Clinton Names Panel to Bolster Health Care Rights

Responding to growing frustration with managed care, President Clinton named a high-level commission Wednesday to protect patients from arbitrary rules and assure that quality care is not sacrificed for profits.

The president charged the commission with developing a “Consumer Bill of Rights” that could serve as the basis for federal or state legislation or as a set of voluntary standards for insurance plans.

He said the “bill of rights” should assure that doctors can talk to patients about all medical options, that doctors are not rewarded for withholding care and that patients are able to appeal decisions denying coverage.

With record numbers of Americans getting their health care from health maintenance organizations and other managed care plans, Clinton said the commission, chaired by two Cabinet secretaries, “will help chart our way through a time of profound change in health care.”

Managed care has helped control the cost of health care by promoting preventive care and removing financial incentives to provide additional, unnecessary services. But it also has imposed new restrictions on patients’ access to doctors and services.

“In this time of transition, many Americans worry that lower costs mean lower quality and less attention to their rights,” Clinton said.

The bill of rights proposals are among the dozens of issues that have been addressed by Congress and by state legislatures, which generally regulate health insurance. States have enacted scores of requirements, including mandatory coverage for particular procedures and assuring access to specialists. But these measures do not cover nearly half of Americans: those covered by employer-sponsored plans of large companies, which are exempt from state regulation.

Last year, Congress waded into the debate by requiring insurance plans to pay for at least two days in the hospital after childbirth. This year, a variety of other bills setting new quality standards has been introduced, including a popular measure requiring minimum hospital stays after mastectomies.

But members of Congress are questioning this piecemeal approach, with many frustrated at the concept of setting national health policy “body part by body part.”

With the announcement, Clinton helped focus the debate on broad structural issues presented by managed care, which covers three-quarters of Americans who get health insurance from an employer.

But Clinton has already endorsed a bill mandating that insurance companies pay for at least two days in the hospital after a mastectomy, and he supports efforts to ban “gag rules” that restrict what doctors can tell patients.

Rep. William M. Thomas (R-Bakersfield), chairman of the House Ways and Means health subcommittee, called the commission a “politically inspired gimmick” and noted that it was announced during last fall’s campaign.

“I doubt this commission will do anything other than rubber-stamp the president’s desired governmental intervention into health care,” he said.

He argued that the commission’s independence is in doubt because it will be chaired by Clinton’s secretaries of Labor and Health and Human Services. Another 32 members, including 29 appointed Wednesday, represent consumers, business, labor, health care providers and insurers, along with policy experts. The panel is to report to Clinton by March 1998.