PATIENTS’ BILL OF RIGHTS: Choice, Info, Right to Sue Vital

      Laura D'Andrea Tyson, dean of the Haas School of Business at the University of California at Berkeley and President Clinton's former chief economic adviser, outlines a series of strategies to improve HMO services in a Business Week editorial. Tyson notes that HMOs have successfully trimmed costs, and reduced the provision of unnecessary care, and that "no evidence that HMOs provide consistently worse care than fee-for-service plans" exists. She adds that "markets for health care work best when consumers have both choice among competing suppliers and the necessary information to make wise choices." Tyson recommends that consumers be given the option of choosing among competing plans and among varying levels of coverage and flexibility in choosing providers. Additionally, she asserts that consumers should be able to sue their HMOs for negligence and damages -- restricted by a "prior review of patient complaints by independent medical experts" and limited in the size of awards. She laments the lack of reliable, widely available HMO performance data, suggesting that "participants in the health care marketplace could benefit from a Securities & Exchange Commission-type organization requiring compulsory registration and public disclosure of certain kinds of information on a timely basis." Tyson concludes: "An adequate patient's bill of rights will improve the market for health care. But society will still have to come to grips with how best to protect life and enhance human dignity in a situation of limited health resources" (Tyson, 8/9 issue).