On Monday, the Supreme Court ruled that patients could not seek damage awards against HMOs that refuse to cover doctor recommended services. With this judgment, a major player in patent rights has been shut down.

While not completely eliminating the right to seek damages, the ability for a patient to receive more than just the cost of services is no longer possible. The court said HMOs are shielded from lawsuits in state courts, where juries are more apt to side with victims and order up multimillion-dollar judgments from insurance companies.

HMOs, while much more affordable, are very limited and restrict how and where a patient can receive treatment. In many cases, HMOs take longer than necessary to approve or reject treatments, whether they are an emergency or not. HMO providers usually limit services to save costs, and patients end up being treated like low cost merchandise needing repair.

"By reserving the right to decide what is — and what is not — medically necessary, managed care plans can now practice medicine without a license, and without the same accountability that physicians face every day," the American Medical Association said after the ruling.

On Capitol Hill, Democrats opposed the ruling, and Senator John Kerry stated it will be a point to use again Bush in his presidential campaign. On the other side, the Bush administration had jumped bandwagons. Bush initially was considered to be on the side of patients while governor of Texas. However, this recent ruling had the full backing of the Bush team, and invalidated a prior law that Bush passed as governor of Texas which protected patient’s rights.