"It's the wrong answer to a non-problem, but the so-called patients'
bill of rights is picking up steam in Congress. Al Gore is lashing out
at George W. Bush for not supporting the idea enthusiastically enough and
this country may ultimately even get it.
"The bill is mainly aimed at HMOs and their efforts to control costs.
The thesis is that thousands of patients are being denied care crucial to
their well-being so the insurance groups can make outsized profits. But
that's a myth. While there is certainly an effort at HMOs to hold down
costs through denying superfluous, unnecessary care, there is no broad
statistical evidence of patients being denied essential, proven
treatments, just examples of the sorts of terrible mistakes that can and
do happen under any system.
"In fact, the health of Americans has never been better – which while
it isn't evidence that managed care is managing well, certainly isn't
evidence of the opposite, either.
"The patients' bill of rights would nevertheless open the door for
increased lawsuits, and that could spell the end of managed care,
reversing its extraordinary achievement of slowing runaway health-care
"Surely, proponents of the bill argue, patients should be able to sue
an insurance company when its cost-control measures are at variance with a
physician's advice. Unfortunately, trial lawyers will always be able to
find a physician somewhere to testify against generally accepted medical
practices. The suits will likely be endless and cost controls therefore
impossible. Not only might severe medical inflation be back with us again,
but health care might suffer; physicians might well fall into their
old habits of prescribing too much treatment, and that, statistics
suggest, is far more dangerous to patients than the limitations imposed by
"Although there are compromises that could deal seriously with some of
the real problems at HMOs, the politicians seem mostly uninterested.
Instead of explaining the facts to concerned constituents, they are
leading the pep rally, and someday those constituents may be among those
paying the price."