MANAGED CARE REFORM: Senators Embark On ‘Quest’

      Senate Labor and Human Resources Chair Jim Jeffords (R-VT) and Sen. Joseph Lieberman (D-CT) unveiled a managed care reform bill yesterday that they said "includes the most important elements of reform without carrying all the political baggage contained in other measures," CongressDaily/A.M. reports. The bill, called the Health Care Quality, Education, Security and Trust (QUEST) Act, establishes patients' rights and minimum quality standards for health plans regulated by the Employee Retirement Income Security Act (ERISA).

The Nitty Gritty
      The bill "would allow patients to appeal treatment decisions to a board and attempt to protect physicians' roles as advocates for their patients." It would also "establish a 'prudent layperson' standard to improve access to emergency room care," and "establish more comprehensive collection of data about care providers and insurers, and make this information more readily available to consumers" (3/3). In addition, the bill would create a Health Quality Council to advise the president and Congress on health care quality issues and would increase the duties of the Agency for Health Care Policy and Research in measuring and evaluating health care quality. Jeffords said QUEST strikes a balance between competing ideas on Capitol Hill that either leave too much to the market or regulate health providers too closely (Jeffords release, 3/2). "Lieberman acknowledged 'there is some overlap' between the QUEST bill and the patients' bill of rights endorsed by President Clinton. It also contains elements of the Patient Access to Responsible Care Act," although it does not provide the right to sue providers as PARCA does.

Mixed Reaction
      Richard Coorsh of the Health Insurance Association of America said, "[W]e remain convinced that federal requirements do not lead to increases in quality. And much of what the good senator is calling for already exists in the private sector" (CongressDaily/A.M., 3/3). Consumers Union, in a letter to Jeffords, was far more supportive: "We are particularly pleased that the act contains some critical consumer protections to address consumers' concerns about managed care's ability to provide quality care." Consumers Union was most pleased with the appeal provisions and the information disclosure provisions. "Consumers Union believes that the proposed bill will substantially improve the quality of care, the quality of information, and the quality of choices in our health care system," the letter states (Consumers Union release, 3/2).