Congress must pass patients' bill of rights Health: Time has come for Democrats and Republicans to rein in managed-care )) groups.

July 01, 1998

IF THERE is one thing Americans agree on it is the need to rein in powerful managed-care groups that increasingly control a patient's health care decisions.

Republicans in Congress, not wanting to cede this issue to Democrats in the fall, have put forth their own set of patients' rights that seems to satisfy no one.

An insurance lobbyist calls the GOP plan "a mishmash of cobbled-together ideas." Consumer groups say it amounts to a timid baby step. Democrats accuse the GOP of catering to the health-care industry that helped put congressional Republicans in power.

With 175 million Americans enrolled in managed-care plans, complaints have ballooned about insurers' refusals to pay for such basics as emergency rooms visits and consultations. The arbitrariness of some of these denials has infuriated consumers, who don't want medical decisions based on an insurer's bottom line.

Until last week, Republicans had refused to consider a "patient bill of rights" pushed by Democrats. A bipartisan measure, reflecting the public's concern, had more than 300 co-sponsors -- more than enough for passage in the House. But Speaker Newt && Gingrich refused to act.

Still, Republicans needed a health-care bill to take back to voters over the July 4 weekend. What emerged embraces some of the Democrats' proposals but with a decidedly conservative twist.

It matters little whether Democrats or Republicans claim credit for the final product. What counts is giving patients an assurance of basic health-care rights. Millions of Americans find themselves at the mercy of HMOs because no national standards exist for managed-care companies.

Any federal law must ensure emergency-room care, quick appeals of treatment denials to a neutral party and a woman's right to choose a gynecologist as her primary-care physician. It also must hold insurers liable for wrongful acts and give physicians the freedom to tell patients about treatment options, even if the health plan doesn't offer them.

Denial of medically necessary care worries many Americans. That's not right. Congress can remedy this situation by giving millions of patients peace of mind without imposing unfair burdens on the industry.

Pub Date: 7/01/98

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