I recently read this book for a med surg class. The very short version is that Cathy Crimmins husband suffered a severe TBI in a boating accident. Anyway she refers to HMO's benefit representatives as Benefit Denial Specialists. The accident happened in Canada. If they had remained in Canada her husband would have been promptly transferred to a Rehab hospital AND
allowed to stay for the amount of Rehab he needed. In the US his HMO denied further inpatient treatment for his injury after about 21 days. While her husband did have a reasonably good outcome from his injury it is still unconscionable that under our system only 1 of 5 TBI patients are given the rehablitation services they need.
After reading her book I just don't buy the criticisms leveled against the Canadian system.