Sunday, May 16, 1999

Balance sought on HMOs

Boehner addressing patients' rights

Gannett News Service

        WASHINGTON — Congress has heard a lot of stories of managed care organizations that deny patients coverage for various medical procedures.

        President Clinton and congressional Democrats say they want a patient ”bill of rights” that would let patients sue health maintenance organizations and guarantee that HMOs' decisions could be reviewed by an outside entity.

        The health insurance industry, however, warns that lawsuits will result in higher costs and loss of coverage for more Americans.

        Now, Rep. John Boehner, R-West Chester, has stepped into the middle of this fight.

        Mr. Boehner, becoming more policy oriented after losing his Republican leadership post last year, is using a new subcommittee chairmanship to craft what he says will be a bipartisan approach toward addressing one of the most sensitive political issues before Congress this year.

        He heads the Employer-Employee Relations Subcommittee of the House Education and the Work Force Committee and has been holding hearings on issues such as access, cost, external review and legal liability of managed care organizations.

        A report on the findings is expected before the end of the month.

        Mr. Boehner hopes it will become the basis for a bipartisan approach to the patients' rights issue.

        “Republicans and Democrats can work together for affordable, accessible, accountable health care — and it's our responsibility to do so,” he said at a recent hearing.

        Mr. Boehner isn't saying yet what specifics he thinks should be in the bill, but his theme has been balance.

        Patient rights need addressing, he maintains, but not in a way that drives up costs so much that more Americans lose their coverage.

        Already, 43 million lack health insurance, a number that is growing.

        The Health Insurance Association of America, a major lobbying group for the health insurance industry, praises Mr. Boehner's approach.

        “I think he is making an important contribution to the debate,” said Chip Kahn, head of the HIAA.

        “The (Democrats') so-called patient protection legislation is really harmful to patients. People will lose their coverage.”

        More liberal policy groups, such as Families USA, say Mr. Boehner's position and that of the health insurance industry go hand in hand.

        “I don't think these protections are going to price people out of the market,” said Judy Waxman, director of government affairs for the group.

        “I think they (Republicans) are feeling pressure that they have to do something.”


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