Editorial: Health insurance and responsibility

Thursday, March 12, 1998 | 12:54 p.m.

The legislation, introduced by Rep. Charlie Norwood, R-Ga., and Sen. Alfonse D'Amato, R-N.Y., seeks to toughen the conditions under which health maintenance organizations can deny care. A provision that would do away with a law that exempts health insurance companies from lawsuits filed in state courts has generated a considerable amount of controversy. Currently, an injured patient can sue in federal court, but can only recover the cost of the service denied; the patient gets nothing for any pain or suffering as the result of a bad decision made by an insurance company.

The proposal to reform health care would undo that, letting patients sue their health insurance companies for denying care. Some businesses are worried that they also could be sued, but Norwood contends the legislation would only allow health insurance companies to be sued.

If the lawsuit provision becomes law, some business groups are recommending their members drop coverage instead of taking a chance of being sued. "We will actively encourage our membership and the business community to stop providing health care," Bruce Josten, a U.S. Chamber of Commerce lobbyist, said.

Despite the Chamber's hyperbole, this is an issue of fairness for patients who are at the mercy of health insurance companies. The purpose of the legislation isn't to create more lawsuits. The intent of the bill is to get health insurance companies to treat patients properly. The sad reality is that some of these health insurance companies must be prodded by the prospect of a lawsuit to provide proper care.