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Patients' rights debated Former AMA chief wants insurers made liable By BILL KETTLER If your doctor makes a mistake, you can sue, but if your health insurance company slips up, you're out of luck. Patients would gain new rights to sue their health insurance companies under several bills now before Congress. These "patient bill of rights" proposals would give individuals the right to sue when an insurance company makes decisions that negatively affect their health. "We want to put liability at the point where decisions are made," said Dr. Thomas Reardon, immediate past president of the American Medical Association. Reardon visited Medford Thursday during a trip through Oregon to build support for a patient bill of rights proposal supported by the American Medical Association. The Bipartisan Patient Protection Act of 2001 (HR526, S283, S284) would give a patient's physician, rather than the insurance company, the responsibility to determine which procedures are medically necessary for patients. The bills also would establish a review process when insurers deny treatments. An obscure 25-year-old federal pension law severely limits most individuals' ability to sue health insurance providers. Reardon offered a hypothetical example of a patient whose physician recommended a cardiac function test that was rejected by an insurance company. If the patient fell over and died the next day, his family could sue the doctor, but the insurance company's liability would be limited to the cost of the test. "We think this federal loophole needs to be closed," he said. Reardon said the bills mark the latest phase of a seven-year campaign that has been driven by public frustration with insurance companies' refusal to pay medical benefits. A proposal similar to those now in Congress passed the House before the 2000 election, but failed narrowly in the Senate. Oregon's Senate delegation split on that vote: Democrat Ron Wyden supported the proposal; Republican Gordon Smith opposed it. Reardon said a national law would ensure that all Americans have the same legal rights and protections, but a spokesman for Jackson County's largest health insurance provider said the states should take responsibility for patient rights legislation. "A national law would stifle innovation," said Dr. Bart McMullan, senior vice president for health services for Regence BlueCross BlueShield of Oregon. "We don't necessarily know who's got the best answers," McMullan said. "Pulling out all the state laws would stifle creative solutions." McMullan noted that a bill before the Oregon Legislature (HB3040) would give patients the right to sue their health plan and create an independent review board to which patients could appeal insurers' decisions. Insurers would not be required to participate in the independent review procedure. Those that participate would face fines of up to $1 million if they failed to comply with a review board's decision. Insurers that chose not to participate in the review procedure could be sued. "We believe we've really crafted a good one that will pass this session," McMullan said. Reardon said the congressional debate over patient rights could heat up soon. He said the AMA will support only proposals that include a binding, independent, claims-review process and expand patients' legal rights. "Insurance companies," he said, "should be just as accountable as a physician is." Reach reporter Bill Kettler at 776-4492, or e-mail [email protected] Mail Tribune Home | Ottaway Newspapers, Inc. | Dow Jones & Co., Inc. | Privacy | Contact Us Copyright � 2001 Mail Tribune, Inc.