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Interest groups clash over right to sue HMOs

Two state Senate panels work on bills filed in response to cries from patients and doctors; Bush calls for "dispute resolution."

By LUCY MORGAN

© St. Petersburg Times, published March 15, 2000


TALLAHASSEE -- To sue or not to sue?

That has become the key question in a complicated health care debate that threatens to dominate this year's legislative session.

Trial lawyers and doctors want the patients of HMOs to be able to file civil lawsuits and recover punitive damages.

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Business, insurance and HMO lobbyists say the threat of lawsuits will force health care costs even higher and leave more Floridians without health care insurance.

Gov. Jeb Bush weighed in on the situation with comments Tuesday on his way into a Cabinet meeting.

"I think we are close to a health care crisis," Bush said, noting problems with nursing homes, doctors who have trouble getting reimbursed and hospitals that are losing money. "We need a stronger, visible dispute resolution process where issues can be dealt with very quickly."

The debate between deeply divided groups surfaced Tuesday as two Senate committees began work on a stack of bills filed in response to cries from patients and their doctors over health care decisions being made by HMOs.

"This workshop is a beginning," noted Sen. Charles Clary, R-Destin, chairman of the Senate health care committee, as he looked out at a standing-room crowd that jammed the joint meeting.

"Actually we wanted to see, face to face, all of the lobbyists in Tallahassee," joked Sen. Jim Scott, R-Fort Lauderdale, chairman of the Senate Banking and Insurance Committee. The two committees heard an outline of the problem from several sources, and quickly agreed it will take another meeting just to finish hearing about the problems.

First came the Academy of Florida Trial Lawyers. It wants the right to file lawsuits against HMOs that do not provide adequate care. Two other states -- Texas and Georgia -- have granted the right to sue, but Florida law allows HMO patients to recover only actual damages and costs.

Legislators should focus on bills that require HMOs to act before patients suffer harm, place the burden to prove they are offering proper treatment on the HMOs, eliminate government involvement in the process and treat the patient-HMO relationship as a contract that can lead to civil litigation, suggested Neal Roth, president of the Trial Lawyers.

"Yes, I'm a trial lawyer," Roth said. "But our goal should be to have as little damage to people as possible."

Lobbyists for the HMOs disagreed.

"If you enact some of the legislation that erodes the ability of managed care to work, you'll be back in the same soup we were in the late '70s and early '80s with rising costs," said Healthplan Southeast lobbyist Sam Bell.

During the first three quarters of 1999, Florida HMOs lost $117-million, said Humana lobbyist Gerald Wester. "Premiums are rapidly rising. Consumers will have less choice."

Florida's HMO system is not broken, just in need of a few repairs, contended Associated Industries lobbyist Jon Shebel as he spoke for the state's business community.

Staff writer Julie Hauserman contributed to this report.

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