November 2000 • Volume 6 Number 11
One more time, patient's rights bill flounders
At press time, it seemed likely the U.S. Congress -- for the third year in a row -- would adjourn without passing a comprehensive bill for patient's rights.
"This has been the Congress of missed opportunities and misplaced priorities," said AAFP President Richard Roberts, M.D., J.D., of Madison, Wis., early this month. "Patients and their doctors have been struggling for years with arbitrary HMO rules and red tape, and all this Congress can do is tell them to wait another year for help."
"We need Congress to step up and get the job done," said AAFP Board Chair Bruce Bagley, M.D., of Albany, N.Y. "It's important to have a strong bill of rights for patients so all health plans have to put the patient first and put profit further down on their priority lists."
Some HMOs -- those Bagley considers the most responsible -- already apply key provisions found in the Bipartisan Consensus Managed Care Improvement Act. For example, contracts Bagley has reviewed lately call for ready access to emergency care, an end to gag clauses, and internal and external appeals processes for patients denied care. The bipartisan consensus bill would have ensured that all health plans, not just some, gave patients needed protections. The bill would also have allowed patients to sue HMOs, something no HMO welcomes.
The House of Representatives passed the bipartisan consensus bill in 1999, but it floundered in the Senate this year. The Academy and many other medical groups criticized the watered-down bill of rights the Senate passed this summer.
Last-ditch efforts this fall to craft a compromise -- initiatives the Academy was deeply involved in -- had failed at press time.
Why? The sticking point is the patient's right to sue managed care companies. Insurers object to that, saying it will drive up health care costs. Senate leaders in the end refused to compromise and enact modified liability provisions letting patients sue HMOs.
Where do we go from here?
Differences in what are acceptable liability provisions had narrowed as the 106th Congress was winding down. Both the Republican and Democratic leaders of the House would like to pass a patient's rights bill.
"The key to success in the 107th Congress again will be with the Senate leadership, but sentiment in both chambers has moved in favor of a patient's bill of rights," said Jeffrey Human, director of the Academy's Washington office. "We hope to turn the tide in 2001."
FP Report is published by the AAFP News Department.
Copyright © 2000 by American Academy of Family Physicians.
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