Patients' Rights: What's at Stake?
The New York Times
August 19, 2001
by Milt Freudenheim
Charles B. Inlander, president of People's Medical Society, a consumer advocacy group, responding to questions:
Q. Will patients' rights legislation do anything for the 43 million people who have no health insurance?
A. Nothing at all. This isn't a health care bill. It is about the business relationships between consumers and health plans. It doesn't mean that your doctors are going to be better, that your hospital room will be improved or that you will get better medicines. The bill has nothing to do with improving the quality of health care or lowering the cost and it offers absolutely nothing for the uninsured. The only time this bill kicks into play is if you are in a managed care plan. For many members of Congress, this is their way of appearing to deal with the big issue.
<http://www.nytimes.com/2001/08/19/business/yourmoney/19FIVE.html>http://www.nytimes.com/2001/08/19/business/yourmoney/19FIVE.html
Comment: After the patients' bill of rights debate has ended, Congress will walk away from real health care reform. What are we going to do about that?
Beth Capell, PhD, a dedicated legislative advocate for the medically underserved, responds to today's quote on the futility of the patients' rights legislation:
On behalf of all those who fought for the Patient Bill of Rights here in California, I disagree profoundly with these observations. We discovered that many people who had health insurance were unable to get the care they needed. It is very much about the quality of health care and whether doctors, hospitals, medicines and other care is what people need.
In California, medical group insolvencies have led medical group managers to encourage physicians to see twice as many patients: that's about the quality and, indeed, the safety of care. In California, patients were shoved out of the hospital when neither they nor their family could care for them--that is, if they had family members who were able to help. In California, before we enacted laws regulating drug formularies, people had their medicines switched with no notice--and no consultation with their physician.
Just because you have coverage does not guarantee that you will get care. That's what the Patients Bill of Rights is about. The fight for universal coverage will be meaningless if it is not a fight to get people care when they need it.
The next fight is to destroy the myth that people who have no insurance get the same kind of care as those of us with insurance.
Beth Capell
Comment: Beth is quite correct. The Patients' Bill of Rights does help to assure access, and every effort should be made to support the more effective U.S. Senate version. But again, that debate will end shortly, Congress will walk away from the issue of universal coverage, and we will have to ask ourselves, "What are we going to do about that?" Beth will be working very hard on this issue, but where will the rest of us be?
Albert P. Cohen, an authority on health finance policy, comments:
As someone who once directed government relations for a wholly owned subsidiary of INA Corp (later CIGNA) in all 50 states and as someone who has represented consumer interests as a hands-on lobbyist in Maryland, I would suggest that expecting legislators to take a lead on something like single payer is not realistic. Maybe legislators should be leaders but few are. Few politicians are leaders. The only reason the patients' bill of rights has had any legs is because consumers have become upset about managed care.
The reason I am increasingly optimistic about the future of single payer is significant growth in support for single payer as is indicated by polling over the last ten years. There are a few groups that have taken a lead in working for a single payer system. While I can not comment about the tactics of the groups and therefore their effectiveness, my suspicion is that the most effective influence driving the change has been the increasingly obvious fact that the private health insurance industry has not worked even for those who have been covered by the products of that industry. Many academic types like Judy Feder and Ted Marmor warned candidate Clinton than managed competition was flawed. And their predictions have been correct vis a vis what we have seen recently with Aetna.
My question is what tools those of us who believe in a single payer system can use to speed up the move toward single payer and to counter the predictable opposition from the Dick Armey's of the world.
I personally believe that we have to have a concrete costed-out product to sell, not just a concept. And we must have the tools to know how that product can be modified and with what fiscal and popular impact of those modifications will be. State differently, we must break down our obstacles into manageable components and solve those components. Moreover, we must not get discouraged and fall back into abstract excuses for failure. To use a sports metaphor, we must keep our eye on the ball.
Best, Al Cohen