We do need strong remedies to prevent HMOs from denying needed care. There is no dispute over that point. All of us are deeply troubled by cases in which an HMO has acted in a way that was not in the best interest of the patient. That is not what this debate is about. The debate is about the best way to solve those problems, to ensure that every patient gets the care that he or she needs when they need it. That is why a strong, independent, and binding appeals process is critical to ensure that patients get the care they need when they need it; that they get the care they were promised. They should not have to hire an attorney and file a lawsuit to get the health care they need. They just can't sue their way to quality care. That is why the key is to make sure that we have an appeals process that is binding, that is independent, and that will force the HMO to provide the care that has been promised. I am particularly concerned that the liability provisions in the McCain-Kennedy bill, as currently drafted, could well discourage employers that currently voluntarily provide health insurance to 172 million employees and their families from continuing to offer coverage.
Editor's note · Context
Discussing the need for strong remedies to prevent HMOs from denying care during a debate on health care legislation.
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