Editorial: Insurers admitting a backlash

Monday, Nov. 29, 1999 | 8:17 a.m.

For years now health insurers have opposed government attempts to mandate basic patient protections, such as requirements that medical care be decided by doctors instead of HMO accountants. Health insurers have said while examples of poor care might garner headlines, they've contended that the HMO horror stories cited were atypical. The health insurance lobby has said repeatedly that the overwhelming majority of Americans are satisfied with their health care, so that any attempts to establish patient protections would be unnecessary.

But last week there was a surprising admission from the industry. USA Today reported on Friday that a confidential memo from the industry's trade group to its members acknowledges that it is the health insurers who bear the responsibility for their tattered image. "Public opinion of our industry is, and always has been, driven more by our own business practices than by public relations," the head of the American Association of Health Plans wrote in a letter to about 1,000 insurance company executives.

The letter even goes on to encourage these executives to consider last month's decision by UnitedHealth Group, which ended the requirement that doctors must first get the authorization from the insurer for referrals, tests and costly procedures. USA Today goes on to report that while the industry trade group's letter doesn't explicitly say that others insurers should follow UnitedHealth's lead, the letter does say the insurer's move "creates an extraordinary opportunity for health plans to change the dynamics confronting managed health care."

Some may suggest that these recent developments are just ploys to soften public support for a patient's bill of rights pending in Congress. While that may be the case, a more likely scenario is the realization that the public just isn't buying the industry's smoke screen anymore. Too many Americans have had necessary medical care denied by an insurer; even for those whose experiences have been satisfactory, they know family members or close friends who have been mistreated by an HMO. So while it is encouraging to see health insurers finally acknowledge that the public condemnation is of their own making, this admission shouldn't preclude the need for putting into law strong patient protections. When Congress reconvenes next year it should pass a patient's bill of rights, guaranteeing that medical decisions will once again be made where they belong -- in th e doctor's office.