patients may be informed that corrective procedures are not necessary and will not be provided (Friedenberg, 1996).
Poll results demonstrating that patients are satisfied with their HMOs tend to reflect healthy patients. These people are the bulk of the enrollees; they pay 20 percent to 30 percent less for their medical care and they receive preventive medical care. Due to a limited budget, and the cost of serious or chronic conditions, the HMO is not as efficient in these instances. The HMO is the authority in determining necessary treatments and decisions are made that benefit the organization; economics appear to be placed ahead of medical care needs (Friedenberg, 1996).
The HMO has limited money that must be budgeted. It is reported that HMOs spend 80 cents of every premium dollar on medical care and the other 20 cents on administration and profits; Kaiser spends 90 cents per premium dollar on health care. Profits are still accumulating. It is stated that in 1994 six of the largest HMOs i
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