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LETTERS TO THE TIMES

Patients' Rights and HMO Ruling

June 26, 2004

The Supreme Court has decided that patients covered by their employers or labor unions under group plans have limited rights to sue their HMOs for refusing medical treatment recommended by physicians (June 22). Patients pay all or part of their health premiums in good faith and some bureaucrat at the insurance company will decide their fate. We Americans see ourselves as a nation of laws and justice. But when unjust laws are passed, tyranny rules. We may as well scrap the pretense of justice for all.

It has become clear that the highest court of the land can no longer claim legitimacy. Certainly this is not the first time that the court has violated people's rights. But the blatant bias in favor the corporate bottom line versus the right to human health is stunning. Unjust laws are worse than no laws at all, since the entire force of the federal government stands behind them. Citizens have absolutely no redress.

Tanja Winter

La Jolla

The greedy and the cavalier at HMOs will not be dissuaded by the threat of a judgment in a civil lawsuit many years in the future, especially when not a dime comes out of their own pockets. They will probably be long gone from their company by that time anyway. The sought-after, large punitive damages envisioned by the advocates of such healthcare lawsuits are more likely to punish the careful and concerned, and -- most of all -- the patients who are struggling to get affordable healthcare.

If we really want to improve health, systems need be in place to see that coverage decisions are made in a way that is fair (at the time they are actually being made) to both patients and doctors seeking something, and also fair to the other patients who are in fact paying for the care.

Coercing HMOs to provide anything requested and simply passing the cost on to the consumer has never been in the interest of working people. American healthcare today diverts too much of the country's resources to products and services that are either unnecessary or so marginal that an aware, reasonable person would not spend his or her own money for them, yet serious needs often go unmet.

Hyman J. Milstein MD

Studio City

What an uncanny ability this Supreme Court has to distinguish between states' rights issues with which the Bush administration agrees and those with which it disagrees. If it actually helps people but violates conservative, free-market doctrine -- think the gutting of the Clean Water and Clean Air acts -- then this court looks the other way while the Bushies shut it down. If it helps shield huge corporations and campaign contributors from litigation, no matter how justifiable -- think children denied medical care to fight their cancers -- then the Bushies are right again.

In fact, it is apparent from the past three years of rulings that states' rights are only inviolate when they protect the execution of retarded people or are asserted within the state of Florida. Not to worry. I'm certain the Marie Antoinettes, excuse me, the Republicans will rush to pass legislation to help the 130 million Americans now denied any legal recourse against denial of treatment by their HMOs. Just as soon as they get through helping the estimated 44 million who lack health insurance.

Daniel Koenig

Placentia

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