In a letter sent today to the Wall Street
Journal, the AMA corrected the Journal's
inaccuracies in a recent (Oct. 31) editorial and made clear
its support for a real patients' bill of rights.
To the Editor:
Readers of your surprisingly uninformed editorial on
patients’ rights (Oct. 31) might at first suspect a Halloween
trick because of the Journal’s many misstatements
masquerading as fact. They would never know, for example, that
more than 18 million Americans have suffered from health care
delayed or denied by managed care since the House of
Representatives passed a bipartisan patients’ bill of rights
more than a year ago.
Nor would they know that patients cannot hold HMOs
accountable for actions that injure or kill so long as the
outdated ERISA law grants health plans unusual, unique and
unfair immunity from liability.
To correct this inequity, the AMA believes that medical
treatment disputes should best be resolved by an independent
external review appeals process that is free from HMO
meddling. Legislation that passed the House allows health
plans to require completion of the independent review before
any lawsuit is heard in court. And a review panel decision
favorable to an HMO can be used as an affirmative defense – a
strong deterrent to frivolous lawsuits.
Your editorial is flat out wrong in stating that the AMA
has rejected any cap on damages. We have not. The real issue
is to deal with a cap in a way that a majority of the Senate
will support and President Clinton will sign into law.
What we do reject are Johnny-come-lately schemes like those
of Reps. Shadegg and Coburn to preempt state laws and the
growing body of case law that says health plans can indeed be
held liable for medical treatment decisions that harm
patients. Rep. Shadegg also proposed that non-physicians could
serve as primary care gatekeepers and sit on the external
review panels that will decide if the HMOs medical treatment
decisions are appropriate.
Both presidential candidates have endorsed a strong
patients’ bill of rights. Gov. Bush knows what he’s talking
about – despite alarmist tactics by the insurance industry,
the sky did not fall on Texas when patients’ rights became law
there three years ago.
D. Ted Lewers, MD
AMA board chair