminated, as well as Planned Parenthood, Medicaid, and control of the insurance companies. I don't think the Tea Party people have any idea of what lies ahead if Mr. Romney is elected and puts the Ryan Plan into place. It wil be a very sad day for medical care in the U.S.