Jewish World Review July 6, 2001/ 15 Tamuz, 5761

Marianne M. Jennings

Marianne M. Jennings
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Consumer Reports


Patient's rights and the Valley of Death


http://www.jewishworldreview.com -- BECAUSE doctors have the political aptitude and public relations savvy of Barbra Streisand and Paula Poundstone respectively, there is an unrelenting drive to destroy the finest health care system in the world. That daft body of patron millionaires, the U.S. Senate, has passed a patient's bill of rights that, if signed, makes the system is terminal.

I hail from health care's most astute group: chronic users. As the mother of a severely handicapped child, I have journeyed from emergency rooms to PPOs, indemnities and HMOs and back again. When it comes to health care, we have been there and done that. While I have my share of treatment battles and horror stories on reimbursement and coverage, I adore our health care system. From deep in the belly of that system I beg the president, "Do not sign the bill."

This legislative reform is grounded in litigation, driven by the American Trial Lawyers Association (ATLA)(70% of its donations went to Democrats), and advanced through anecdotes. Horror stories about coverage denied and urban legend one-up-man-ship fuel a dissatisfaction myth despite data that show most Americans are happy with their HMOs. Time featured a story about a woman who was denied coverage for breast cancer treatment. Buried in the story is her concealment of critical information from her insurance company when she signed up: a history of lumpy breasts. Since the 19th century, insurers have warned about such disclosures. Preexisting condition clauses exist so that insurers can assess risk and set premiums. Failure to disclose such ailments entitles the insurer to rescind the contract (coverage) for related illnesses. Her case sounds more like an insurer's bill of rights issue.

Such flawed anecdotes spur ATLA-financed Daschle et al. on to destruction. They point to our esteemed friends to the North and the Brits as exemplars. Coverage for all for all seasons and reasons. The right-to-sue in the pending patient's bill of rights is a stick to beat payers into universal coverage. Such was the goal of these socialist systems, but their results are dismal.

At a Heritage Foundation health care symposium, a Canadian physician offered the following: 78% of Canadians believe their health care system is in crisis, up from 73% just 1.5 years ago; only one in four Canadians rate their health care system as "very good," down from 1991 when a majority rated it "excellent"; and 63% of Canadian physicians feel there has been a decline in the quality of health care.

Manitoba struggles to end "hallway medicine" where crowded hospitals place beds and patients in hallways because of acute space shortages. Canada has only as many MRI scanners per capita as Colombia. Canadian MRI owners were earning money by renting out their facilities to veterinarians in the evenings. Because of canine envy, Canada has halted evening MRI pooch elite usage. England permits evening cross-species health care. If your name is Spot, you move to the top of the MRI queue.

In Canada, a woman will wait one month for a biopsy of a breast lump. In the United States, 90% of women with a lump are biopsied within 2 weeks. Cancer survival rates in Canada are well below U.S. rates. A New Brunswick patient with colorectal cancer is twice as likely to die as a Utah patient with the same condition.

Those who can afford it go outside these universal coverage systems. In England, 14 million (of 63 million total) have their own health insurance and use independent providers. Senator Sharon Carstairs, a Canadian government leader, took her husband and $15,000 south to the U.S. for treatment Seven Canadian provinces now send their citizens to the U.S. for radiation treatment because of excessive wait times.

Individual windfalls from patients' rights litigation will increase health care costs. Higher costs mean fewer insurers and HMOs and employers nixing insurance benefits. Such impacts will bring inevitable surrender to the Feds and we'll all line up with Fido.

If the goal of this hackneyed legislation truly was accountability, not ATLA payback, then the free market is the solution. Free markets trounce those whose customers (patients) are dissatisfied while doing a heck of a job on pricing, all without lawyers. A system with medical savings accounts, vouchers, large insurance pools, patient choice, full information, and no price caps would allow shopping for medical care. If you can go elsewhere, you don't need a bill of rights.

Attempting to provide every treatment for everyone with enforcement through litigation is socialized medicine via trial lawyers. Canada and Britain have been there and done that. The Canadians are down here with us and the Brits are building a private system on the side for man and beast. Their experiences teach us that government mandates mean rationed low-quality care.

No lawyer can change those mortality rates in the universal access systems of our socialist friends who began with rights for everyone and ended with a system that never denies care but that imposes a death sentence with the wait to get it.


JWR contributor Marianne M. Jennings is a professor of legal and ethical studies at Arizona State University. Send your comments by clicking here.

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© 2000, Marianne M. Jennings