A Patients' Bill of Rights would be unnecessary if individuals were given the opportunity to manage their own health decisions, say some health-delivery experts. Under such a scenario, patients, physicians, employers and insurers would come out the winners.

The reform is called consumer-driven health care and here's how it would work.

• Employers provide most health-insurance plans, which insulate employees from the true cost of their medical care; instead, employers should provide the same amount of funds to employees, who would be able to purchase their own health plans.

• Current laws that exclude insurance premiums from taxation if purchased by a company, but not if bought by an individual, would have to be changed to allow individuals to purchase their own policy without a tax penalty.

• Pooling mechanisms -- such as voluntary cooperatives or "health marts" -- would enable individuals to take advantage of group rates and act as clearinghouses to qualify participating plans.

• Medical Savings Accounts -- which allow tax-exempt dollars to be reserved for health care, in conjunction with less expensive catastrophic-care insurance -- are currently limited to companies with 50 or fewer workers. They must be made available to everyone.

With employees making the choices, they would have an incentive to manage their own medical decisions wisely and employers would be relieved of liability. Aside from the obvious benefits to employers and employees, physicians would not have to fight Health Maintenance Organizations for control of patient care. And HMOs would be relieved of much of the need to ration benefits in order to hold down costs.

Source: Daniel H. Johnson Jr. (past president of the American Medical Association, Heritage Foundation), "Beyond the Patients' Bill of Rights," Wall Street Journal, July 10, 2001.

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