Editorial: Shortchanging medical patients

THE Senate Republican leadership must think the American people aren't smart enough to see through its halfhearted plan to reform managed care.

Recently Republicans had been making noise that they would offer a meaningful alternative to a Democratic plan. It was hoped this proposal might genuinely help patients at the mercy of their health plans. Sadly, after reviewing the GOP plan announced on Wednesday, that just isn't the case.

There are some provisions offered by Republicans that match those presented long ago by Democrats. The GOP and Democrats both would require that emergency care would be covered when a lay person thinks it's needed; that women would be permitted to see obstetricians and gynecologists without having to receive a referral, and that health plans couldn't restrict what physicians tell their patients about treatment options.

But when comparing in detail the Democratic patient "bill of rights" to the Republican plan, there is no comparison in scope. First, it's critical to note that the protections in the Republican plan are severely limited. They would apply only to the 48 million people whose health insurance is federally regulated since their employers, usually large companies, assume the financial risks for their medical needs. In contrast, the Democratic plan would apply to all 148 million consumers of health plans.

In addition to the needed breadth of the Democratic plan, another important difference is the parties' view on whether patients can sue their health plans. Current law prohibits suits based on personal injury or wrongful death from improper denial of treatment. Democrats want to remove the federal protection these health plans now have.

Republicans suggest that the ability to sue will push up health care costs, but this is just a red herring. If patients don't have the right to sue, there is no incentive for health plans to place medicine above profits. There is no justifiable reason why this industry should be immune from lawsuits.

At one time managed care worked to deliver a balance of quality care and reasonable costs. But today the pendulum has swung too far in favor of making profits at the expense of patient care. It's time for Congress to pass the Democratic plan that will place patients on equal footing with health plans, making these companies focus once again on delivering top-flight medical care.

archive