STATE OF THE UNION II: Managed Care Reform Applauded
In last night's speech, President Clinton urged bipartisan congressional action to enact a patients' bill of rights. "Medical decisions ought to be made by medical doctors, not insurance company accountants," he said. "I urge this Congress to reach across the aisle and write into law a Consumer Bill of Rights that says this: You have the right to know all your medical options, not just the cheapest. You have the right to choose the doctor you want for the care you need. You have the right to emergency room care, wherever and whenever you need it. You have the right to keep your medical records confidential. Traditional care or managed care, every American deserves quality care" (transcript, 1/27).
Cheers From The Crowd
According to the Washington Post, Clinton received applause from "many on both sides of the aisle" when he brought up managed care reform (Harris 1/28). In a post-speech analysis, CNN's Jeff Greenfield noted, "One of the loudest and most spontaneous applause lines in the speech came when the president took a shot at managed care as it is done now. ... Audiences all over the country were cheering it. Here the president is saying he is going to fix that" (1/27). In the GOP response to Clinton's speech, Senate Majority Leader Trent Lott (R-MS) made only a passing reference to managed care reform, saying only that Republicans are "committed to more positive reforms in health care" (GOP response, 1/27).
Rep. Charlie Norwood (R-GA), who has introduced a consumer protection bill more stringent than Clinton's, "challenged the president to ... [recognize] the importance of choice and accountability in any reform effort." Norwood noted that his bill "would guarantee that employees have a choice in health plans, and for managed care plans to be legally responsible if a patient is damaged as a result of the denial of medically-necessary care." According to Norwood, the Clinton patients' rights proposal "fails to address either issue." Rep. Greg Ganske (R-IA) criticized Republican leaders for classifying efforts to reform the managed care industry as "Clinton Care II," and said that the reforms in Norwood's proposal have nothing to do with "socializing medicine or implementing universal coverage" (release, 1/27).
The Health Insurance Association of America responded to Clinton's plan by saying that the "[g]overnment should lead by example and incentive, not by mandate." The group further said the government "should promote the power of the private marketplace to deliver quality care through innovation and responsiveness to consumer demand; not substitute its single judgment for the millions of choices that individual employers and consumers make every day" (release, 1/27).
Children Are People Too
A number of groups sent a letter to Health and Human Services Secretary Donna Shalala earlier this week saying that the president's commission on consumer protection failed to consider the special needs of children, including access to pediatric providers and child health specialists and targeted research to better understand the health concerns facing children. According to the letter, children need special protections "as a result of their dependence on others for access to health and mental health care services, the potential for significant adverse effect of illness on their development and growth, and the need for access to providers and facilities with appropriate pediatric expertise." The letter was signed by a number of groups, including the American Academy of Pediatrics, the American Psychological Association and the American Psychiatric Association (release, 1/26).
The American College of Emergency Physicians praised the president's decision to emphasize passage of the consumer bill of rights. "[ACEP] strongly supports provisions that protect a person's access to emergency care and establish the prudent layperson standard of emergency as a basic protection for all Americans," said Nancy Auer, the group's president (release, 1/27).