HMO REFORMS: Kaiser Foundation Study Questioned
The American Association of Health Plans criticized a Kaiser Family Foundation-sponsored study that measured the cost impact of two managed care reform proposals, calling the analysis incomplete. AAHP President Karen Ignagni said, "The biggest thing for us is they didn't score the [Patient Access To Responsible Care Act] provision we have been on record as indicating are the most troubling." The Wall Street Journal reports that these provisions "include the right-to-sue language and other provisions aimed at protecting providers in their dealing with health plans" (McGinley, 4/23). The study, conducted by Coopers & Lybrand, did not account for the costs of requiring "managed care plans to contract with more doctors and thus undercut cost controls." Taken together, the right to sue and any-willing-provider provisions "have an enormous impact on cost and even a small increase in cost has an enormous downward impact on how many people can afford insurance," said Julie Cantor Weinberg, the National Association of Manufacturers' vice president for health policy (Rubin, Los Angeles Times, 4/23).
Offering Their Own Analysis
The AAHP "plans to release a study Monday that covers" the liability and any-willing-provider provisions "and shows higher costs," the Journal reports (4/23). The group commissioned the Barents Group to analyze PARCA, the patients' rights bill introduced by congressional Democrats, and "other similar legislation." The analysis will be released Monday "as part of a Health Benefits Coalition press conference" (AAHP release, 4/22). Discussing the managed care reform issue in general, AAHP's Susan Pisano said, "The bill of rights represents good goals. The question becomes does it require legislative intervention to have it happen." Pisano "said her group would prefer that market forces guide whether consumer protections are added to health plans" (Los Angeles Times, 4/23).
Seizing The Day
Reacting to the Kaiser Foundation study's analysis, President Clinton said, "This report again shows the utter groundlessness of claims that a patients' bill of rights will significantly increase health care costs. With this new information, there is no excuse left for inaction. I therefore call on Congress again to send me legislation that gives Americans the health care protections they need and deserve" (release, 4/22).
Hard At Work
The Journal notes that PARCA's sponsor, Rep. Charlie Norwood (R-GA), and House Commerce Committee Chair Thomas Bliley Jr. (R-VA) are working "to develop a four-part proposal that would encourage employers, consumers, providers and insurers to create 'HealthMarts,' health-coverage purchasing pools for small businesses." The Norwood/Bliley proposal "also would include several patient protections, though not necessarily the right-to-sue provision; medical malpractice reform and a proposal to make health costs for the self-employed fully deductible by the year 2000" (4/23).