| Abstrakt: |
The American health care market has evolved to the point where independent practice association structured health maintenance organizations (HMOs) are the most common health benefit offered to employees by their employers. Employer-sponsored health care delivery systems are regulated by the Employee Retirement Income Security Act (ERISA) of 1974, which contains a loophole against liability for HMOs. That is, although HMOs are both an insurer and a health care provider, they are immune from liability for acts of medical negligence. Therefore, although HMOs have usurped physician and patient control over health care decisions through characteristic cost-containment policies and procedures, physicians remain fully accountable in a lawsuit brought by unhappy and dissatisfied patients. The Patient Bill of Rights is legislation currently before Congress that would amend ERISA and force insurers to put patients' health before the company bottom line. The American Medical Association and American College of Physicians, among many, endorse proposed reform provisions, including assurances that doctors and patients can openly discuss treatment options and enforcement mechanisms in which health plans would be held legally accountable when they make decisions that harm patients. The United States Supreme Court, given the conservative composition, will likely practice judicial restraint and defer to Congress to enact the needed changes to ERISA. |
