In a victory for President Clinton, the US House of Representatives voted overwhelmingly to approve new rights for patients to take action against their healthcare insurers and health maintenance organisations. The most controversial part of the bill would allow patients to sue these bodies if they are denied the medical care they need.
The bill, which was jointly sponsored by Georgian Republican Charles Norwood, a dentist, and John Dingell, a Michigan Democrat, stems from the rising frustration felt by Americans and their doctors about the influence that insurance companies have in the decision making process of health care (11 September,p 657).
Specifically, doctors and patients have been complaining for years that most health maintenance organisations have financial incentives to approve fewer tests and cover fewer expensive procedures.
If approved by the Senate next year, the bill would follow the lead of similar votes at the state level in California and Texas.
Currently, employees who receive health insurance from their employers are allowed to sue their insurer only for the cost of a treatment denied, and, even then, only in a federal court. The new legislation would allow patients to sue in a state or federal court and would allow them to sue for unlimited damages.
The bill would also not allow the health maintenance organisations to stop doctors telling patients about costly but beneficial treatment options. It would also require insurance companies to pay for emergency room treatment without the patient having to receive prior approval.
Also, the bill would allow a patient to see her obstetrician and gynaecologist without having to get prior approval.
Politically, many in Washington are calling the vote the most important so far this year. Although Republican leaders such as the speaker of the House, J Dennis Hastert, had argued that the bill would open the floodgates to a tide of frivolous suits by trial lawyers, his members in the House were not swayed and sided with President Clinton.