For Immediate Release
March 18, 1999

Contact: Jim Farrell or Andy McDonald
(202) 224-8440

Wellstone Urges Passage of Strong Patients' Bill of Rights

Senate Committee Considering Legislation This Week

Offers Physician Choice, Health Care Ombudsman, Patient Advocacy Protection, Other Amendments

Says Republican bill, in present form, is "woefully inadequate"

 


 (Washington, D.C.) -- Echoing the concerns of Minnesotans about the need to improve the nation's health care system, Senator Paul Wellstone renewed his call today for passage of a strong Patients' Bill of Rights this year at a Senate Committee meeting where the legislation is being considered. He offered several amendments to improve the existing bill, which he called, in its present form, "woefully inadequate." Enacting a Patients' Bill of Rights has been a priority for Wellstone since 1994, when he introduced the first Patient Protection Act. The measure is being debated in the Senate Health, Education, Labor and Pensions (HELP) Committee, of which Wellstone is a member.

"Five years ago I introduced a patient protection bill because I was already hearing the stories from Minnesotans of necessary care delayed and denied," Wellstone said. "These concerns about managed care are heard louder than ever today. Patients and caregivers should be protected against bottom-line medicine. Our system should be about managed care rather than "managed cost." I believe that everyone in America has the right to quality, affordable and comprehensive health care coverage. Patients shouldn't have to fight with their insurance companies over every bit of coverage."

"The Republican version of this bill, being debated this week, is woefully inadequate and a half-hearted attempt at enacting patient protections," Wellstone said. "This bill in its current form is weak, and does not go nearly far enough. I will work hard to make sure we pass a bill that addresses the real needs of patients in our system."

Wellstone's "Point of Service" Amendment guarantees patients the choice to stay with or go to a particular doctor not included in a plan's network of providers. If patients cannot find the doctor they need in their health plan they can go elsewhere.

"This Point of Service Amendment is about freedom of choice for patients, about continuity and about getting people access to the care that they need," Wellstone said. "Patients should have the right to choose a doctor from the widest possible selection and continue their relationship with a doctor whom they trust for as long as possible."

Wellstone's "Patient Advocacy Protection" Amendment says that plans cannot penalize doctors who advocate for patients during an appeals process. It also protects licensed and certified health care professionals from retaliation if they report problems (Whistleblowers) related to quality of care to (1) the hospital or plan, (2) proper regulatory authorities; or (3) private accreditation organizations.

 

"Protecting patient advocacy is about the trust between patients and their doctors that is so essential to patients' satisfaction with their health care," Wellstone said. "Patients should know they are receiving the best medical advice from their doctors, who are free to speak on their patients' behalf so that they receive the best care possible. Doctors should be free to act on behalf of patients without fear of being penalized by a health plan. And health plans should not be allowed to dump providers simply because they report quality concerns."

Wellstone's "Ombudsman" Amendment will establish an Office of Consumer Information, Counseling and Assistance -- or ombudsman -- in every state, to be administered by each state. An ombudsman provides many important services including, consumer assistance with health insurance options, establishment of a toll free hotline to answer questions promptly, consumer education about patients' rights and responsibilities under their health plans, assistance with internal and external appeals when necessary, and collection and dissemination of timely health care information.

"Our current health care system is a maze. There is a lot of confusion among people about their health insurance options, and their rights and responsibilities in the managed care system," Wellstone said. "A full-fledged ombudsman fills an important role, providing consumer assistance and education and improving access to care and access to the appeals process. Better educated consumers who are better able to access the care that they need will mean fewer complaints, fewer appeals and fewer lawsuits."

Mental Health Care and Substance Abuse Treatment Amendments

Wellstone also offered amendments to prevent discrimination by health plans against persons with mental illness and an amendment to prevent plans from blocking or prohibiting patient access to available substance abuse treatment or other behavioral health care services.

"People struggling with mental and emotional disorders need treatment and support, not termination from health plans because they have specific behaviors associated with their illness. This would be like dropping heart patients if they have chest pains," Wellstone said. "And people who are able should be allowed to pay their own money for behavioral care that is denied by plans. This is a small, but important common-sense fix to an unfortunate problem faced by many families with loved ones who need this care."