It was bound to come to this.
When politics mixes with healthcare clinical matters, bad policy decisions frequently result. The danger is especially acute when politicians and interest groups can't resist the temptation to capitalize on uncertainty and confusion arising from the transition from fee-for-service medicine to managed care.
*In Washington, members of the Senate, in a stealth move, added two controversial health insurance requirements to a popular spending bill for the Department of Veterans Affairs. One amendment would require insurers to offer the same annual and lifetime coverage limitations for mental health benefits as for physical illnesses. The other requires insurers to pay for at least a 48-hour hospital stay for a new mother after a vaginal birth and 96 hours following a Caesarean section.
How ironic that the initiative is led by Republicans who paint themselves as defenders of the free market but who are pushing federal mandates in order to fashion themselves as champions of mental health and protectors of mothers and infants. Government ought not dictate clinical treatment parameters that are best decided by physicians and other healthcare professionals. What's next? Free snake oil for terminal cancer patients?
In California, organized nursing and a Ralph Nader-backed organization are pushing a ballot initiative known as Proposition 216 that would do such things as levy taxes on mergers of healthcare organizations and establish so-called "safe staffing" levels for hospitals and nursing homes. The initiative ignores the fact that no one really knows what is a safe staffing level. Furthermore, some provisions-such as a gag-clause measure-ban practices that already are illegal in the state. And some requirements would impose outrageous costs on restructuring healthcare organizations.
Managed care is far from perfect. But providers and payers need a chance to overhaul healthcare delivery without undue interference from those with their own agendas.