MANAGED CARE REFORM: Don’t Look For Major Bill In Congress This Year
Roll Call columnist Morton Kondracke today writes that "Congress is unlikely to respond to public anger at HMOs with heavily regulatory legislation this year." However, he notes that lawmakers are also "not likely to give patients more health care choices and information, either." Kondracke contends that Rep. Charlie Norwood's (R-GA) Patient Access to Responsible Care Act is not "likely to pass" this year, largely because it is an "anathema to Republican leaders, who regard it as certain to trigger higher health costs and insurance rates and increase the number of persons without health insurance." Instead, he notes that "Republican leaders, if they are worried enough about anti-HMO sentiment, are prepared to pass token legislation barring health plans from denying information to patients, protecting patient privacy and imposing minimum hospital stays after mastectomies."
A Better Option?
Kondracke suggests another option for increasing the amount of health plan information available to consumers, an option based on a proposal made by David Kendall and Robert Levine of the Progressive Policy Institute. The Kendall/Levine plan would create "an Internet-style health information network that would include an individual's coded health records, up-to-date data on the best medical practices for various conditions and performance records of doctors, hospitals and HMOs." Under this system, Kondracke writes, "[p]atients or someone they choose could access the network and electronically match the patient's medical problem to the scientific and performance data," and "[p]atients would deposit a report on their treatment and its results into the database -- without identifying themselves and losing privacy -- to add to the information available to others." Kondracke notes that "Kendall and Levine are in the process of expanding on the idea to reform the entire U.S. health delivery system," under which every American would "have a Health Management Account, paid into by employers and/or the government" ... and the "maximum choice ... to choose the best health plan for their medical needs." "Conceptually, the whole system, operating privately but with government backing, would resemble such computerized new entities as the Visa credit card consortium of banks, credit reporting systems, ATM networks, the Internet and the universal bar code system," Kondracke writes.
Don't Bet On It
Kondracke notes that only one HMO reform bill, introduced by Sens. James Jeffords (R-VT) and Joseph Lieberman (D-CT), "contains a start toward a performance- and information-based" system. He concludes that Republicans should "launch at least a study of a national health information network. It would be based on the concepts of personal choice and responsibility -- just what Republicans say they believe in" (4/20).