"THE HEART OF THE MATTER"
Guests: Rep. Charlie Norwood, GA, Vivian Nulty, health care consumer; President Clinton, Karen Ignani, American Assn. of Health Plans
Topic: Patients Rights Bill
Reporter: Aaron Cohen
Host/Producer: Steve Girard
NEMA: Thanks for joining us...a couple of stories for you...a bit later, well talk about how to get the right gift for kids this holiday season. But first...the President has hastily endorsed the patients bill of rights designed by his advisory commission on consumer protection and quality in health care - sending shock waves through the managed care industry. Aaron Cohen has Health on the Hill...
COHEN: Vivian Nultys problem is but an example of what Americans dont like about their health maintenance organizations. Until last year, her 44 year old husband Gary was an environmental geologist with the Pacific Gas & Electric Company. Now, Gary Nultys confined to a wheelchair because of a rare neurological disorder...
NULTY: For Garys safety, our doctor determined that home health care was medically necessary. Our health insurance company denied our doctors request. Unfortunately, Garys condition did not stabilize.
COHEN: Vivian Nultys complaint about her HMO before a congressional subcommittee this fall is not uncommon. Thats why President Clinton hastily adopted recommendations of his health care commission to enact a bill of rights for consumers. The bill of rights would further his goal of reforming the health care system piece by piece....
CLINTON: There is an emerging consensus in America. While people may not have wanted to bite the whole apple at once in 1994, almost the whole populace wants to keep nibbling away at the apple until we have solved the problems of cost, accessibility and quality for all responsible American citizens.
COHEN: The bill of rights, which the President plans to ask Congress to adopt in 1998, would five patients more choices of doctors, more information about the doctors they choose, and more say in treatment decisions. For example, a physician would have to inform patients of all treatment options, no matter what they cost. The President is one step behind and a few details short of whats already picking up steam on Capitol Hill. Republican Congressman Charlie Norwood, a former dentist, has over 200 House co-sponsors on a bill that roughly mirrors the work of the presidential commission...but it would also allow families like the Nultys to sue their HMO if its refusal to pay for treatment adds medical insult to injury...
NORWOOD: It is intended to make liable the administrators, the bureaucrats or the accountants...that wish to make health care decisions. If you wish to be in this field, and it is lucrative, then you must be responsible and accountable for those health care decisions.
COHEN: The President and nearly half of the House are tapping into a wellspring of discontent with managed care providers...which is a double edged sword for HMO"S. The public supported managed care to reduce the out-of-control costs of health care, but the industry suffered a backlash when families like the Nultys felt the sting of rationing. A Kaiser Family Foundation poll revealed that three fifths of people believe managed care has made it more difficult to get a specialist. The Norwood bill and the bill of rights have an extraordinary amount of opposition from GOP leaders who feel the effort will make health care too bureaucratic...the business community, which says companies would be forced to cancel health benefits...and the HMOs themselves. Karen Ignani is president of The American Association of Health Plans...
IGNANI: Although what may seem like a free vote against managed care, this is a vote against American families, and affordable access to quality health care.
COHEN: Sentiment like that is what killed the Clinton Health Security Act a few years ago...and managed care industry representatives promise an all out effort to defeat the bill of rights and the Norwood bill. But a recent study doesnt quite bear out their claim that patients rights would bankrupt HMOs. An analysis by the Lewin Group, a health consulting firm, reports that mandated consumer rights would only cost an additional 84 cents per patient...if its phased in over several years. With what Vivian Nulty paid to provide home care for her husband and what it must have cost to renovate her house to accommodate her husband Garys needs, shes willing to accept that burden....
NULTY: I fell that its time that this law is changed so that other families dont have to go through the pain, suffering financial loss and humiliation that we went through, just to get the care their doctors feel they need.
COHEN: For Health on the Hill, Im Aaron Cohen.
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