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Making predictions is a risky business, but we now think it is unlikely that lawmakers will pass so-called patient protection legislation, at least not along the lines of the overreaching measures introduced earlier.
With only a few weeks left in the congressional session and no evidence in sight of Republicans and Democrats reaching an agreement, patient protection legislation -- better described as managed care-bashing -- does appear to be dead.
Things have changed dramatically since nearly a year ago when, what we thought was the worst of the patient protection measures, a bill introduced by Rep. Charles Norwood, R-Ga., commanded support from nearly half of the House of Representatives. The bill, among other things, would have allowed insurers, health maintenance organizations and group health plans to be sued in state court for damages alleged to have been caused by decisions to deny or restrict health care.
Today, except for a few die-hard advocates, such as Sen. Edward Kennedy, D-Mass., and Rep. John Dingell, D-Mich., most members of Congress aren't much interested in the issue beyond narrow concerns, such as assuring hospital coverage for women undergoing mastectomies. Even Rep. Norwood has disavowed his own bill in favor of a much more reasonable approach backed by the House Republican leadership.
Public support for these bills also appears to have withered. For example, when legislators returned to their home districts during the summer recess, they generally found very little interest in the measures among constituents.
We don't find this surprising. From the beginning, as we earlier editorialized, patient protection bills really were wolves disguised in sheep's clothing.
The bills built upon a growing -- and justified -- public anger over practices by some managed care plans, like gagging physicians from discussing a range of treatment options with patients and making it cumbersome to see a specialist. However, the proposals expanded into something far broader than curbing managed care abuses.
The name "patient protection" really masked the hidden but real agendas of the worst of the bills: giving plaintiffs attorneys a new revenue source by opening up health care plan coverage disputes to the tort litigation system as well as dismantling managed care by requiring HMOs and PPOs to open their networks to essentially all providers.
A business- and insurer-supported campaign helped to educate Congress about what really was contained in the bills -- income protection and enhancement for the plaintiffs bar and providers -- and that campaign certainly played a role in defusing support for these innocuous-sounding but dangerous bills.
No doubt the issue of assuring that enrollees in managed care plans are treated fairly will be back, as it perhaps should be, on the congressional agenda next year.
With legislators now better informed on the issue, they will be more likely to craft an approach that truly protects enrollees from plan abuses without damaging the foundation of managed care.