Irina Bristow
Cadet
I was told to write a persuasive essay for my english class, so I took up a controversial political topic, which I thought deserved attention, and thought it might be read here! sorry no alias lol
Resolved: That the United States Congress pass a patients’ bill of rights, including the right to sue health maintenance organizations (HMO’s).
by: (for you people) Irina Bristow
Imagine for a moment that it is a warm spring day; you and your wife are sitting in the stands of a baseball field watching your young son play a game of softball. You could not imagine a better life; you are an ordinary man who works at a factory and takes care of his family. Your wife and son are your world. You smile and shout as your son runs the bases; but something is not right, he stopped; watching in horror, you see your son fall to the ground with a sickening thud, echoing throughout the whole stadium. You find out your only son needs an emergency heart transplant operation that you cannot afford; your HMO will not help, and the insurance will not cover the operation. You vow to do whatever it takes to keep your son alive; with time and options running out, a desperate gamble becomes your only hope – you take the emergency room hostage. John Q., starring Denzel Washington and produced by New Line Cinema; this film, as most cinema does, takes a horrible situation to the next level. Obviously a situation like this has not yet taken place; but isn’t it a possibility, given that no one has patients’ rights, that maybe some one will take a circumstance like this to a horrendous level. Therefore, if a patient and the patient’s family were to go through a heart-wrenching condition such as this, they would not have the right to sue their HMO, or Health Maintenance Organization, which could have drove a patient to this extent. Now every patient should be guaranteed the following:
• Guaranteed Access To Needed Health Care Specialists;
• Access To Emergency Room Services When And Where The Need Arises;
• Continuity Of Care Protections To Assure Patient Care will not change abruptly if their provider is dropped;
• Access To A Timely Internal And Independent External Appeals Process for consumers to resolve their differences with their health plans;
• A Limit On Financial Incentives To Doctors;
• Assuring That Doctors And Patients Can Openly Discuss Treatment Options;
• Assuring that Women Have Direct Access To An OB-GYN;
• An Enforcement Mechanism That Ensures Recourse for Patients who have been maimed or die because of health plan actions.
That is the comprehensive Patient’s Bill of Rights America needs and deserves. Americans have waited too long for a strong, enforceable, Patients' Bill of Rights. For five years, the senate has worked in good faith to pass a strong, enforceable Patients' Bill of Rights -- one which protects all Americans in all health plans, guarantees access to needed health care specialists and other critical health care providers, and includes an enforcement mechanism to make sure these rights are real. And for five years, the American people have waited (Democrat, 2).
The most important and debated of that list is An Enforcement Mechanism That Ensures Recourse for Patients. An HMO or Health Management Organization is a form of health insurance combining a range of coverage’s in a group basis. A group of doctors and other medical professionals offer care through the HMO for a flat monthly rate with no deductibles. However, only visits to professionals within the HMO network are covered by the policy. The HMO must clear all visits, prescriptions and other care in order to be covered. A primary physician within the HMO handles referrals (Birenbaum, 35). Senator Bob Daschle defends the democratic bill regarding HMO’s and a patients right to sue when addressing congress in his oratory, “Our bill is a real plan; theirs is a placebo. Our bill covers every American with private health insurance; their bill leaves out 100 million Americans. Our bill lets doctors make decisions about medical treatment; their bill lets insurance company accountants call all the shots. Our bill guarantees that you see the opportunity for qualified medical specialists whenever you may need them; their bill does not. If your HMO refuses to pay for care your doctor says you need, our bill allows you to appeal that decision, to appeal that decision to an independent review board. Their bill contains an appeal process, too, but they let your HMO decide what you can appeal and hand-pick the people who make the decisions.” Now Mr. Daschle is presenting a very strong case. Why should we leave out a part of the population that deserves the right to health insurance just like anyone else? What kind of person would turn someone away that is dying of a gunshot wound because his or her HMO will not correspond? Why should hospital lawyers be the ones to make decisions regarding life or death?
The senate democrats have been trying to pass this bill with no help from the republicans. A compromise outlines reasonable criteria and time frames for initial claims review and internal appeals procedures. It also creates a timely and independent external review process that assures individuals a fair and unbiased decision. When patients have medical emergencies, the review process can be expedited. Neither party can select the external review entity nor can neither unilaterally delay the review process by withholding needed information. Reviewers are free to make an independent determination about whether care is needed and are not bound by plan decisions or policies. And patients have legal recourse if the managed care plan does not comply with the decision of the external review entity (Democrat, 1).
On Wednesday, July 15, 1998, former President Bill Clinton made one of his more memorable speeches dealing with the passage of a Patient’s Bill of Rights, he stated, “To ensure that every American is protected by a Patients' Bill of Rights, Congress must also act. In the remaining days left in this legislative session, I call on the Congress once again to pass a strong, enforceable Patients' Bill of Rights, a bill that guarantees access to specialists, so people with cancer, heart disease, and other life-threatening illnesses get the care they need, a bill that guarantees continuity of care, so pregnant women can have the same doctor throughout their pregnancy, even if that doctor is dropped from a plan, a bill that makes these rights real by guaranteeing a remedy to people who have been injured or lost family members as a result of a bad decision.” Patients need protections now -- because delay has real consequences. Studies indicate that each day Americans are forced to wait for a strong Patients Bill of Rights leaves 35,000 patients without the access to specialty care they need and results in 10,000 physicians seeing patients who have been harmed because a plan refused a diagnostic test. This is unacceptable (Democrat, 2).
In June, the U.S. Senate passed a strong Patients' Bill of Rights with real, enforceable protections. Unfortunately, the House of Representatives has passed, with President Bush's support, a Patients' Bill of Rights that stacks the deck against patients and provides special protections for HMOs that ordinary Americans (and all other businesses) don't have. On every difference between the Senate and House HMO reform bills, the McCain-Edwards-Kennedy bill stands with patients and doctors and the House Republicans/Bush bill stands with the insurance companies. This fall, the Patients' Bill of Rights will move to a House-Senate conference, and supporters of real reform will be fighting for a level playing field between doctors, patients and their families and the insurance companies (Democrat, 2). Protecting patients' rights shouldn't be a political issue. The only place in America where patient’s rights is a political issue is here in Washington DC. Nearly every doctor’s association, every nurse’s association, and every patients' rights group in America agrees that we need a strong, enforceable, Patients' Bill of Rights now. Let's put the people's interests ahead of the special interests and work to make this summer a season of progress for all Americans. America look forward to an open and fair debate and the passage of a real Patients' Bill of Rights that will truly strengthen our health care system, protect our families, and enrich our nation for the 21st century.
discuss this amongst yourselves!
Resolved: That the United States Congress pass a patients’ bill of rights, including the right to sue health maintenance organizations (HMO’s).
by: (for you people) Irina Bristow
Imagine for a moment that it is a warm spring day; you and your wife are sitting in the stands of a baseball field watching your young son play a game of softball. You could not imagine a better life; you are an ordinary man who works at a factory and takes care of his family. Your wife and son are your world. You smile and shout as your son runs the bases; but something is not right, he stopped; watching in horror, you see your son fall to the ground with a sickening thud, echoing throughout the whole stadium. You find out your only son needs an emergency heart transplant operation that you cannot afford; your HMO will not help, and the insurance will not cover the operation. You vow to do whatever it takes to keep your son alive; with time and options running out, a desperate gamble becomes your only hope – you take the emergency room hostage. John Q., starring Denzel Washington and produced by New Line Cinema; this film, as most cinema does, takes a horrible situation to the next level. Obviously a situation like this has not yet taken place; but isn’t it a possibility, given that no one has patients’ rights, that maybe some one will take a circumstance like this to a horrendous level. Therefore, if a patient and the patient’s family were to go through a heart-wrenching condition such as this, they would not have the right to sue their HMO, or Health Maintenance Organization, which could have drove a patient to this extent. Now every patient should be guaranteed the following:
• Guaranteed Access To Needed Health Care Specialists;
• Access To Emergency Room Services When And Where The Need Arises;
• Continuity Of Care Protections To Assure Patient Care will not change abruptly if their provider is dropped;
• Access To A Timely Internal And Independent External Appeals Process for consumers to resolve their differences with their health plans;
• A Limit On Financial Incentives To Doctors;
• Assuring That Doctors And Patients Can Openly Discuss Treatment Options;
• Assuring that Women Have Direct Access To An OB-GYN;
• An Enforcement Mechanism That Ensures Recourse for Patients who have been maimed or die because of health plan actions.
That is the comprehensive Patient’s Bill of Rights America needs and deserves. Americans have waited too long for a strong, enforceable, Patients' Bill of Rights. For five years, the senate has worked in good faith to pass a strong, enforceable Patients' Bill of Rights -- one which protects all Americans in all health plans, guarantees access to needed health care specialists and other critical health care providers, and includes an enforcement mechanism to make sure these rights are real. And for five years, the American people have waited (Democrat, 2).
The most important and debated of that list is An Enforcement Mechanism That Ensures Recourse for Patients. An HMO or Health Management Organization is a form of health insurance combining a range of coverage’s in a group basis. A group of doctors and other medical professionals offer care through the HMO for a flat monthly rate with no deductibles. However, only visits to professionals within the HMO network are covered by the policy. The HMO must clear all visits, prescriptions and other care in order to be covered. A primary physician within the HMO handles referrals (Birenbaum, 35). Senator Bob Daschle defends the democratic bill regarding HMO’s and a patients right to sue when addressing congress in his oratory, “Our bill is a real plan; theirs is a placebo. Our bill covers every American with private health insurance; their bill leaves out 100 million Americans. Our bill lets doctors make decisions about medical treatment; their bill lets insurance company accountants call all the shots. Our bill guarantees that you see the opportunity for qualified medical specialists whenever you may need them; their bill does not. If your HMO refuses to pay for care your doctor says you need, our bill allows you to appeal that decision, to appeal that decision to an independent review board. Their bill contains an appeal process, too, but they let your HMO decide what you can appeal and hand-pick the people who make the decisions.” Now Mr. Daschle is presenting a very strong case. Why should we leave out a part of the population that deserves the right to health insurance just like anyone else? What kind of person would turn someone away that is dying of a gunshot wound because his or her HMO will not correspond? Why should hospital lawyers be the ones to make decisions regarding life or death?
The senate democrats have been trying to pass this bill with no help from the republicans. A compromise outlines reasonable criteria and time frames for initial claims review and internal appeals procedures. It also creates a timely and independent external review process that assures individuals a fair and unbiased decision. When patients have medical emergencies, the review process can be expedited. Neither party can select the external review entity nor can neither unilaterally delay the review process by withholding needed information. Reviewers are free to make an independent determination about whether care is needed and are not bound by plan decisions or policies. And patients have legal recourse if the managed care plan does not comply with the decision of the external review entity (Democrat, 1).
On Wednesday, July 15, 1998, former President Bill Clinton made one of his more memorable speeches dealing with the passage of a Patient’s Bill of Rights, he stated, “To ensure that every American is protected by a Patients' Bill of Rights, Congress must also act. In the remaining days left in this legislative session, I call on the Congress once again to pass a strong, enforceable Patients' Bill of Rights, a bill that guarantees access to specialists, so people with cancer, heart disease, and other life-threatening illnesses get the care they need, a bill that guarantees continuity of care, so pregnant women can have the same doctor throughout their pregnancy, even if that doctor is dropped from a plan, a bill that makes these rights real by guaranteeing a remedy to people who have been injured or lost family members as a result of a bad decision.” Patients need protections now -- because delay has real consequences. Studies indicate that each day Americans are forced to wait for a strong Patients Bill of Rights leaves 35,000 patients without the access to specialty care they need and results in 10,000 physicians seeing patients who have been harmed because a plan refused a diagnostic test. This is unacceptable (Democrat, 2).
In June, the U.S. Senate passed a strong Patients' Bill of Rights with real, enforceable protections. Unfortunately, the House of Representatives has passed, with President Bush's support, a Patients' Bill of Rights that stacks the deck against patients and provides special protections for HMOs that ordinary Americans (and all other businesses) don't have. On every difference between the Senate and House HMO reform bills, the McCain-Edwards-Kennedy bill stands with patients and doctors and the House Republicans/Bush bill stands with the insurance companies. This fall, the Patients' Bill of Rights will move to a House-Senate conference, and supporters of real reform will be fighting for a level playing field between doctors, patients and their families and the insurance companies (Democrat, 2). Protecting patients' rights shouldn't be a political issue. The only place in America where patient’s rights is a political issue is here in Washington DC. Nearly every doctor’s association, every nurse’s association, and every patients' rights group in America agrees that we need a strong, enforceable, Patients' Bill of Rights now. Let's put the people's interests ahead of the special interests and work to make this summer a season of progress for all Americans. America look forward to an open and fair debate and the passage of a real Patients' Bill of Rights that will truly strengthen our health care system, protect our families, and enrich our nation for the 21st century.
discuss this amongst yourselves!
