PATIENTS’ RIGHTS: Positions Solidify as Issue Heats Up
The White House yesterday signaled that "President Clinton may be willing to accept something less than an unfettered patients' right to sue managed care plans," endorsing a provision contained in a managed care reform bill introduced last week by Rep. Greg Ganske (R-IA). The measure would allow patients to sue HMOs, but "shield plans from punitive damages if the plans agree to abide by the rulings of external appeals panels" (CongressDaily, 2/17). CongressDaily also reports that officials from the American Medical Association and the U.S. Chamber of Commerce are meeting "behind closed doors in Palm Beach, FL," in an effort to find common ground on managed care reform. Leaders of the Health Insurance Association of America, the American Hospital Association, the American Association of Health Plans and the Healthcare Leadership Council will also attend some of the meetings (2/17).
Powerhouse Effort
The AFL/CIO said yesterday that it will spend $40 million between now and the 2000 elections to elect candidates who support its positions on patients' rights, the minimum wage and "protecting non-traditional workers" (Gordon, Newsday, 2/18). The Washington Post reports that the effort "will focus on 40 to 60 key congressional districts in about 20 states." It will also "aim to build up union support in California and six eastern and midwestern states that could prove pivotal to any Democratic presidential candidate" (Swoboda, 2/18).
Who Decides
Today's Wall Street Journal reports that the "latest hot-button issue in the patients' rights battle" is "[w]ho gets to decide when treatment is medically necessary?" The AMA and Democrats "in Congress want to make it harder for managed care plans to overrule the judgment of treating physicians about what constitutes medically necessary and appropriate care." Health plans and their Republican allies charge that such a move would drive up costs. The Journal notes that "the fracas signals an escalation of the battle over patient protection proposals" as Congress prepares to take up the issue. The Health Benefits Coalition is airing radio spots in six cities "urging lawmakers to oppose HMO-overhaul legislation" (McGinley, 2/18).