PATIENTS’ RIGHTS II: REACTIONS, BOTH PRO AND CON
Health care industry groups were quick to react to PresidentThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
Clinton's endorsement yesterday of a comprehensive set of
patients' rights (see lead story). Karen Ignagni, president of
the American Association of Health Plans, said, "We accept the
challenge that the Secretary [of HHS] and the Commission has
outlined, and indeed we have launched an industry initiative that
embraces many of the principles. ... We're pleased that the
president himself noted the value of those private sector
activities." The crucial point now, she said, is "defining the
role of government: what's the balance point between private
sector and public sector activity" before we "prematurely rush
into legislation? ... The final factor is, how do these
complicated questions actually get vetted and answered in a year
of election-year politics. And we could perhaps leave that for
another year. And I think that what we've seen thus far is an
opportunity for certain politicians, rhetorically, to try to
suggest that there is a backlash, that a vote against managed
care is a free vote. Frankly I think that that misses the boat"
("NewsHour," PBS, 11/20). Health Insurance Association of
America spokesperson Richard Coorsh said, "Federal regulation
would stifle the innovation that currently goes on, and we must
make sure that people have access to coverage, not impediments to
it." Coorsh cited a Congressional Budget Office report which
found "that for every 1 percent increase in insurance costs, an
estimated 200,000 people lose coverage because small businesses
are priced out of the system" (Sobieraj, Washington Times,
11/21). Michael Cannon, a health care policy analyst at Citizens
for a Sound Economy, said, "[A]dded benefits bring added costs,
and increased costs mean more Americans cannot afford insurance.
This is not a 'Bill of Rights.' It is a bill of goods" (release,
11/20).
MORE BUSINESS VOICES
Angie Hunter, director of federal affairs for the Council
for Affordable Health Insurance, said, "In order to bring down
health care costs and increase access, lawmakers need to
institute reforms that give consumers more choices and more
control over their health care spending. Every time Congress
passes a new federal mandate guised as a 'consumer protection'
the country becomes closer and closer to a government-run health
care system" (release, 11/20). In a letter to President Clinton,
the Association of Private Pension and Welfare Plans said that it
should be the role of employers, not the government, to control
the type of coverage offered. Association President James Klein
wrote that the best way to reach the objective of a health care
system responsive to the needs of its workers is "not through
added regulations which will make it more difficult for some
employers to offer coverage at all" (release, 11/20).
VOICES OF SUPPORT
Consumer and patient advocates were almost unanimously in
support of what many termed an important "first step." AFL-CIO
President John Sweeney said the protections "may not be as much
as people need in all circumstances, and they may be more than
health plans would like to see in any case, but they respond
constructively to the real life problems experienced by working
families across the nation." He added that it is "important that
the recommendations call for [a] uniform national framework"
instead of a "patchwork" of state proposals (release, 11/20).
The Consumers Union praised the provision for an external
grievance and appeal process. Adrienne Mitchem, legislative
counsel to the group, said, "[T]he managed care industry, which
has an unfortunate track record of skimping on care to increase
profits, should not be both judge and jury when it comes to
settling medical care disputes with their patients" (release,
11/20). American Nurses Association President Beverly Malone
praised the proposal for making "substantial progress in
recognizing the need to put patient protection at the center of
our health care system." She added, "These rights reinforce the
core work of nurses and provide unprecedented support for
patients as full partners with providers in determining their
health care" (release, 11/20).
NOT ENOUGH
Mental health advocates offered some support for the bill of
rights, but National Association for the Mentally Ill Executive
Director Laurie Flynn said that "ongoing work is needed to assure
quality and accountability for individuals with severe mental
illnesses." NAMI recommended that national standards also
include protections that ensure access to necessary inpatient
treatment, community services and anti-psychotic medications
(release, 11/20). Michael Faenza, president of the National
Mental Health Association, said the rights bill "will help
provide essential safeguards for mental health consumers in an
increasingly cost-based health care system." However, he
expressed concern that the bill of rights does not "ban
discrimination in marketing and enrollment practices or recommend
that all Americans have the same access to mental health
treatments that they have to physical health services" (release,
11/20).
THE WORD FROM ENTHOVEN
Stanford University health economist Alain Enthoven, who
also chairs California's Task Force on Managed Care, said the
patients' rights package "has some good things and some not so
good things." He continued, "I think they missed perhaps the
most important thing they could have done. And that is, roughly
a third of the people in this country do not have a choice of
health care plans. I was really hoping that the national task
force would recommend ... that the Congress re-pass something
like the HMO act that said people could have choices of plans."
Asked if he was surprised by the backlash against the managed
care system he helped define and implement, Enthoven said, "Given
what happened, I'm not very surprised. It played out in a rather
different way from what I had envisaged when I proposed the
managed care revolution 20 years ago" ("NewsHour," PBS, 11/20).