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Copyright 2000 The Atlanta Constitution  
The Atlanta Journal and Constitution

June 15, 2000, Thursday, Home Edition

SECTION: Editorial; Pg. 22A

LENGTH: 401 words

HEADLINE: Losing our patients with Congress



If health care consumers don't like the fact that HMOs place profits over patients, they should ask Congress to change the law. Or so says the U.S. Supreme Court. But the insurance industry's campaign contributions speak louder than wishes of the people, so Congress has blocked federal legislation to allow patients to sue their HMOs.

Earlier this week, the Supreme Court handed down a unanimous decision rejecting the right of a patient to hold her HMO responsible under federal law for poor medical care. (She recovered $ 35,000 from her doctor in a state malpractice action, but since her health plan was an employer-sponsored one involving a federal law --- the Employer Retirement Income Security Act --- the matter of HMO liability went to federal court.) The case, Pegram v. Herdrich, was brought by a woman whose appendix ruptured because she was required to wait several days for an ultrasound test before getting the needed surgery.

Justice David Souter said federal law doesn't allow claims by patients against HMOs for treatment decisions. When Congress approved HMOs, Souter said, it approved the idea of allowing HMOs to hold down health care costs by giving financial rewards to doctors. In other words, it's OK if your HMO pays its doctors more money to deny you needed medical care.

Rep. Charlie Norwood (R-Ga.) has long sought to pass a patients' rights bill which would include patients' right to sue. (A few states, including Georgia, already give patients the right to take their HMOs to court. The court has not yet ruled on whether those state laws are pre-empted by federal law.) But Norwood's bill doesn't have many Republican backers. He managed to get his legislation through the House, but Senate Republicans last week rejected a similar measure on a straight party-line vote. A House-Senate conference committee isn't likely to deal with the issue prior to the election.

The fact that the insurance industry gave nearly $ 4 million in soft money to the GOP in 1999 --- twice as much as to the Democratic Party --- is worth noting. Between 1993 and 1998, in fact, the industry poured $ 8 million into GOP coffers through the soft money loophole in the campaign finance laws.

But politicians always deny a connection between campaign contributions and their votes on issues.

What other reason does the GOP Senate have for not passing a patients' bill of rights?

LOAD-DATE: June 15, 2000

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