On the Third Hand: Patient rights

Commentary September 20, 2013 at 09:13 AM
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Some of my biases are that the idea of trying to help more people pay for health care is nice; that most of the people trying to implement the Patient Protection and Affordable Care Act (PPACA) are lovely, hard-working folks who mean well; and that PPACA itself will probably turn out to be riddled with neon, fire-breathing, psychic worms of the like that no mortal can imagine.

Every law has good things in it and bad things in it, and PPACA will be no exception.

My guess would be that the stuff that seems scariest today will turn out to be of no importance whatsoever, and that the stuff that will eat our livers out will be fragments of footnotes that few of us have noticed.

A case in point: The PPACA patient bill of rights section.

The other day, I was interviewing Mark Holloway, a compliance specialist at Lockton, for a regulatory story, and somehow remembered to ask him, "Whatever happened to the PPACA bill of rights section?"

The patient rights section does things like setting provider access standards and standards for internal and external appeals.

Back in the 1990s and early Aughts, many insurance and employer groups viewed patient rights proposals about the same way PPACA critics view the PPACA public exchange program today.

In February 2001, for example, President Bush said a poorly-designed patient rights proposal would be a "windfall for trial lawyers" and force employers to drop health coverage.

Holloway had a hard time thinking of anything to say about the actual PPACA patient rights provisions, which, apparently, have been in effect through temporary U.S. Department of Health and Human Services (HHS) since July 1, 2011, and enforced since January 2012.

Maybe someone has some patient rights horror stories, but none leapt to Holloway's mind. He could remember getting many recent questions about the topic.

On the one hand, the public exchanges, the ban on medical underwriting and the new PPACA risk management programs are a lot more complicated than the PPACA patient rights section. There would be a lot more that could go wrong under the best of circumstances, and these are clearly difficult circumstances for the PPACA implementers.

On the other hand, given that patient rights implementation has been a snooze, maybe implementation of a lot of the other stuff will also be a snooze.

On the third hand, we know the neon psychic worms are out there. Maybe they're lurking somewhere in the tanning salon provisions.

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