Editorial
Much Ado About Nothing
Michael J. Bernhardt, M.D., Editor
Our respected learned solons were debating this week about a "Patients' Bill of Rights". There were subtle and significant differences between the Republican and Democratic versions of the bill, with the fundamental difference being the right to sue an HMO. As has been covered before in this column, managed care organizations are protected from civil litigation through the ERISA laws.
Before you get all whooped up into a lather about going after the HMOs and suing their britches off, remember, all things of biological waste run downhill. And, in the current medical economic climate we are at the base of the hill. Certainly if the right to sue a Managed Care Organization were to become law, the managed care organizations would find a way to pass these costs onto the participating physicians (remember the hold harmless clause).
I am definitely a political cynic, especially after viewing the way the private practice of medicine has been savage by the current administration and the last several Congress'. A Patients' Bill of Rights without a corresponding Physicians' Bill of Rights is incomplete. Fundamental to the physicians' bill of rights should be the philosophy that the private practice of medicine is not deplorable, despicable, and unethical. And that, believe it or not, doctors have a cost to run their business and reimbursements should be demanded and made legally obligatory to factor in a profit basis for work done. Capitated contracts should be banned as they are counterproductive to patient well-being and quite often to physician well-being. All or none acceptance of insurance products should be outlawed, as should the ability of an HMO to dismiss a physician from their panel without due process. The concept of "we are not telling you what to do, only what will be covered" can be remedied by making the medical director of an HMO personally liable for the results of noncoverage, as those of us in the field are liable for every decision we make. Obviously there is an equation: coverage equals what will be done. Clearly, with costs as they are, if it is not covered, it's not going to happen.
As stated, I have become a political cynic, equally suspicious of both parties in their treatment of the medical community. If the Patient Bill of Rights was really a good thing, would this current administration support it?