PATIENTS’ RIGHTS: Poll Shows Disaffected Public

      A poll released yesterday indicates that while most Americans are wary about the care provided by HMOs, they believe "personal initiative has greater ability to improve the quality of health care than does legislation" (Mullinnix/Taylor, Detroit News, 9/10). Conducted for the Foundation for Future Leadership by the GOP polling firm Luntz Research Companies, the poll found that only 17% of respondents would have "total confidence" in their health insurer or HMO to provide the best available medical care to an injured family member or loved one. In one of the more telling questions in the poll, 53.6% felt that a veterinarian typically spends more time with a pet than an HMO doctor does with a patient. The survey of 850 likely voters was conducted last month; it has a margin of error of +/-3.4% (release, 9/9). Consistent with the poll's findings, the Detroit News reports that "complaints are climbing against HMOs." Teri Morante of the Michigan Insurance Bureau said "her office experienced a 'slight increase'" in complaints during the first six months of this year. Maryland Insurance Commissioner Steven Larson said complaints per month to his office have increased from between 300 and 600 last year to between 500 and 1,000 this year (9/10).

No Big Brother
      Despite the severe shortcomings of managed care in the public's mind, the Luntz poll indicates that government solutions are not necessarily what voters want. Almost three-quarters of those polled agreed with the statement, "You need to rely on yourself to interact with your doctors and insurance companies in order to get good health care," while only 14.2% agreed that "[g]overnment can and will improve the service and health care Americans get from their HMO" (release, 9/9). While Luntz said proposed managed care reforms, such as the right to appeal decisions, the right to sue health plans and a ban on physician gag rules, are "overwhelmingly" supported, people still look to the traditional doctor-patient relationship for their health care solutions. Fundamentally, "they're afraid of what government can do in health care," Luntz said (press conference, 9/9). Consistent with this position, Luntz said a Republican "[f]ailure to pass a managed care bill is unlikely to cost" them votes this fall. "The Republican strategy has been effective in addressing health care concerns to the degree the public wanted them addressed," he said (Rovner, CongressDaily/A.M., 9/10).

HMO Politics Roundup

• Stumping for the GOP: Sen. Rick Santorum (R-PA) yesterday gave an address touting the Senate GOP patients' rights bill as the way to go in health care reform. He stressed that the Republican plan would allow patients to have their appeals heard within 72 hours. Also, he "made a case for medical savings accounts as an alternative to HMOs." He said, "If you're locked into an HMO, you're frozen. But if we provide medical savings accounts, then I think you will drive HMOs to be better" (Burger, Pittsburgh Tribune-Review, 9/9).
• Business Opposes Compromise Bill: A group of business interest groups sent a letter to all members of Congress Tuesday, urging them to oppose the Chafee-Graham-Lieberman-Specter-Baucus bill, which has been touted as a compromise effort between the two parties' proposals. They wrote: "By bringing back skyrocketing costs and putting employers at risk of business-ending lawsuits, the Chafee proposal punishes and burdens all employers who voluntarily provide health coverage to more than 150 million Americans" (release, 9/8).
• New DOL Program for Grievances: The U.S. Department of Labor announced yesterday a new regulation aimed at ensuring HMO members a timely internal review when they have a grievance and an expedited review for urgent claims. The rule gives patients better access to their records, requires plans to provide enrollees with better disclosure regarding their appeal rights, and cuts the maximum time health plans have to respond to non-urgent appeals from 90 to 30 days and requires plans to respond to urgent appeals within 72 hours (DOL release, 9/9).
• Business Roundtable Runs Ad: The Business Roundtable unveiled a TV spot today denouncing Senate Democrats' patients' rights bill. The ad will air during the Senate debate on managed care reform. An announcer explains that the Democrats' bill would damage the health care system by placing health plans and employers at risk of lawsuits relating to coverage decisions. Business Roundtable Health and Retirement Task Force Chair M. Anthony Burns said, "Expanding liability as the Kennedy bill does, will help no one: it will force employers to drop sponsorship of health benefits, force employees to pay higher premiums, and force patients needing treatment to wait while otherwise resolvable coverage issues turn into protracted legal proceedings" (release, 9/10).
• "Day of Action" For AFL-CIO: The AFL-CIO is sponsoring a "National Day of Action for HMO Reform" today. Consumers, health care providers and community leaders in over 40 cities will rally in front of HMOs and U.S. Senate district offices to "send a message to the Senate" (release, 9/8).
• Showdown in CT: Rep. Barbara Kennelly (D-CT), challenging incumbent Gov. John Rowland (R) in the fall election, turned "up the heat on what she considers her strongest campaign issue," asking Rowland to sign a pledge committing him to support patients' right to sue their health plans. A Rowland spokesperson said, "[T]he governor is not going to sink to this level and engage in Mrs. Kennelly's publicity stunts on important issues of public policy. Gov. Rowland has a record of reforming the HMO system. Mrs. Kennelly has a record of talking about it" (Daly, Hartford Courant, 9/10).