Tuesday, April 18, 2000 | 9:58 a.m.
There was hopeful news late last week when House and Senate negotiators announced that they had reached a consensus on one of the key provisions of a patient's bill of rights. Under this agreement, a patient denied care by a health insurer would be able to appeal to an independent review panel. Many details have yet to be worked out, though, since the bill still is being drafted. The key, then, is to make sure that the bill's final language affords protection for those patients, such as Las Vegan Anna Gonzales, who say they have been denied care.
Gonzales told her horror story Friday during a Senate field hearing in Las Vegas conducted by Sens. Byron Dorgan, D-N.D., and Harry Reid, D-Nev. Dorgan, chairman of the Democratic Policy Committee, has held several such meetings around the nation to highlight the necessity for HMO reform. Gonzales, who recently was found to have Hodgkin's disease, was exasperated by what she said was her HMO's refusal to authorize timely care. The insurer shuffled her from doctor to doctor, which delayed the diagnosis and treatment of the life-threatening illness. In her testimony, Gonzales said she spent a lot of her energy battling her HMO instead of fighting her disease.
While an independent review panel is critical -- and has the potential to ensure better care -- a patient's bill of rights also should allow patients to sue their HMOs if they're denied treatment, a remedy that federal law currently precludes in most cases. The current situation is out of whack and places profits over patient care. Until HMOs understand that they may suffer financially from egregious decisions, they too often will continue to ignore the needs of their patients.
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