HMO LIABILITY: Op-Ed Contends Bill Is A Cover For Trial Lawyers
An opinion piece in the San Jose Mercury News, contends that HMO liability legislation (see related story) is merely trial-lawyer sponsored "legislation ... masked to appear as health care reform." Toby Stime of Fresno-based Total Access Benefits writes, "The slogan 'get sick, call a doctor' has turned into 'get sick, call a lawyer.'" AB 2436, he writes, would allow trial lawyers to sue health plans for medical malpractice while bypassing another law -- the Medical Injury Compensation Reform Act -- which limits the awards in malpractice cases. "Put simply," Stime says, this means "more money for trial lawyers; higher costs for consumers; and another impediment to quality health care." He writes, "Increased health care costs might be justified if health care quality is improved. But lawsuits only happen after the fact. When a person has already been injured, lawsuits do little to improve quality." He contends that if the bill becomes law, HMOs would start practicing "'defensive utilization review' -- approving unnecessary and costly treatments just to avoid litigation." Stime recommends instead providing "consumers with an effective procedure to contest an HMO coverage decision" -- a process that relies on "independent, impartial outside reviewers" (8/4).
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