We urge you to support a managed care reform bill that protects the ability of patients to enforce their rights to medical care. Although a number of managed care reform bills purport to be a panacea for patients, only some provide patients with a legal mechanism to enforce their rights. Even a clearly defined right to specialty care does little to protect a patient’s health if such care can be routinely delayed or denied with impunity. Only legal remedies provide adequate protection against managed care’s biggest abuses.
Americans overwhelmingly favor holding managed care accountable. A Kaiser Family Foundation poll in September 1998 found that 73 percent of voters believe that patients should be able to hold managed care plans legally accountable for wrongful delays or denials.
A right to a remedy will not drive up premium costs. The Kaiser Family Foundation study conducted by Coopers & Lybrand found that premiums would increase three to 13 cents per month per enrollee if Americans were permitted to hold managed care legally accountable. This is an extremely small price to pay to ensure the health of American families. In Texas, a law allowing patients to hold managed care responsible for medical malpractice has only resulted in one lawsuit in over a year. Ironically, the industry’s cry that liability will raise costs assumes that health plans are very negligent and that patients suffer real harm.
Don’t fall for the industry’s rhetoric. External review is essential, but it cannot substitute for legal rights. Managed care is fighting accountability, proposing instead that patients who have been unfairly denied health care be limited to external appeals. External review is simply not enough to protect patients against the worst managed care abuses. Accountability is the ultimate deterrent and is an essential last resort when all else fails. Only legal accountability gives injured patients what they need to ensure that managed care does the right thing and puts patients first.
We urge you to give Americans the tools they need to take care of themselves and their families. Support legislation that allows patients to enforce their rights to medical care.
American Association for Marriage and Family Therapy
American Association of Nurse Anesthetists
American Association of Oral and Maxillofacial Surgeons
American Association of Physicians of Indian Origin
American Association of University Women
American College of Obstetricians and Gynecologists
American Counseling Association
American Federation of State, County and Municipal Employees
American Nurses Association
American Occupational Therapy Association
American Psychological Association
American Society of Plastic and Reconstructive Surgeons
American Speech-Language-Hearing Association
Bazelon Center for Mental Health Law
Center on Disability and Health
Center for Patient Advocacy
Consumer Federation of America
Friends Committee on National Legislation (Quaker)
Lutheran Office for Governmental Affairs, ELCA
National Association of People with AIDS
National Association of Social Workers
National Community Pharmacists Association
National Partnership for Women & Families
Neighbor to Neighbor
Service Employees International Union
National Partnership for Women & Families.