How many DU'ers out there are denied the healthcare....

[whistle]

...they are told they should have (hospital stays, procedures, tests, prescriptions, etc) by their HMO's just because the insurance company does not want to pay for what the doctors requested? The Supreme Court just ruled tough shit, you can't sue if you are injured or get sicker. Health insurance costs are rising 15% to 25% while what they will pay for benefits your employers cover continue to erode. This is another rethuglican policy being rammed down our throats.

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Supreme Court victory for health insurers
By Ellen Kelleher in New York
Published: June 21 2004 18:52 | Last Updated: June 21 2004 18:52


The Supreme Court has awarded a sweeping victory to US health insurers, voting to overturn a lower court ruling that would have permitted patients to sue insurance companies at the state level for providing inadequate healthcare.


The justices ruled unanimously that the Employee Retirement Income Security Act (Erisa), the federal law that regulates employer-sponsored health plans, requires patients to sue their insurers over malpractice in federal courts - not at the state level.

The decision strikes down two appeals court rulings filed in Texas against Aetna and Cigna, two of the biggest US insurers. Aetna and Cigna run health maintenance organisations in Texas, a state with a law allowing patients to sue health insurers over medical care.

"When a federal statute completely pre-empts a state law cause of action, the state claim can be removed. Erisa is such a statute," Justice Clarence Thomas wrote in Monday's opinion.

In the first case, a man participating in Aetna's managed care programme sued the company for requiring that he use a cheaper version of a prescribed painkiller. The cheaper drug almost killed him, he charged. In the second case, a woman sued Cigna because the insurer only paid for one day in hospital after a hysterectomy. She later suffered complications.

The decision had been expected, based on the tenor of oral arguments that took place a few months ago, according to Wall Street analysts.

Matthew Borsch, an analyst with Goldman Sachs, wrote, "The issue appears settled for now . . . Today's decision could reignite debate in Congress over legislation that would set national paremeters on how managed care companies can be held liable for medical malpractice."

A federal appellate court had previously ruled that Aetna and Cigna improperly denied these patients medical treatment. Last year, Aetna and Cigna brought their case to the Supreme Court.

Insurers welcomed the ruling. Karen Ignagni, president of America's Health Insurance Plans, an industry lobbying group, said it would put "the brakes on trial lawyers' attempts to turn every benefit decision into a lawsuit".

The ruling is likely to prompt more debate on Capitol Hill over whether companies that offer managed care health plans are liable for malpractice. Congress had tried to pass legislation that would create a "patient's bill of rights", but has failed to enact such a law.