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Copyright 2000 The Kansas City Star Co.  

November 30, 2000, Thursday METROPOLITAN EDITION


LENGTH: 389 words

HEADLINE: Protecting patients

The Clinton administration's new rules for many health plans
appear to give tens of millions of Americans a better chance of
receiving the medical care that they and their employers want.

Like various legislative proposals for a patients' bill of
some of the administration's new rules seem quite basic. One
rule, for example, tells insurers to take no more than 72 hours to
decide on claims for urgently needed care. This seems, if anything,
too long.

Another rule gives patients 180 days to file appeals on claims,
rather than the current 60 days. Some health plans can be incredibly
confusing and bureaucratic; sometimes even obtaining written
instructions on appeal procedures can be difficult. So it is
unreasonable to shut off appeals after only 60 days.

The Health Insurance Association of America again argues against
reasonable consumer protections by complaining about the costs. But
medical cost-containment should not be achieved by targeting sick

Insurance is supposed to collect money from a large population to
help those who meet with misfortune. It is backward to suggest that
people who meet with misfortune should endure more suffering and
heavier financial burdens so that everyone else can be protected from
the rising costs of medical care.

Although the next president could modify the new federal rules,
both Texas Gov. George W. Bush and Vice President Al Gore presented
themselves to voters this year as strong advocates of patients'
rights. Bush has praised provisions in Texas law that are similar to
the new federal rules.

The administration said it did not have the authority to make it
easier for patients to sue health plans that deny needed medical
care. Congressional action remains necessary to fix the right-to-sue

The unusual legal shield enjoyed by health plans encourages
abusive practices by some companies and places more responsible plans
at a competitive disadvantage.

More important, broad restrictions on the right to sue
irresponsible health plans put health-care consumers at risk.

Americans pay plenty of tax dollars to support the legal system.
They should be allowed to use that system when necessary to ensure
that they and their families receive appropriate medical care.

LOAD-DATE: November 30, 2000

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