HMO Slammed in Record-Setting Court Case

The handwriting is on the wall for HMOs, and it isn't hard to read: A jury in San Bernardino, Calif., ordered Aetna U.S. Health Care of California to pay $120.5 million -- a record sum for an HMO suit -- to the wife of a man who couldn't get the company to cover his experimental cancer treatment and died. "The jury's statement is clear: Many people are just fed up with HMOs," says TIME medical columnist Christine Gorman.

The bureaucracy, hurdles and information gaps that many HMOs have set up between patients and doctors in order to protect their corporate bottom lines have infuriated huge segments of the population. The Aetna verdict is the latest indication that, when given the chance, citizens are willing to vent their frustrations big time. "If I were anyone affiliated with running an HMO, I'd be worried about this development," says Gorman. For the moment, the Aetna verdict is an aberration in the sense that most people cannot sue their HMOs for large, punishing damage claims -- federal law forbids it. "The only reason the surviving spouse could sue in this case was because of an exception for government employees," says Gorman. It's an exception many people may feel needs some explaining by Congress as public pressure grows for amputating corporate bureaucrats from medical practice.