DMHC, State Patients’ Rights Law Have Helped California HMO Members Avoid ‘John Q.’ Scenarios, Zingale Says
The Department of Managed Health Care, established in 1999 as part of a state patients' rights bill, has helped California HMO members avoid the problems that Denzel Washington's character faces in the film "John Q.," DMHC Director Daniel Zingale writes in a Sacramento Bee opinion piece. In the movie, Washington's character takes hostages in a hospital after his son is denied a heart transplant. Zingale cites the case of a "real Jane Q." named Angie Birdwell, a Bay Area resident who sought treatment for her son, who had a serious heart condition. After her HMO denied treatment for her son, Birdwell appealed the decision through the DMHC's Independent Medical Review program. A panel of independent doctors reviewed her case and forced her HMO to provide the treatment, Zingale writes, adding that Birdwell's son is now "free of the heart problems and severe pain that had plagued him." He writes, "In the HMO medical world there's a need for government to take an active role on behalf of sick patients who want to see their doctor -- not a lawyer, an HMO official or a stack of forms." He urges the federal government and other states to "follow our lead" on managed care reform. "The HMOs should understand that ... patients want to move ahead and will never let California go back to the days of 'John Q.' Just ask Jane Q.," Zingale concludes (Zingale, Sacramento Bee, 3/19).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.