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Subcommittee Examines Managed Care Reform

With pressure mounting for Congress to enact a patients’ bill of rights, the House Ways and Means Subcommittee on Health held the first in a series of hearings on patient protection legislation. On April 24, the subcommittee focused on two of the more contentious issues surrounding such legislation, the external appeals process and the right to sue.

Opening the hearing, Subcommittee Chair Nancy Johnson (R-CT) stated that there is widespread agreement on certain principles of reform such as access to obstetricians and gynecologists, pediatricians, specialty care, and clinical trials. However, she noted that there are problems with “litigation putting doctors and HMOs out of business.”

Dr. Richard F. Corlin of the American Medical Association concurred, “Virtually everyone now agrees that any patient protection legislation considered by Congress should include certain basic rights which all patients deserve and want. Even the details of those rights in most of the various competing bills are extraordinarily similar.” He added that the more difficult issue is “how to ensure that health plans can be held accountable for their decisions.”

Judith Lichtman of the National Partnership for Women and Families told the subcommittee, “Women are the primary consumers of health care services in this country, as well as the majority of managed care enrollees.” Noting that “Women especially stand to benefit from managed care done right,” Ms. Lichtman added, “A quality managed care plan can make it easier for women to learn about and obtain services, such as mammograms, Pap smears, and prenatal care, and take advantage of health-promoting benefits, from smoking-cessation classes to discounted health club memberships.”

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