PATIENTS’ RIGHTS: A Hot Political Issue In 1998

      Sunday's Washington Post looks at how managed care reform is becoming a "potent political issue" this year. Growing public support for HMO reform is "producing considerable political angst" for both parties. For Democrats, the issue is "whether they are better off if Congress adopts a patients' rights law before the elections in November." If no such protections are enacted, the Post notes, Democrats "can blame the GOP for thwarting what the public wants." For Republicans, the "dilemma ... runs deeper": "At one level, the very premise of a federal guarantee of patients' rights conflicts with the conservative distaste for government bureaucracy as a solution to social problems. At another level, the loudest critics of such a law are traditional GOP constituencies -- employer and insurance groups." But Republicans "cannot afford to cede such a popular issue to Democrats" as they defend a narrow House majority this year.

All (HMO) Politics Is Local
      The Post article notes that "both parties are talking about health care this year" in their campaign messages. The article cites Hotline publisher Doug Bailey's survey of 126 campaign commercials from 50 congressional and gubernatorial primaries. Bailey found "12 single-issue ads about managed care" alone. The managed care industry is also stepping up efforts to influence public opinion. The Association of American Health Plans "is spending about $1 million this year on advertising, mailings and development of policy positions, as well as working in 10 states to forge alliances with consumers and business groups in districts of key lawmakers." In addition, the Health Benefits Coalition has spent more than $1 million lobbying on the issue this year. See the Post article for a side-by-side comparison of two major HMO reform bills in Congress (Goldstein/Neal, 5/31).

'Be Careful What You Wish For'
      Writing in yesterday's New York Times, Michael Weinstein argues that managed care reform is "almost certain to do the opposite of what consumers say they want." Weinstein writes: "Rather than expand consumer options, they will drive patients into restrictive types of HMOs that limit patients to a small roster of doctors. The bills could also wipe out old-fashioned fee-for-service health insurance, which puts medical choices completely in the hands of doctors and patients." He concludes the piece by noting that the "dilemma" for policymakers "is accountability versus choice. Virtually everybody's health care hinges on that conflict, yet nobody in politics is talking about it" (5/31).

Hometown Opposition
      One of the leading HMO reform bills in Congress is sponsored by Rep. Charlie Norwood (R-GA). An editorial in the Augusta Chronicle criticizes Norwood's proposal, contending that his Patient Access to Responsible Care Act "is still too much of a Big Government health care bill, not all that dissimilar from parts of President Clinton's 'Patients' Bill of Rights.'" According to the editorial, the better alternative to HMO reforms is the creation of medical savings accounts. "MSAs empower people to control their own health care costs by letting them choose the health care program that best suits their needs," the Chronicle argues (5/31).