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Commentary The time has come to pass a patients’ Bill of Rights

Rebecca Morris, a breast cancer survivor from Virginia, was initially denied insurance coverage for her reconstructive surgery following a mastectomy, despite a federal law requiring insurance companies to cover the cost of this procedure. However, due to a legislative oversight, this law is unenforceable.

Despite the fact that a number of states now have reconstructive surgery benefits laws providing for strong enforcement, in the states without such laws there is no opportunity to hold plans accountable if they unfairly deny this coverage.

Rececca’s story illustrates the futility of a law that promises “rights,” but that is not backed by strong enforcement provisions and a right to sue for adequate damages. It also highlights the need to ensure that all patients, no matter what state they live in, benefit from strong and enforceable federal protections. It doesn’t matter what “rights” are promised. The reality is that patients who are unable to hold their insurance plans accountable have no meaningful protections at all.

For seven years, patients like Rebecca, physicians and other health care advocates have been fighting to pass meaningful managed care reform. I believe that all Americans deserve quality health care and that medical decisions should be made by patients and their doctors, not by health maintenance organization (HMO) bureaucrats. That is why I , along with many Republican and Democratic colleagues , support the bipartisan Ganske-Dingell-Norwood Patients’ Bill of Rights.


Not Alone

And we are not alone. According to a recent survey, public interest and support for a Patients’ Bill of Rights is as strong as ever. Fifty-one percent of Americans say that the need for a strong, enforceable Patients’ Bill of Rights is just as urgent now as it was two years ago, and 39 percent say the need to pass the legislation is even more urgent now.

Additionally, the issue is a truly bipartisan one. The vast majority of all Americans favor a strong, enforceable Patients’ Bill of Rights: 79 percent of Republicans, 85 percent of Independents, and 87 percent of Democrats favor the legislation, according to a Kaiser Family Foundation Survey completed in April 2001)

But never mind what polls tell us. Let’s hear what doctors are saying. On behalf of 300,000 physicians, the American Medical Association says any Patients’ Bill of Rights must: “give every American the right to choose their own doctor, cover all Americans with employer-based health insurance, ensure that all external reviews of medical decisions are conducted by independent and qualified physicians, and hold a plan accountable when the plan makes a decision that harms or kills someone.” The Ganske-Dingell-Norwood Patients’ Bill of Rights, and no other legislation, achieves these aims.

This Patients’ Bill of Rights will end abuses of HMOs and managed care health plans that occur every day. Instead of insurance companies making medical decisions, the Patients’ Bill of Rights will empower doctors to make those decisions. Americans have the right to treatment based on medical decisions, not profit margins.

When health plans act negligently they can harm, and even kill, those they aim to help. Americans hold teachers accountable for education, doctors accountable for medicine , and patients have the right to hold health plans accountable for decisions affecting their own health.


The Right Medication

All too often patients visit a plan doctor who can’t prescribe a certain medication because it is not covered on the HMO plan’s “formula,” or list of approved drugs. Or a patient has to jump through bureaucratic hoops to see a doctor who specializes in treating their illness. The Patients’ Bill of Rights guarantees the right to appropriate medication based on medical need and the right to access specialty care.

With new leadership in the Senate and continued broad-based support in the House, the time is right to press forward and enact meaningful managed care reform as embodied in the bipartisan Ganske-Dingell-Norwood Patients’ Bill of Rights.

The goal of the Patients’ Bill of Rights is to return health care decisions to the hands of the rightful decision-makers: patients and their doctors. The American people have waited too long to exercise basic rights regarding the sanctity of our health and we will wait no longer.

Filner represents San Diego County’s 50th Congressional District.

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