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HMOs Hide Between the Legal and Moral

June 01, 2002

As a writer with a law degree who has done extensive research on the failure of medical insurance companies to reimburse doctors, I sympathize with the backers of legislation that would make it harder for insurance companies to bounce claims back and forth and leave them unpaid ("HMOs to Face Payment Pressure," May 26).

However, legislation preventing such behavior already is on the books in California, including the requirement of prompt handling of claims. These laws routinely are ignored by insurance companies, which manipulated the federal government into passing legislation that deprives doctors and patients of the ability to hit these companies in the pocketbook with lawsuits for breach of contract and fraud.

Although it is tempting to address an injustice by merely passing a new law, it is unlikely insurance companies would comply, given their unethical behavior up to now, which would have made them the subject of district attorney investigations if they were ordinary businesses.

Unfortunately, one cannot legislate bureaucracies into doing a moral act or respecting others' rights, whether major insurance companies, Enron or the Catholic hierarchy. All bureaucracies act alike--to protect their existence, power and profit at the expense of everything else.

Caroline Miranda

North Hollywood

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