FIXING HEALTH CARE - Lawyers, HMOs maintain tight grip
By Alan Nathan
Published October 11, 2007

Whether it’s the GOP Kow-towing to the Health Maintenance Organization (HMO) lobbyists, or Democrats succumbing to the American Trial Lawyers Association (ATLA), the two establishment-parties are discovering that donors often cost more than they give.

It’s like the imaginary independence of young college students: The degree to which they’re reliant upon Mumzie and Dadzie is the extent to which they are answerable to them. Real freedom requires either self-sustaining means, or good-will assistance with no strings attached. Unfortunately, these interest groups provide enough string to support a bondage convention.

Republicans have always stood for removing healthcare from the workplace. The argument has been that by managing health insurance as we do individually purchased car insurance, HMO’s would be far more accommodating to customers because they’d be answerable to more of them.

The logic is that efficiency rises and prices drop when companies are subjected to increased competition. However, Republicans are constantly taking money from those who want the direct antithesis, thus making the relationship beyond counterintuitive.

HMO’s prefer to have all their patients bundled together under the auspices of employer-clients. Consequently, the GOP is appropriately marginalized on this issue. While they correctly disagree with Democrats on their preferred socialized medicine, their bonds with the HMO’s preempt them from advancing their own otherwise more credible strategy. By default, they wind up defending the unpardonable status-quo.

Popular talk hosts, Rush Limbaugh and Sean Hannity, are fond of saying that, “We have the best healthcare system in the world.” Wrong! We have the best healthcare science in the world – there’s a difference.

A primary example of the GOP’s disconnect on the matter was illustrated by the handling of The Patients’ Bill of Rights. This was proposed legislation that would have entitled citizens to sue HMO’s for the harm caused to them through interrupted or misdirected care. As all members of corporate America are held accountable when they violate consumer rights, folks naturally questioned why HMO’s couldn’t be held similarly accountable?

The answer is that under the Employment Retirement Income Security Act (ERISA), we’re bound by a quid-pro-quo arrangement wherein HMO’s are protected from normal civil law suits in exchange for the patient’s right to coverage regardless of pre-existing health conditions – providing their coverage is through an employer-client of that HMO.

The challenge was then as it is now: How might we permit the harmed patient to seek legal redress without losing coverage, and still ensure that HMO’s have proportional safeguards from frivolous lawsuits? The popular Norwood-Dingle legislation of 2001 would have provided for that compromise, but it was shamelessly derailed by President Bush and the lobby-poisoned Republican leadership.

Democrats want low-cost healthcare for all Americans, but refuse to budge on the torte reform that could help facilitate the goal. Out of a slavish deference to the legal community, they’re unwilling to diminish the number of frivolous lawsuits to which doctors are currently subjected, despite knowing that all of us would benefit from the relief.

This could occur because physicians no longer would need to pass onto clients the overhead burdens of either, a) insane spiraling malpractice insurance, or b) court awards for sums that are beyond their plan’s coverage hence requiring the rest to be paid for out of pocket.

Even though Democrats so often espouse the little guy as their constituency, the money they want from groups like the ATLA apparently trumps that little guy’s importance - along with their own professed allegiances to him.

Of course Republicans aren’t making a very convincing argument for torte reform either when they so tenaciously oppose motion reform – it’s embarrassingly one-sided. The frivolous motion is a tactic that allows corporate America to keep even the most compelling cases from seeing the inside of a court.

This happens when the corporation in question has deep enough pockets to keep the plaintiff away from a trial until that plaintiff is drained of funds. Plaintiffs suffer this when they’re either without independent means, or their lawyer doesn’t think the pay-off is worth pursuing on a contingency basis.

Championing their moneyed constituents over their voting constituents, neither Republicans nor Democrats have the stomach for any real torte reform, i.e., reigning in both frivolous law suits and frivolous motions.

America’s healthcare battles won’t be resolved immediately. But if these parties could loosen their donors’ strangling grip, we’d see a more authentic debate that shortens the wait.

 



Alan Nathan, combative centrist, columnist, speaker and the nationally syndicated host of "Battle Line With Alan Nathan" on the Radio America Network.

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