flyforfun
Beach Fanatic
I went to see Sicko two weeks ago. After spending the last 22 years as a provider in the healthcare industry I have to concur that the health insurance industry is ripping us all off. I have to give this movie a B+ and recommend everyone take the time to see it. Numerous examples of abuse by the insurance industry that should have there heads spinning for a couple of months. I can personally tell you stories that trump the examples in this movie. More made a good argument with regards to Universal Health Care which I think (good or bad) will be the future for this country. I give him lots of credit of demonstrating how both political parties of congress have sold their souls to the health insurance industry. There is a very simple fix without going the Universal Health Care route but congress and every state legislature lacks to courage to confront the problem, which is simply remove the current ERISA exemption and state HMO laws that exempt the majority of abusive carriers exemption from liability (see Alabama's HMO exemption). These exemptions allow health insurance plans to not cover hospitalization, drugs, diagnosistic testing and a wide range of other services without any risk of liability. Yes, you can pay them loads of money every month for premiums and they get to decided the care you receive regardless if it disables or kills you. The settlements you occasionally hear about are forced settlements cause they have the law on their side. Only foreign diplomats have this same level of exemption from liability. All 50 states have similar language and exemptions. Why else can United Healthcare's CEO continue to be listed in the top three of highest paid CEO's in the US! It's the only industry in the entire US that has such high level of protection against liability.
HEALTH MAINTENANCE ORGANIZATIONS (HMO)
ALABAMA STATUTORY EXEMPTION TO INSURANCE LAWS
Section 27-21A-23
Statutory construction and relationship to other laws.
(a) Except as otherwise provided in this chapter, provisions of the insurance law and provisions of health care service plan laws shall not be applicable to any health maintenance organization granted a certificate of authority under this chapter. This provision shall not apply to an insurer or health care service plan licensed and regulated pursuant to the insurance law or the health care service plan laws of this state except with respect to its health maintenance organization activities authorized and regulated pursuant to this chapter.
(b) Solicitation of enrollees by a health maintenance organization granted a certificate of authority shall not be construed to violate any provision of law relating to solicitation or advertising by health professionals.
(c) Any health maintenance organization authorized under this chapter shall not be deemed to be practicing medicine and shall be exempt from the provisions of Section 34-24-310, et seq., relating to the practice of medicine.
(d) No person participating in the arrangements of a health maintenance organization other than the actual provider of health care services or supplies directly to enrollees and their families shall be liable for negligence, misfeasance, nonfeasance, or malpractice in connection with the furnishing of such services and supplies.
(e) Nothing in this chapter shall be construed in any way to repeal or conflict with any provision of the certificate of need law.
(f) Notwithstanding the provisions of subsection (a), a health maintenance organization shall be subject to Section 27-1-17.
(g) Notwithstanding the provisions of subsection (a), a health maintenance organization shall be subject to the provisions of Chapter 56 of this title, regarding the Access to Eye Care Act.
(h) Notwithstanding the provisions of subsection (a), a health maintenance organization shall be subject to the provisions of Chapter 54 of this title.
(i) Notwithstanding the provisions of subsection (a), a health maintenance organization shall be subject to the provisions of Chapter 57 of this title, requiring coverage to be offered for the payment of colorectal cancer examinations for covered persons who are 50 years of age or older, or for covered persons who are less than 50 years of age and at high risk for colorectal cancer according to current American Cancer Society colorectal cancer screening guidelines.
(Acts 1986, No. 86-471, p. 854, ?23; Act 2001-445, p. 573, ?1; Act 2001-477, p. 640, ?10; Act 2002-511, ?1; Act 2004-502, p. 969, ?8.)
HEALTH MAINTENANCE ORGANIZATIONS (HMO)
ALABAMA STATUTORY EXEMPTION TO INSURANCE LAWS
Section 27-21A-23
Statutory construction and relationship to other laws.
(a) Except as otherwise provided in this chapter, provisions of the insurance law and provisions of health care service plan laws shall not be applicable to any health maintenance organization granted a certificate of authority under this chapter. This provision shall not apply to an insurer or health care service plan licensed and regulated pursuant to the insurance law or the health care service plan laws of this state except with respect to its health maintenance organization activities authorized and regulated pursuant to this chapter.
(b) Solicitation of enrollees by a health maintenance organization granted a certificate of authority shall not be construed to violate any provision of law relating to solicitation or advertising by health professionals.
(c) Any health maintenance organization authorized under this chapter shall not be deemed to be practicing medicine and shall be exempt from the provisions of Section 34-24-310, et seq., relating to the practice of medicine.
(d) No person participating in the arrangements of a health maintenance organization other than the actual provider of health care services or supplies directly to enrollees and their families shall be liable for negligence, misfeasance, nonfeasance, or malpractice in connection with the furnishing of such services and supplies.
(e) Nothing in this chapter shall be construed in any way to repeal or conflict with any provision of the certificate of need law.
(f) Notwithstanding the provisions of subsection (a), a health maintenance organization shall be subject to Section 27-1-17.
(g) Notwithstanding the provisions of subsection (a), a health maintenance organization shall be subject to the provisions of Chapter 56 of this title, regarding the Access to Eye Care Act.
(h) Notwithstanding the provisions of subsection (a), a health maintenance organization shall be subject to the provisions of Chapter 54 of this title.
(i) Notwithstanding the provisions of subsection (a), a health maintenance organization shall be subject to the provisions of Chapter 57 of this title, requiring coverage to be offered for the payment of colorectal cancer examinations for covered persons who are 50 years of age or older, or for covered persons who are less than 50 years of age and at high risk for colorectal cancer according to current American Cancer Society colorectal cancer screening guidelines.
(Acts 1986, No. 86-471, p. 854, ?23; Act 2001-445, p. 573, ?1; Act 2001-477, p. 640, ?10; Act 2002-511, ?1; Act 2004-502, p. 969, ?8.)