Editorial: Patients’ rights need protection

Monday, May 11, 1998 | 10:25 a.m.

MANAGED care reform is one of the most important issues facing the nation this year -- but you sure wouldn't know it by the lack of action in Congress.

The inertia isn't from lack of trying from some concerned Republicans and Democrats, but the Republican leadership itself doesn't seem too motivated to move any time soon on putting in place effective safeguards to protect patients from renegade health maintenance organizations.

In an effort to turn up the heat, the Associated Press reports that Democrats have taken to reading a real-life horror story of managed care every day in the Senate until Congress passes consumer protections. "We hear story after story about why we need real patient protections now," Senate Minority Leader Tom Daschle said at a news conference last week.

Rather than talking about the debate in abstract economic terms, the strategy puts a human face on the issue. For instance, Democrats recounted the story of Buddy Kuhl, who died at age 45 from heart failure after his HMO delayed approval for special surgery. Kuhl left behind a wife and two children.

A presidential commission last year recommended a number of guarantees for patient protection: an outside review when health plans deny care, better access to medical specialists and reasonable coverage of emergency room care.

In the trenches of Congress, at least, this isn't a partisan issue. Rep. Charles Norwood, R-Ga., has drafted legislation that would afford even more protections for consumers. Norwood has signed on 230 House members to his bill, including 90 Republicans.

Norwood's legislation would require HMOs to let patients choose their doctors (although the price would be more for doctors not on the HMO's list) and get rid of protections some employer-sponsored plans enjoy against lawsuits.

Many so-called "bright minds" hailed the trend of managed care as a savior for health care in this nation. It may have saved companies money and created a windfall for HMOs, but it has resulted in too many cases of patients ending up with substandard medical care. Congress must pass legislation that gives managed care patients the consumer protection they deserve.