You'll find hundreds of files on cleft lip, cleft palate here on widesmiles.org.

This one is about: Dr. Liu's comments on fighting HMO's 


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I've responded once before about HMOs, PPOs and capitation plans. You as parents, need to advocate for your child's medical/dental needs.  In this situation, I would tell the plan that has dropped the knowledgeable pediatrician that:

1. A knowledgeable pediatrician in clefts treating your child will NOT order unnecessary tests.  This will save them money.

2.  If the new pediatrician misses anything, you will hold the HMO plan responsible for delays in your child's development. And, often times, missed things cost more later to correct.

3.  You will complain to your employer, the purchaser of the HMO plan, that you are not happy with the plan. Get other fellow employees to do the same.

There is nothing the practitioner can really do. We are the providers of the care needed.  For us to advocate for your children is viewed often as self-serving on our part.  We don't like these PPOs, HMOs and capitation plans. They tend to interfere with what goes on between doctors and their patients.

I agree with an earlier comment that not all HMOs are the same.  Some are better than others. All are in the business of making a profit. None are in it to provide the best care at no cost to them. Therefore, they will try to cover as little as they have to. Yet, in order for them to make more money, they need to sign up more people with their plans. Therefore, if you make enough "noise" with potential bad publicity for the plan, you will get results.

My two cents worth.

John R. Liu, DDS
Dental Consultant, Wide Smiles


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