The Patient’s Bill of Rights-the government version and a real version

The Administration recently released its version of a Patients Bill of Rights making the announcement in part via a global e-mail  Following is the text of that e-mail.  There are links within the e-mail to see the actual Bill of Rights which you will find is not more than a restatement of the insurance reforms contained in PPACA.   The problem is that the insurance company or plan administrator is not involved in your health care, you are not the insurance company’s patient, you are its customer and you are buying insurance against unforeseen risk just as you buy auto and homeowners insurance.  Of course, we all know that is not true, health insurance is different we need to be protected from each and every cost no matter how minor or routine or even preventive – but that is another story and the ship has sailed on that one. 

Here is what the HHS website says about the Patient Bill of Rights.  When did any health insurance ever prevent Americans from being in charge of their own health? Regulators should stick to regulating and stop politicizing.

Patient’s Bill of Rights
On June 22, 2010, President Obama announced new regulations that include a set of protections that apply to health coverage starting on or after September 23, 2010, six months after the enactment of the Affordable Care Act. These new protections create an important foundation of patients’ rights in the private health insurance market that puts Americans in charge of their own health.

Nevertheless we do need a patient bill of rights.  At the end of this article I have listed what I believe should be in such a document.

Good afternoon,

It seems like everywhere you go in this country, you hear story after story of Americans who have been let down by the private health insurance system.  Parents in Texas unable to buy coverage for their infant born with a heart defect.  A Los Angeles woman forced to stop chemotherapy for months while fighting her insurer’s claim that her cancer was a pre-existing condition. Patients whose life-saving treatments and therapies are cut short due to annual or lifetime coverage limits.

Yesterday, President Obama put an end to these unfair practices once and for all by announcing new rules made possible by the Affordable Care Act. These new rules will take effect for most plans starting on or after September 23rd. They will remove barriers between you and your doctor and help provide the peace of mind that health insurance will be there when you need it the most. You can watch the President and me speak about the people who these rules will help and why we fought so hard to make them part of the new law: http://www.whitehouse.gov/patients-rights

A major goal of the Affordable Care Act is to put American consumers back in charge of their coverage and care.

Here are a few key ways these new rules will help do that:

• Stop insurance companies from imposing pre-existing condition exclusions on your children;
• Prohibit insurers from rescinding or taking away your coverage based on an unintentional mistake on an application;
• Ban insurers from setting lifetime limits on your coverage and restrict their use of annual limits on coverage;
• Ensure that you can choose the primary care doctor or pediatrician you want from your plan’s provider network;
• Eliminate the need for a referral to see an ob-gyn;
• Prohibit insurance companies from requiring “prior approval” before you seek emergency care at a hospital outside your plan’s network.

These rules effectively put in place a basic set of consumer protections known over the years as the “Patient’s Bill of Rights.” This is a concept introduced 15 years ago and supported by both Democrats and Republicans. After years of effort and the passage of the Affordable Care Act, I’m proud to say we are finally protecting those rights and putting health care back in the right hands: yours.

Now, let me touch on a few other updates about what we’re doing to implement health care reform.

Over the past several weeks, we have:

• Ensured that if you like your current health care plan, you can keep it — by issuing some new regulations for insurance plans that give you, your family, and your business more control over your health care choices;
• Worked to get coverage to one of the groups who is least insured, young people, through a new provision that will allow children up to the age of 26 to stay on their parents health care plan (a benefit that we successfully persuaded many insurers to implement ahead of schedule);
• Announced tax credits that will benefit millions of small businesses that have been struggling to provide care to their employees;
• Begun mailing $250 checks to tens of thousands of seniors who have reached the ‘donut hole’ — a term used to describe the gap in Medicare Part D prescription coverage — to help seniors manage their health care costs;
• Announced new support to strengthen and expand the health care workforce, including increasing the number of primary care doctors and nurses.

You can learn more at:

http://www.whitehouse.gov/patients-rights

The passage of the Affordable Care Act was an historic victory for the American people, laying a new foundation for relief from skyrocketing health insurance costs and for secure, stable, and affordable health care coverage. But passage brought us an important new challenge — implementation — and I look forward to sharing additional news and updates as we steadily turn the promise of health reform into reality.

Sincerely,

Kathleen Sebelius
Secretary of Health and Human Services

A real Patient Bill of Rights

The patient: 

1. has a right to know the cost of services before they are preformed.
2. must know that no services will be performed unless they are medically necessary for the diagnoses and treatment of an illness.
3. has a right to expect that his or her physician operates an efficient practice designed to minimize costs
4. should receive a full and clear explanation of all the implications and potential affects of a medication that is prescribed.
5. must know in advance if he is being referred to a facility in which the doctor has a financial interests.
6. must have an easily accessible way to evaluate the quality of the care being provided and of the individual provider of care.
7. will not be placed on a prescription drug because of the influence of pharmaceutical marketing.
8. has a right to expect that the health care provider charges a fair and reasonable fee and knows the cost of each procedure or test being ordered
9. has a right to a clean clinical setting employing every known procedure to eliminate the possibility of infection
10. has a right to know the location of care is not influenced by unsubtantiated advertising or solely because physician affiliation
11. has a right to avoid duplicate testing merely because of referral to a new physician or specialist

If the PPACA actually reformed health care in the United States, a patient’s bill of rights would look more like the above.