While the insurance companies and Obama bitch at each other, another deal appears to have been made by the industry, Baucus and the administration. This one will be just too much for people who have not been able to decide whether to be for or against the weak refroms shaping up in Congress. Anyone who has seen Michael Moore’s films simply will throw up their hands in disbelief.
It goes like this: For many people, desperate for medical treatments previously denied by insurors, the reform bills in Congress offer litttle hope. As it stands, policy holders have great difficulty in reversing an insurance company’s denial of treatment, for example, an MRI which the insurance company doesn’t think is necessary or a new cancer treatment that costs a lot.
The Los Angeles Times reports:
... a patient’s ability to fight insurers’ coverage decisions could be more important than ever because Congress, in promoting cost containment and price competition, may actually add to the pressure on insurers to deny requests for treatment.” The bills would require insurers to “cover everyone, regardless of pre-existing conditions,” making it “more difficult for insurers to control their costs, or ‘bend the cost curve,’ by avoiding sick people. That leaves insurers with the other big cost-containment tool: turning down requests to cover treatments.
Experts said the legislation under consideration does not significantly enhance patient protections against insurers refusing to cover requests for treatment. Most people currently have no right to challenge health insurers’ treatment decisions by suing them for damages.
The Employee Retirement Income and Security Act (ERISA), reports Kaiser Health News, ”bars suits for damages over health benefit decisions” for the 132 million people who get insurance through employers. Current health care bills do not remove the barrier.
Born in 1936, James Ridgeway has been reporting on politics for more than 45 years. He is currently Senior Washington Correspondent for Mother Jones, and recently wrote a blog on the 2008 presidential election for the Guardian online. He previously served as Washington Correspondent for the Village Voice; wrote for Ramparts and The New Republic; and founded and edited two independent newsletters, Hard Times and The Elements.
Ridgeway is the author of 16 books, including The Five Unanswered Questions About 9/11, It’s All for Sale: The Control of Global Resources, and Blood in the Face: The Ku Klux Klan, Aryan Nations, Nazi Skinheads, and the Rise of a New White Culture. He co-directed a companion film to Blood in the Face and a second documentary film, Feed, and has co-produced web videos for GuardianFilms.
Additional information and samples of James Ridgeway’s work can be found on his web site, http://jamesridgeway.net.
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