Health-care policy experts say that neither the Democratic nor the Republican version of the "patients' bill of rights" is necessary.

Advocates of patient-protection legislation claim it would give patients greater access to doctors, specialists, emergency care and prescription drugs. It also would limit or eliminate financial incentives for doctors to withhold care and "gag rules" that limit what they can tell patients.

But employers and employees have demanded greater freedom of choice and health plans are responding.

• Two years ago, the American Association of Health Plans -- the managed care trade association -- adopted a code of conduct that includes most of the consumer protections in the patients' bill of rights.

• Association officials report that 95 percent of members were in compliance with at least six of the seven policies.

• On the other hand, the actuarial firm Milliman & Robertson estimates the Democratic bill could drive up the cost of health insurance by 23 percent -- meaning the cost of a standard HMO family plan could rise from about $5,000 a year to $6,250, pushing millions more into the ranks of the uninsured.

• Although 39 states passed patient protection legislation between 1994 and 1998 and some 900 state laws affecting managed care are on the books nationwide, it is not clear that they have made much difference.

Concerning malpractice liability: the Democrats opt to hold employers legally liable for mistakes, while the Republicans favor outside review by an independent panel. Studies have estimated the Democratic approach would drive up insurance costs by 2.7 percent to 8.6 percent, while the GOP plan would result in an increase of less than 0.5 percent.

Source: John C. Goodman and Merrill Matthews Jr. (both of the National Center for Policy Analysis), "Patients Need Protection from Congress," Wall Street Journal, July 14, 1999.