HMSA: Contract
can be changed

The proposal's critics say new clauses
hamper doctor-patient relations

By Helen Altonn
Star-Bulletin

The Hawaii Medical Service Association's proposed new contract -- strongly criticized by some doctors -- is still open for discussion, HMSA spokesman Fred Fortin said today.

It isn't a question of withdrawing the contract because of opposition, he said. "We have remained open to negotiated discussions with the physicians all through this process."

Fortin said talks are continuing with the hope of resolving major issues by the end of the week.

Among those protesting certain features of the contract are the Hawaii Coalition for Health, a nonprofit public-health advocacy group; the Hawaii Federation of Physicians & Dentists; and the Hawaii Medical Association.

Critics say new clauses in the contract are offensive to the doctor-patient relationship and would hamper physicians from being advocates for patients.

"Some of the more outrageous claims are simply not true," Fortin said. "The idea that we would somehow be involved in the actual practice of medicine is absurd -- examples such as our ability to cut back on mammograms and things like this."

He said almost every HMSA plan contains a near-full range of preventative services, such as mammograms. "Those may be the fears that some physicians may have, but that's not the reality with this contract."

He denied suggestions HMSA is more concerned with costs than quality or appropriateness of care.

"That is absolutely 180 degrees wrong ... given the reality of types of services and coverage HMSA has in its health plan."