Hmo Patients Deserve More Consideration


A bill recently proposed by Rep. Debra Brimhall in the Arizona Legislature takes aim at HMOs. This is surely a worthy target for legislative action.

Managed health care has been effective at controlling what used to be spiraling health care costs. But the system has left many patients frustrated with the care they can receive, and doctors frustrated with the care they can offer. An adjustment in rights for patients is warranted.

Brimhall has signed up 25 co-sponsors for a resolution that would put expanded rights for patients up to a vote of the public in the fall of the year 2000.

If adopted by the electorate, among other things Brimhall's proposal would:

  • entitle patients to see certain care providers, including chiropractors and gynecologists, without having to go through their primary care physician;
  • allow patients to sue HMOs for damages caused by medical decisions made by the HMO or its representatives;
  • bar financial incentives or penalties that delay or deny care;
  • allow doctors to prescribe any medically necessary drug -- not just those on an HMO's approved list.
  • have the State Department of Insurance act as a patient advocate to help those having trouble with an HMO secure the care they need.

Of course, these new rights would come with a cost, and opponents warn about that. Count the Arizona Chamber of Commerce and Gov. Jane Hull in opposition. That is why Brimhall's proposal is for a citizen vote -- Hull vetoed a bill last year that contained some of the same proposals.

We do not want to return to the days when workers kept seeing their take-home pay shrink and the amount being sent to the health insurance company grow.

But a balance must be struck between the power that HMOs now have and what the public should get.

The Brimhall bill is a step in that direction.

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