HMO Hype

"Do you want to spend money on lawyers or on health care?"
Julie Cantor-Weinberg
National Association of Manufacturers

"The tort system doesn’t do a very good job of consumer protection."
Karen Ignagni, President and CEO
American Association of Health Plans

President Clinton’s Patient’s Bill of Rights
would "bankroll frivolous lawsuits by his rich trial lawyer friends."
Ralph Reed
Political Consultant

"Words like ’reasonable,’ ‘necessary,’ ‘appropriate’ and ‘community standard’ simply fail when it comes to helping health plans allocate their members’ resources wisely…When plans are taken to court, it is almost always because of a dispute over those words."
David Eddy, M.D., Ph.D.
Internationally recognized expert on healthcare rationing
HMO Consultant

The Reality of How This Stuff Works

Trial Lawyers are Good for HMOs

"Kaiser Permanente has whittled down its outside legal help from 150 law firms to four…Kaiser’s cutbacks are expected to save the company up to 20 percent in outside legal fees, which reached up to $l0 million in 1997.

Kaiser’s San Francisco based law firm has approximately 375 attorneys in five offices: San Francisco, San Jose, Los Angeles, New York, and Washington, D.C. This firm will offer legal representation in labor, employment, business and health, and regulatory litigation."

San Francisco Business Times, 1998

HARDBALL Questions

  1. In 1997, Kaiser Permanente spent at least $10 million on outside trial lawyers in addition to salaries and benefits of trial lawyers employed by the HMO.

    Ms. Cantor-Weinberg, aren’t HMOs spending outrageous amounts of money on trial lawyers to violate patient rights and protections instead of providing healthcare?

  2. Kaiser Permanente thinks trial lawyers do a very good job of protecting HMOs in labor, employment, business, health and regulatory litigation.

    Ms. Ignagni, wouldn’t the tort system do a very good job of consumer protection if patients had the right to sue and had lawyers to enforce that right?

  3. Kaiser Permanente’s outside trial lawyer friends (to say nothing of its numerous in-house staff of trial lawyers) suck more than $10 million a year out of patient premiums that could pay for tests and treatments.

    Mr. Reed, don’t the facts show that HMOs have "rich, trial lawyer friends," not patients?

  4. Kaiser Permanente’s hundreds of trial lawyers squander members’ resources to defend the HMO in wrongly denying "reasonable, necessary and appropriate" tests and treatments.
  5. Dr. Eddy, when HMOs get taken to court, isn’t it almost always due to "stealth" healthcare rationing, and never due to the wise allocation of members’ resources?

Responses Will Be Published

HMOs violate patient rights.
Patients need lawyers to enforce their rights.