A national advertising campaign unveiled last week by the American Association of Health Plans was designed to encourage healthcare stakeholders to "put aside old biases" and take a "fresh look" at the patients' bill of rights, said AAHP President and Chief Executive Officer Karen Ignagni. Instead, the old biases blew up and fresh accusations flew as hospital and physician groups reacted angrily to the insurance group's move.
In fact, on Friday, heads of the American Hospital Association, the American Medical Association and the American Nurses Association sent a joint letter to the AAHP accusing the group of crossing a "sacred line" with "sensational scare tactics" and demanding that the AAHP pull its ad immediately.
"Public confidence in the health care delivery system should not be threatened or sacrificed for political benefit," the letter said.
The AAHP began airing a 30-second television ad in an attempt to bring the reduction of medical errors into the congressional debate about HMO liability. The ad was perceived by many as a political stalling tactic.
"As the only entity in society immune from accountability for the harm they do, HMOs will do anything to preserve their special status," Nancy Dickey, M.D., board member and immediate past president of the AMA, said in a written statement.
The AMA supports patient-protection legislation that allows HMO enrollees to sue their health plans. But the association opposes legislation that would require mandatory reporting of medical errors by physicians and hospitals. It also opposes efforts to open to the public the National Practitioner Data Bank, a repository of malpractice and disciplinary actions against physicians.
"Just as Congress is ready to meet the public's demand for a real patients' rights bill, the HMO industry is making a desperate 11th-hour attempt to change the subject with expensive TV ads," Dickey said.
The AAHP has set aside $200,000 for advertising in the area of patient protection, Ignagni said. A first buy for $52,000 will air the spot nationally on CNN and on the major networks inside the Beltway.
The ad, called "Lost & Found," appeals to the public to help shift the focus of the patients' rights bill from allowing consumers to sue HMOs to better reporting of medical errors.
AHA President Richard Davidson leveled criticism at the ads in a written statement.
"We resent AAHP's attempt to undermine confidence in the millions of America's caregivers," Davidson said. He also sent a letter to Ignagni saying the ad put the AAHP "in the same league as the gun lobby and big tobacco."
The AHA initially opposed patient-protection legislation, but after the movement gained a head of steam, it hopped on the bandwagon (July 20, 1998, p. 16). And like the AMA, the AHA opposes mandatory error reporting and opening of the databank to the public.
Written punches by Federation of American Health Systems President and CEO Thomas Scully were perhaps the strongest.
"Managed care's pitiful and irresponsible attempt to change the subject in the midst of a meaningful and essential debate over the questionable practices of the managed-care industry is shameless," Scully said. "The AAHP and its members should be embarrassed that, with the failure of their own feeble positions, that they have to resort to these tactics."
Ignagni said the groups' reactions were based on what they were hearing from press reports and on speculation made before seeing the ad. She asserted that the AAHP is searching for a common platform to improve quality that avoids unnecessary litigation.
The AAHP supports a mandatory, nationally uniform medical-error reporting system for hospitals and physicians. At the same time, it wants to ensure confidentiality so that individuals and institutions are not penalized for disclosing errors.
House and Senate lawmakers are working in conference committee to craft a compromise for the patients' bill of rights. One issue slowing down passage of the Democrat- and Republican-backed bill is whether health plans should be held legally liable for harm caused to patients.