Patients' Choices

The "patients' bill of rights" making its way through Congress is touted as a major piece of legislation. But it is light years away from what the Clinton administration attempted eight years ago. That was an overhaul of the healthcare system, with potentially vast federal involvement. This bill is an incremental fix.

But some of the same issues that arose then are front and center now. Primary among them: individual choice in healthcare.

The issue of choice has generally narrowed to the options offered by now-pervasive health maintenance organizations and whether those options are adequate and fair. Congress, generally, has decided they're not. But HMOs are private organizations supposedly responsive to market forces. If patients are unhappy with what they're being offered, why aren't the HMOs changing on their own?

By and large, they have been. More of them have expanded coverage to allow, for instance, patients to stick, at least for a time, with physicians who have recently left the plan. Many have set up review boards to handle complaints. In other words, the industry is moving in the same direction as Congress, and maybe more quickly. So why the push on Capitol Hill?

A big part of the answer is politics. All sides perceive patients' rights as an attractive express to hop on. President Bush, who opposes portions of the Senate bill dealing with liability and lawsuits, wants to join the ride.

As the bill moves forward, certain values should be kept foremost: containing costs, regulatory restraint to allow private care providers to respond to consumer desires, and, of course, individual choice. Ultimately, laws should allow maximum freedom for people to choose their healthcare.

(c) Copyright 2001. The Christian Science Monitor