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June 1999

AFSCME Urges Congress to Pass Bill Protecting Health Care Workers, Consumers

The Patients’ Bill of Rights — legislation to curb abuses in managed care — must include protections for health care workers who point out the system’s shortcomings, and must also prevent the industry from making decisions that might interfere with the provision of quality care. This is what AFSCME is telling lawmakers.

A petition to Congress on the measure (S. 6/H.R. 358) has been posted on AFSCME’s home page at By clicking on the petition site, AFSCME members can sign this electronic petition urging Congress to pass a real Patients’ Bill of Rights which includes “whistleblower” protection for health care workers.

Sen. Edward M. Kennedy (D-Mass.) and Rep. John Dingell (D-Mich.) have reintroduced a bill that has strong enforceable protections for consumers and health care workers. Republican leaders in the House and Senate have introduced their own bills, but they would do little to protect consumers or workers. In fact, the Senate Republican leadership bill (S. 300) doesn’t cover public employees.

AFSCME, along with other unions and consumer organizations, has been pressing Congress since 1997 to pass strong protections. In addition to whistleblower protection, legislation must guarantee that managed care bureaucrats and insurance company accountants are not allowed to arbitrarily overturn treatment decisions by health care professionals. Patients denied care by plans must be able to appeal the decision to an independent board of experts, and the board’s decision must be binding. Finally, plans must be held accountable for decisions which injure patients.

The dramatic growth of enrollment in health maintenance organizations (HMOs) and other forms of managed care plans has transformed the health care industry, changing how health care services are paid for and delivered. In 1980, 90 percent of Americans were covered by traditional fee-for-service plans. Today, three-quarters of working families are enrolled in an HMO, preferred provider organization or some other form of managed care. Public programs like Medicare and Medicaid are either encouraging or requiring participants to switch to managed care plans.

The shift to managed care has been accompanied by another trend: the expansion of for-profit businesses into managed care. Both of these trends have created strong incentives for reducing costs and cutting corners throughout the health care industry.

More and more, managed care plans are sending patients home too early from hospitals and nursing homes, denying patients access to specialists and blocking emergency treatment. Workers and families are increasingly insecure about whether quality care will be there when they face a crisis.