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Copyright 2000 The Seattle Times Company  
The Seattle Times

January 12, 2000, Wednesday Night Final Edition


LENGTH: 805 words

HEADLINE: Patients' bill of rights: the time is at hand

BYLINE: Lorraine Wojahn, Shay Schual-Berke, Tom Campbell; Special to The Times

THE days of Marcus Welby and friendly home visits by your family doctor are well behind us. Managed care is entrenched. We now have a health-care system in which insurance companies play a key role in medical decisions.

But that doesn't mean patients shouldn't be able to hold these insurers legally accountable, just as we have always been able to hold doctors and nurses accountable.

The fact that your HMO has made your doctor a "gate-keeping, primary-care physician" is no reason you should have to worry about whether you are getting the best medical care available. Patients should be able to choose their own doctors, and doctors should be allowed to practice quality medicine instead of having to protect the insurer's profitability.

The reality is that most Americans trust their doctor, but too many don't trust their HMO. Does my HMO allow my doctor to tell me about every available treatment, or just the ones that won't cost the insurance company too much? Is my doctor required to continue my treatment even though I might be better off seeing a specialist who has greater expertise in my disease? Am I stuck with no recourse if my health plan says it won't pay for the care I need?

These questions are at the heart of the continuing national debate about patients' rights, and a meaningful law protecting consumers would go a long way toward restoring everyone's trust and faith in their doctor - and in our health-care system as a whole. A strong patients' rights bill will ensure that medical decisions are being made by those best qualified to make them.

Unfortunately, the U.S. Congress has been unequal to the task. Despite the U.S. House's enactment last fall of a legitimate patients' rights bill, the proposal got bogged down when Senate and House conferees failed to take action - yet again.

The time to act has come.

This week, the Legislature will take the first step toward providing the remedy that polls consistently show the public wants: a way to hold health plans accountable for the decisions they make; guarantees that information about our health will remain confidential; and better access to the specialists when needed. Hearings on a bill to do just that were held the past two days in Olympia.

Here in Washington, we already have many of the protections that Congress has been quibbling over for years.

Women here have the right to see their OB/Gyn without a referral. Doctors cannot be inhibited from telling their patients about all the treatments available, not just the ones the insurer will cover. And insurance companies have to pay for emergency-room care for patients who went there believing they were in dire straits.

But Washington consumers still don't have the right to appeal denials of coverage to an independent expert, or to hold an insurer accountable in a courtroom for bad medical decisions.

These rights - along with a right to keep your medical information private, a right to see qualified specialists when needed, and a right to know exactly what is covered by your policy - are in our bill.

During the course of the upcoming debate, you may see competing bills that water down some rights, and you will surely hear that this proposal will drive up health-care costs.

But that's just not the case. The nonpartisan Congressional Budget Office estimates that a bill similar to ours would increase costs by only 1.4 percent. And in Texas, where a similar law has been in place for two years, malpractice insurance is falling, consumers' premiums are holding steady, patient satisfaction is improving, and there has been minimal litigation.

United HealthCare, one of the nation's largest health-insurance carriers, recently dropped their pre-authorization requirements because it was costing them more than it was saving. We have made every effort to craft this bill to strike a balance between improving quality and maintaining affordability.

We believe - and most consumers and doctors agree - that a marginal increase in cost is a small price to pay to rescue the trusted doctor-patient relationship and restore trust in the health-care system. If our health-care system is to work well, we need a basic framework of shared and universal protections.

This proposal will build such a framework - it will increase consumer confidence, force all insurers to play by the same rules, and allow us to resume the debate about what we should do for the thousands of Washingtonians who have no insurance at all. State Sen. Lorraine Wojahn, D-Tacoma, is a member of the Senate's Health and Long-term Care Committee. Reps. Shay Schual-Berke, D-Normandy Park, and Tom Campbell, R-Roy, are members of the House Health Care Committee. They are sponsoring identical patients' rights bills in their respective chambers (Senate Bill 6199 and House Bill 2331).

GRAPHIC: ILLUSTRATION; Geoffrey Moss / Creators Syndicate: Patients's bill of rights

LOAD-DATE: January 13, 2000

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