Ok, here's the deal. You're hurt. Your leg/arm/whatever is bleeding and you're nowhere near the one hospital your HMO allows you to visit (if you had a couple of weeks to get the pre-approval). You're past the point of wondering how you're going to pay for it. You are now wondering if you'll ever see your children smile again. You stumble into the Emergency Room anyway. Surely they'll help.
Well, yes a little. They'll do their best to bandage your wound and maybe even give you something for the pain. But that's about it. If your arm/leg/whatever is severed, they don't have to attempt to reattach it (even if delaying means you lose the appendage!) All the law says they have to do (and all your HMO will possibly pay for) is to "stabilize you." That means they take you out of immediate danger without regards for your suffering or the future impact of their inaction.
Why do I mention this today of all days? Well, today the Republicans in congress, after taking truckloads of money from the very HMO's they are acting to protect, have derailed efforts to prevent scenarios like the one I just described. Actually, my imagined injury didn't go far enough! Under the Republican plan, the hospital might have to help you, but your insurance company doesn't necessarily have to pay for it. If you need medical help, that's your problem.
Basically, the Republicans have extended the privilege of practicing medicine to all accountants. If your doctor says you require some form of medically necessary treatment. S/he can be overruled by any accountant. Gee, you've got to see their point. Accountants are pretty much the same as doctors. They both study medicine for years and are both licensed by a state board to practice medicine, diagnose illness and prescribe drugs. Aren't they?
Oh, wait a minute. I see the difference now. A doctor can be sued for negligence or malpractice. But under the GOP plan, accountants and their HMO employers are immune from lawsuits and have nothing to fear from hurting or even killing a patient.
Democratic Senators also wanted to make provisions to allow women undergoing mastectomy to stay a day in the hospital if the patient and doctor agree it's necessary. But the Republicans voted this down. They insisted that medical decisions like this are too important and costly to be left to medical professionals. Only an accountant can tell how long a woman should remain in the hospital after major surgery.
Why? Because the HMO's paid them to say so. The lobbyists whispered in their ears and the Republican lips moved like a hideous impression of Howdy Doody. They said "You can't allow people to sue HMO's for misconduct because there would be a flood of frivolous lawsuits and that would drive costs up." But in Texas, home of a tough patients bill of rights, there have only been two lawsuits in two years! Hardly a flood. That's not important. This is about money.
There's no chance for this legislation this term. About all we can hope for is a Presidential veto and a six-seat pickup next term (by the Democrats, that is.) This isn't a matter of waiting for the planets to align and force the do-nothing Republicans to act for American citizens. It's a matter of working hard to elect another Democrat to the Whitehouse and then back him up with a majority in the House and Senate. With Republicans like Bob Smith jumping ship, that's getting more likely all the time. And cold-hearted decisions like this one make it a LOT easier for people to vote Democratic.