PATIENTS’ RIGHTS: Gap Between Parties Wider Than It Seems
Today's New York Times reports that a close examination of the Republican and Democratic bills on patients' rights "shows that there are also major differences in important areas on which the two sides had seemed to agree," particularly in the provisions on emergency care and medical privacy. Prior to the House Republican proposal being passed last month, it was generally accepted that both parties agreed on a "prudent layperson" standard for seeking emergency care and requiring that a health plan cover it. But the GOP bill actually creates a "two-step test," which governs the initial screening examination in an emergency room while establishing a "prudent emergency medical professional" test to cover additional emergency services. Furthermore, the Republican bill lacks a provision saying a patient cannot be charged more for emergency services at another hospital than they would be at a hospital affiliated with the HMO. John Scott, director of the Washington office of the American College of Emergency Physicians, said: "[T]his new standard of a prudent emergency medical professional was invented out of thin air. It creates new opportunities for HMOs to second-guess the treating physician and to deny payment for emergency services."
Managed Care Key In KY
Today's Wall Street Journal looks at the race for Kentucky's third congressional district seat and how managed care reform is the focal issue. Former Democratic state attorney general Chris Gorman accuses first-term incumbent Rep. Anne Northup (R) of "putting special interests ahead of the health of the people of Louisville" with her opposition to the Democratic patients' rights proposal. Northup, one the other hand, argues that the Democratic bill is "an excuse for huge new federal controls" on health care. She voted with the GOP majority for its managed care bill, a move some analysts say diffuses the charge that she is soft on HMOs. "I don't think, 'Nah, nah, nah, nah, my bill is better than your bill,' is going to be a persuasive argument," said analyst Stuart Rothenberg. However, the race is shaping up to be a "bellwether of public sentiment" on the issue, as well as a crucial race if the GOP is to keep its 11-vote House majority. So far, the AFL-CIO has run ads for Gorman, and the Health Benefits Coalition has done likewise for Northup. And recently, House Speaker Newt Gingrich (R-GA) visited the district to campaign for Northup (McGinley, 8/4).
The latest editorials on the patients' rights issue:
- A Business Week editorial comes out against giving HMO members the right to sue their health plans. "Advocates of the right to sue say few lawsuits will actually be filed, because HMOs will act defensively by covering more treatments. But the threat of suits against doctors has led mainly to waste, such as unnecessary tests or surgery intended to rob plaintiffs' lawyers of arguments. Managed care can cut such waste and control costs. If Clinton wants real reform, he should keep the lawyers out and bring appeals panels in," the editorial concludes (8/10 issue).
- Macon Telegraph: "Congress is deadlocked, and it appears likely that nothing will pass this year. The Democratic reform bills do not have enough votes to pass, and the Republican bills don't have enough votes to overcome a presidential veto. ... However, any bill would be an improvement over the present system in which patients and doctors have little to say in matters of life and death" (8/4).
- Philadelphia Inquirer: This editorial criticizes Congress for passing HMO reforms while failing to address the rising number of uninsured Americans. "A can-do Congress would repair the worst hurt -- the fractured system that leaves millions without health insurance" (8/4).