Problems with employer-provided health insurance - the Employee Retirement Income Security Act and health care reform

Article Abstract:

Most health care reform proposals are variations on the current employer-provided health insurance, but true reform will come only when a national health care plan is implemented. The Employee Retirement Income Security Act of 1974 (ERISA) regulates health benefits and pensions but does not require employers to provide health insurance. Coverage depends on an employer's good will and available funds, and as health insurance premiums increase, more and more costs are being shifted to employees or the government. The trend now is toward self-insurance, allowing employers to set their own limits and reducing or dropping coverage of expensive illnesses like AIDS, heart disease and cancer. One possible solution to the problem of decreasing coverage and increasing costs is to have the federal government continue to oversee health benefits but establish some minimal national standards. However, improvements in employer-provided health insurance still will not help the unemployed. A fair health insurance plan would not be based on where you work or whether you work.

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State regulation of managed care and the Employee Retirement Income Security Act

Article Abstract:

Congress should amend the Employee Retirement Income and Security Act (ERISA) to allow states to regulate managed care organizations. ERISA was passed in 1974 to protect workers' pensions. However, it also covers health benefits and the result is that managed care organizations do not have to comply with state laws. Consequently, many states can not regulate these businesses. Congress has already amended ERISA to protect pregnant women from drive-through deliveries. It is unlikely that Congress will pass federal legislation to reform health care. States should be allowed to do so but this would require changing ERISA.

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What recourse? - liability for managed-care decisions and the Employee Retirement Income Security Act

Article Abstract:

The Employee Retirement Income Security Act of 1974 exempts healthcare providers from being liable for legal actions in cases of personal injury caused due to their negligence or wrongdoing. Finacial incentive for the providers to deny care for the patients, public awareness of this legal imbalance, and congressional interference in the matter are discussed.

United States, Care and treatment, Interpretation and construction, Medical care, Patients, Patient care, Liability (Law), Legal liability

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