Motorcycle Accident Newsroom

A Patient Sustained Injuries To His Neck And Spine From A Motorcycle Accident

A patient sustained injuries to his neck and spine from a motorcycle accident, after he was taken to the hospital. The hospital's physicians recommended immediate surgery, but the health plan, the HMO, refused to certify the procedure.
Soon afterwards, the patient was paralyzed. That patient didn't have a chance to go through an internal and external appeals process. Are you going to continue with ERISA, which says the only liability, the only remedy is the cost of care denied? I think that is not justice. Thank you, Mr. Chairman. Mr. Bilirakis. I thank the gentleman. Mr. Dingell, for an opening tatement.
Mr. Dingell. Mr. Chairman, your courtesy is appreciated. I commend you and Chairman Tauzin for your interest in this very
important matter of the Patients' Bill of Rights. I want to say that I hope my colleagues and our audience were listening to Dr. Ganske, my co-sponsor and good friend, and I want to commend him and Mr. Brown and, also, my very special friend, Dr. Norwood, for the fine leadership that they and so many others have given on this particular piece of legislation. There are a number of things that need to be addressed. First of all, we have to see to it that the rights in the Patients' Bill of Rights go to all people who are covered by plans of this kind and not just to a portion. Second of all, we have to address the problem of liability fairly and to see to it that we, in fact, have a liability system which assures that the patient gets what he wants and
what he thinks he is getting under the plan of which he is a part.  I would note that we didn't include such device in the
Kennedy-Kassebaum bill and, as a result, that bill is largely nugatory in its impact. I would note that last year Dr. Ganske and I co-sponsored a bill with the help and the leadership and participation and counsel of Dr. Norwood that provides some middle ground on the question of liability.

It says that traditionally cases which have gone to State court, i.e., medically reviewable decisions, will continue to go there; that contract cases will, of course, go to Federal courts. This whole question of lawsuits is a red herring, as has been observed, as also is the unfortunate question of the other unfortunate questions that are raised. I would note that when you are hurt by wrongdoing, you ought to have some remedy. Denial of that remedy is clearly wrong. ERISA provides shelter for wrongdoing and there are only two categories of persons in this Nation who can absolutely escape liability for their wrongdoing. One is foreign diplomats and the other is HMOs under the ERISA situation.I think we have the capacity to get at least one crowd of wrongdoers, and I think it would be a splendid idea that we did so. Having said this, I have a superb opening statement, Mr. Chairman, that I know you and the other participants in this matter will enjoy reading. I would ask unanimous consent that it be inserted in the record, and I believe I have made my statement conclude in a timely fashion, and I thank you.