Copyright 2000 The Seattle Times Company
The
Seattle Times
January 12, 2000, Wednesday Night Final
Edition
SECTION: EDITORIAL; Pg. B5
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
BODY:
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