Additional Democrats could help patients' rights bill

Democrats in the House of Representatives are hoping the second time around will be a charm for them in their quest to get a national health-care Patients' Bill of Rights Act passed.

The bill failed by only five votes in the last Congress, but with five newly elected Democrats to the House, many politicians such as Rep. Shelley Berkley, D-Nev., are hopeful once again.

Berkley is a co-sponsor of HR 3605, scheduled to be introduced today.

The bill, in part, would allow a chronically ill patient to choose a specialist as his or her primary-care physician, allow women to choose obstetricians and gynecologists as their primary-care physicians, provide continuity of care for patients if a health maintenance organization changes provider doctors, allow certain patients to participate in approved clinical trials, create an ombudsman program to assist patients in filing grievances or appeals, and provide for an agency other than the HMO to handle grievances.

"I believe health care in this country is not serving anyone properly," Berkley said late Monday. "Patients are not happy. Doctors are not happy with the way they are told to treat patients. I think it's important to introduce this bill, and I just hope we come together in a bipartisan way."

Berkley said she is especially interested in the ombusdman portion, because people need someone to help them navigate through the different health-care plans and to assist in appeals and grievances.

But Keith Beagle, chairman of the Nevada Association of Health Plans, said a lot of what the House bill is proposing is already being done by the state Insurance Division and HMOs themselves.

"I think the staff at the Division of Insurance is already handling calls," Beagle said. "This would just be a duplication of services."

Beagle said the problem with mandating that a specialist be appointed the primary-care physician is that this doctor wouldn't be qualified to diagnose other health problems, as a general practitioner is.

In addition, he said, mandating clinical trials would be expensive. "The entire patient plan would have to pay for this," Beagle said. "They might only represent 100 people."

Assemblywoman Barbara Buckley, D-Las Vegas, sees the House bill as a continuation of her state AB 156, which reformed health care throughout Nevada during the last legislative session. Buckley said she wanted to include a chronic-care provision, because she felt no one should be forced to change doctors when they are seriously ill.

"HMOs were not set up to take care of the chronically ill," said Ruth Mills, president of the Nevada Health Care Reform Project, the grass-roots organization instrumental in getting AB 156 passed. "If HMOs are to continue to stay in the health-care business, they have to change their style. Every person is unique. It's really hard to set up rules.

"They (HMOs) should realize that there will always be a patient where the rules don't apply."

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