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Life Health > Health Insurance

Patients' Rights Wrestling Continues

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The battle over patients bill of rights legislation was unresolved at press time as the Senate tried to hammer out a compromise that will not be vetoed by President Bush while House leaders advanced a new proposal that has White House support.

Looking first at the Senate, S. 872, the legislation sponsored by Sens. Edward Kennedy, D-Mass., and John McCain, R-Ariz., which is strongly opposed by business and insurance groups, gained ground last week as supporters beat back several attempts to scale back its liability provisions.

A proposed amendment to exempt businesses with 50 or fewer workers from any liability was defeated by a 53-45 vote. However, at press time, supporters of S. 872 said they plan to offer an amendment that will provide some relief for small businesses, although the specifics were not available at this writing.

It was unclear whether the amendment would be enough to overcome Bushs threat to veto S. 872.

On the House side, a new bill, H.R. 2315, was introduced by a bipartisan group led by Reps. Ernie Fletcher, R-Ky., and Collin Peterson, D-Minn., that would allow some lawsuits against health plans.

The legislation was immediately embraced by the House Republican leadership and endorsed by Bush.

Under H.R. 2315, patients would have the right to an independent review of an adverse coverage or medical decision within 72 hours.

If the review panel rules in favor of the patient, and the health plan does not implement the decision, the patient can sue the plan. However, lawsuits over coverage decisions would have to be filed in federal courts. Lawsuits over medical decisions could be filed in state courts.

House Speaker Dennis Hastert, R-Ill., calls H.R. 2315 a “true patients bill of rights” that makes health care more accessible and affordable while health plans are made more accountable.”

S. 872, he says, is by contrast a “windfall for trial lawyers.”

But Rep. Charles Norwood, R-Ga., who supports the House version of S. 872, which is H.R. 526, calls H.R. 2315, an “imposter” bill of rights. “Any member who supports this package does so for the exclusive benefit of the HMO lobby,” he says.

Meanwhile, Bush took on the touchy issue of genetic testing during a radio address to the nation, saying his administration is working on legislation that would make genetic discrimination illegal.

Noting that scientists recently completed mapping the human genome, Bush says that as with any other power, this information can be abused.

“Employers could be tempted to deny a job based on a persons genetic profile,” Bush says. “Insurance companies might use that information to deny an application for coverage, or charge excessive premiums.”

Genetic discrimination is unjustified, Bush says, because it is little more than speculation and a genetic predisposition does not mean the condition will develop.

“To deny employment or insurance to a healthy person based only on a predisposition violates our countrys belief in equal treatment and individual merit,” Bush says.

Richard Coorsh, a spokesman for the Health Insurance Association of America, says the health insurance industry agrees with Bush.

Individual medical information must be protected, Coorsh says, and people should be able to have some type of health coverage.

There is no evidence of any discrimination by health insurers based on the use of genetic information, he adds.

Moreover, Coorsh says, HIAA has polled its own members to see if they use genetic information or require applicants to undergo any type of genetic test to obtain coverage.

No HIAA members do so, Coorsh says, and none have plans to do so.

Herb Perone, a spokesman for the American Council of Life Insurers, notes that the debate over genetic information has focused on health insurance, rather than life insurance.

He says he does not know of any life insurer that requires genetic information.

However, Perone says, life insurers need to have access to any and all information about health status that is known to an applicant and the applicants doctor.

Genetic information may be included in that mix, he says, but it would be only one piece of information among many that would be used in the underwriting process.

Reproduced from National Underwriter Life & Health/Financial Services Edition, July 6, 2001. Copyright 2001 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.

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