Originally created 04/27/97

A good bill, we suppose



Rep. Charlie Norwood, R-Ga., is taking a key leadership role in the fight to make managed health care programs more responsive to consumer needs. Legislation the one-time Augusta dentist introduced Wednesday amounts to a bill of rights for patients.

The Patient Access to Responsible Care Act (PARC) would, according to Norwood, restore patient freedoms eroded under managed care systems and health maintenance organizations.

"Managed care plans have done a fine job of holding down costs," he says, "and that's helped keep health insurance affordable for millions of families. But many of those families are left with no real choice in decisions involving their health."

To be sure, a chronic complaint of many people in managed care is that they don't get the medical treatment they - and their doctors - say they need because HMO or insurance bureaucrats, with no medical training, make the decisions - not based on what's best for the patient, but what's best for the bottom-line.

Basically, the Norwood plan shifts decision-making away from the corporate bureaucrats and back toward doctors and patients. It also allows patients to go outside their managed plans if they'll pay the extra price, and it lifts the "gag" some managed care programs put on doctors in discussing treatment with their patients.

Many state legislatures have already moved in the same direction Norwood's bill does, but the Augusta congressman says federal regulations are necessary because self-insured health care plans - which constitute 70 percent of Georgia's plans - are exempt from state patient protection laws due to legislation Congress passed in the 1970s.

Moreover, Norwood denies PARC is a federal mandate as the term is traditionally understood. His legislation does not order medical treatments or length of hospital stays; it simply gives patients more choices.

Critics would argue with that, however. The health care industry charges that PARC is a traditional mandate that will raise prices. That's the effect all new regulations have on business, including the health care business. Norwood says that's scare talk. Businesses and industries that buy these plans for their employees will keep the pressure on health-care providers not to boost costs.

Other critics, such as publisher Steve Forbes and the Heritage Foundation, believe that PARC-type legislation will lead to Clinton-style nationalization of the health care in small steps, instead of by one large step. True consumer choice, they say, won't be restored until the tax and benefit system is revamped to allow consumers to shop for their own health care plans, just as they do now for auto and property insurance.

Forbes and Heritage may be right, but unfortunately there's little sentiment in Congress now for such a massive revamp. Until there is, Norwood's PARC - which has been introduced in the Senate by Alphonse D'Amato, R-N.Y. - is the best reform on the table.