When bean counters call the shots at insurance companies, physicians and consumers grumble about the impact on medical care. Yet no one seems very disturbed over the feeding frenzy erupting among lawyers targeting beleaguered managed-care companies.
The class action lawsuits against many of the managed-care giants got a brief burst of media attention, but interest soon shifted to Washington. House and Senate leaders are attempting to resolve differences in legislation to protect patient rights under managed care, particularly as concerns the rights of consumers to sue their health plans.
Deliberation and compromise are hard to come by in the legislative branch these days, and the strong partisan tone surrounding selection of conference committee members will make the attempt even harder. But class action lawsuits offer dismal opportunity for reasonable discourse.
One professor of public policy has described the current atmosphere as a "litigation lottery." Attorneys target an entire industry, like tobacco or managed care, then file suits in state courts seeking massive damages. As they did in the tobacco wars, lawyers who succeed in these cases stand to earn fees at the rate of hundreds of thousands of dollars an hour. As a result, they are under great pressure to be first to hit the jackpot before the targets are cleaned out by other litigants. The rush to litigate pre-empts debate about what's in the public interest.
Aggressive managed-care cost cutters are starting to recognize they have gone beyond what is acceptable to the public and health profession. UnitedHealth Group, for example, last month announced it will let the doctor be the final arbiter in matters of medical necessity. Such actions suggest effective but gradual reform of managed care could develop if it's not stifled by combative lawyers seeking to turn the insurance debate into a financial free-for-all.