Their assumption is that all Too Good HMO members are in it together. They are believers in public health, community and justice. If the latter is true, then patients are watching out for themselves as individuals, and for their families. These are people just trying to make a living every day, and trying hard to make good choices. There is a community of covered lives, but HMO communities lack the shared assumptions and values characteristic of communities we can recognize, like school, work and home.
Members share at least one belief.
They care for and even recognize each other. Many try to be fair and responsible. Health plans recruit new members aggressively. Here in Chicago, there has not been the same effort to retain old ones, but in other parts of the country with greater managed care penetration, competition for retention is fierce. In Albuquerque, for example, plans advertise their mammography rates in hope of retaining their customers.