California’s Patients’ Rights Law Can be a Model for Federal Legislation, Consumer Advocates Say
Federal lawmakers debating patients' rights legislation should "look in the direction of California, which has the strongest patients' rights laws in the nation," Jamie Court and Frank Smith write in a Los Angeles Times op-ed. Court, executive director of the Foundation for Taxpayer and Consumer Rights, and Smith, a senior fellow at the Institute for Civil Society, state that California's patients' rights law guarantees individuals access to second opinions, a statewide HMO regulator, an independent review of denial claims by doctors and, "as a final resort," the right to sue a health plan. Court and Smith note that President Bush has said he will veto a federal patients' rights bill (S 283) sponsored by Sens. John McCain (R-Ariz.), Edward Kennedy (D-Mass.) and John Edwards (D-N.C.), which would allow patients to sue in state court for denial of care or quality issues and in federal court for non-quality of care issues. Bush says such legislation would lead to a large number of lawsuits and would benefit "lawyers, not patients." Court and Smith say that when California's patients' rights law was proposed, insurers expressed the same concern, arguing that it would lead to "an explosion of frivolous litigation and increased health costs." However, they write that while California's law allows for unlimited damages in patient lawsuits, there "has not been a single lawsuit filed."
They also note that "most" of the disputes have been settled by state regulators "with minimal hassles or resistance from HMOs." According to data from the state Department of Managed Health Care, of the 165 cases against HMOs heard by independent review boards, 65% were decided in favor of the insurance companies. Noting that state laws are "no panacea," Court and Smith say that federal legislation is "needed because no state law can ever regulate the health plans of large, interstate employers" with "self-funded" health plans that are federally regulated. They conclude: "California has test-driven the patients' bill of rights and, at this early stage, it appears to be a strong consumer protection model. If President Bush is truly interested in sound policy and not protecting the insurance and HMO industries, he will replicate California's model" (Court/Smith, Los Angeles Times, 6/14).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.