Tough Call: Is Supreme Court Ruling on Suing HMOs A Defeat For Patients?, CNNfn.

Original Source: MARKET CALL

ALLEN CHERNOFF, CNNfn ANCHOR, MARKET CALL: The Supreme Court ruled on Monday that patients cannot sue for large damages, if their HMO refuses to pay for doctor-recommended medical care. The ruling says that HMOs are shielded from state courts where juries are more inclined to award large settlement. But patients may sue in federal court where awards are capped at only the cost of medical services the HMO refused to cover.

Is the HMO ruling a victory for tort reform or a defeat for patient`s rights? Joining me to make that "Tough Call" is Ron Pollack of Families USA and Harold Iselin of the law firm Greenberg, Traurig. The firm specializes in governmental affairs and the health care business.

Gentlemen, thank you very much for joining me this morning.

(CROSS TALK)

CHERNOFF: Ron, let`s start with you. This sounds like a big defeat for patients.

RON POLLACK, FAMILIES USA: Well, it is. It means when patients get denied care -- that could lead to serious injury or even death -- there`s no way that they can hold their health plans accountable. And the real problem here is if the health plan knows it`s going to have no liability beyond the cost of the service that should have been provided in the first place, they just don`t have an incentive to get it right. It just doesn`t deter them from denying care. And that`s what I think is going to be the greatest harm.