NCPA - National Center for Policy Analysis

Health Plans Ahead Of Politicians

July 3, 2001

Leading health insurers have already adopted the protections mandated in the Patients' Bill of Rights being debated in Congress, according to a report in the Washington Post.

Furthermore, the tight cost controls adopted by Health Maintenance Organizations (HMOs) -- such as requiring advance approval for access to specialists or for hospitalizations -- have been largely abandoned in favor of plans that give consumers more choices and control.

For example,

  • Four years ago, Healthcare Inc. began paying for emergency room visits whenever patients believed they needed to go.
  • In 1999, United HealthCare told its doctors they no longer needed the company's permission to perform most medical procedures.
  • Blue Cross and Blue Shield plans in many states allow dissatisfied patients to file grievances with outside appeals boards.

Analysts say that as the economy boomed over the past several years, companies eager to offer good benefits to attract scarce workers heeded employee complaints about the frustrations of dealing with managed care and began to buy the kind of coverage that gave workers more medical freedom.

Confronted with rampant consumer resentment, the private marketplace has reacted more rapidly than the government. Thus Congress is arguing over problems with managed care that the industry has started to resolve.

Consumer advocates and industry analysts say the most contentious remaining issue -- the right to sue health plans -- is far less important to most patients than their ability to see the kind of doctor they want.

Source: Amy Goldstein, "Senate's Health Care Bill Lags Behind Some HMOs," Washington Post, July 1, 2001.


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