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Officials of America largest health insurer have no doubt come to expect constant scrutiny from investors, analysts, patients, doctors and the like. These days, however, Aetna top brass has got to be wishing it could borrow a page from Greek mythology, where one eyed Cyclops lumbered atop Mt. Aetna, unable to see their human captives escape.

The struggling health insurer, which has 22 million customers, is profoundly aware of all that is happening and in some ways, crumbling on its own health care mountain, that of the health maintenance organization (HMO). Healthcare of Blue Bell, Pa., by far the largest generator of the company revenues, has been feeling chronically fluish over the effects Oxandrolone Oral of high costs in its Medicare line, embattled relations with doctors and hospitals around the country and operating losses in its Prudential Health Care business, which it recently acquired.

Those troubles have led to a string of events. Following the resignation in February of CEO Richard L. Huber, the company announced in early March that it had rejected a takeover bid by WellPoint Health Networks of California and ING Group, a Dutch financial services group. Instead, the company said it planned to split into two separate, publicly traded companies, one for managed health care and one for financial services. By splitting into two businesses, "Each company can achieve a stronger focus on its customers, improve performance, more closely align management with shareholders and independently evaluate strategic options," commented new CEO William H. Donaldson.

Last week came word that Aetna had hired an executive recruiting firm to find a CEO for its health care business. This on the same day of an April 6 meeting of institutional investors in New York City, who convened, as one participant put it, "to take decisive action" to improve Aetna share price. The company stock closed on April 10 at $58.06. It has fluctuated from a high of $60.63 last November 17 to a low of $38.69 on February 18. buy cheap jintropin online Investors feel strongly that the share price is greatly undervalued, prompting them to agree with Aetna decision to turn down the takeover offer of $70 a share.

This week news is brighter than most. Aetna announced on Tuesday a settlement of a lawsuit brought by the state of Texas. According to an article in the Wall Street Journal, the settlement is a "landmark" one that could set a new standard for the way HMOs do business with doctors and consumers. Aetna has agreed to institute a number of new policies that benefit "Jintropin (Gensci Pharmaceutical Co. Ltd.)" physicians and consumers. Healthcare had reached contractual agreements with two major health providers in New Jersey, Robert Wood Johnson University Hospital and Atlantic Health Systems.

Both agreements extend the relationship between the hospitals and the health insurer, an outcome that seemed unlikely late last year, when hospitals began rebelling against the cost cutting demands of HMOs like Aetna. Robert Wood Johnson dispute with Aetna, for example, was that the insurer wanted a 30% cut in what it pays the hospital annually. Robert Wood Johnson said it would end Proviron And Dianabol its contract with Aetna, and now the insurer has responded with a more favorable agreement.

These latest events speak to the heart of the multitude of troubles at Aetna, a one time traditional insurer that transformed itself into an HMO five years ago to build up margins and market share by, for one, successfully holding down employers health care premiums. Gone, or at least fading, are the days where HMOs can control medical costs by squeezing them out of hospitals, doctors and, in the end, patients.

Ironically, the booming economy may also be adding to HMO woes. It possible that a downturn will revive the importance of cost containment and utilization rates, notes Mark Pauly, Wharton professor of health care systems and public policy, but for now, "the health care and insurance industries are being pressured to move toward fewer restrictions on care, not more."

"The model where the HMO itself manages care on a daily basis may very well be over," adds Uwe E. Reinhardt, a health care economist at Princeton University. "The economy is so good that employees won put up with Primobolan Hgh Cycle the strictures that properly managed care imply. Because of that, these people are at a tremendous disadvantage trying to manage care. In the end, the HMOs don have the market clout they need to control doctors and patients." In addition to facing a backlash from the likes of Robert Wood Johnson University Hospital, some physicians have also rebelled against the insurer tactics, particularly an Aetna mandate requiring them to treat low paying HMO members or be forced to give up Aetna members in the "buy cheap jintropin online" higher paying preferred provider networks. In one of the provisions of the Texas settlement, Aetna has agreed to allow doctors to choose whether to participate in some or all of the insurer health plans.

And then, of course, there are higher medical costs. Health care inflation is returning, say experts, to double digits after several years of being kept in check. That has to do, in part, with the rising costs of drugs, which average about 12% of an HMO costs, Reinhardt says. Other factors like consumers becoming more educated and demanding expanded medical care are forcing managed care companies to raise their premiums by at least 10% in order to stay profitable.

Reinhardt cautions that this is just the beginning. "For the next few years, as long as the economy booms, you will see health care costs rising in double digits again until we just can take anymore." Adds Pauly: "In the real world, even if rates were uniform, people don all want to be treated the same way. They are much less concerned about holding down their medical spending and if their incomes are rising, Bivirkninger they place less value on economy."

Then what? Reinhardt says health care will go one of two ways. "We will either go into a regulated utility model where doctors are allowed to unionize and hospitals 4-chlorodehydromethyltestosteron band together to negotiate some tolerable premium increase that will ultimately have to be approved by the state government, or we will go into the multi tiered model." The multi tiered model, as Reinhardt see it, is where 35 million uninsured get whatever health care they can; the next class, including gas station attendants and waitresses, those who serve the middle class, will get care from tightly managed HMOs, if at all; the middle and upper middle class will spend more out of pocket for more flexible preferred provider care; and the top 15% will pay handsomely for the old fashioned indemnity plan, where they will have access to tomorrow technology. "That multi tiered system is already coming in place," says Reinhardt, "but I think it will be more widespread."

Aetna plan is to fit somewhere into this picture, though it has an uphill battle to stop the erosion of its health care business and restore its reputation with doctors, patients and investors. The scrutiny will no doubt intensify, especially from investors who have plans to put pressure on the board and management at the company annual shareholder meeting April 28 in Hartford, Connecticut.