The American Association of Health Plans has launched a media campaign to block a bill that would allow patients to sue their health plans. The ads tout a survey that found doctors overwhelmingly oppose allowing patients to go to court. Doctors groups, however, have disputed the survey and vow to press for patient rights legislation this year.
The poll and media campaign are designed to quash a bill sponsored by Sens. John McCain (R-Ariz.), Edward Kennedy (D-Mass.) and John Edwards (D-N.C.), says Robert Doherty, senior vice president of governmental affairs and public policy at the American College of Physicians-American Society of Internal Medicine in Washington. The bill, known as McCain-Kennedy, provides for an independent external review process and allows patients to sue health plans in federal court over coverage issues and in state courts over negligence and harm issues.
The AAHP poll of 400 doctors, conducted in February by Ayres, McHenry & Associates, found that 75% of respondents favored giving an independent physician appeals panel the power to resolve disputes regarding health plans over coverage, while 17% preferred giving patients the option to sue their health plan for damages.
The AAHP commissioned the poll because it hadn't seen any surveys of what doctors wanted in terms of health plan liability, says spokesperson Susan Pisano.
"We thought it would be useful information" in the debate about patient rights legislation, Pisano says. "We think it's important that we have a convergence of views" among doctors, consumers and business and other interests.
AAHP packaged the survey results into one television ad and one print ad to be run across the country, says Phil Blando, an AAHP spokesperson. While Blando declined to state the cost of the campaign or markets to be targeted, he did say the ads have been and would continue to be shown on an ad hoc basis whenever the patient rights issue heats up. AAHP also is "arming our constituencies with talking points, data and information they can use in their districts. It's a really targeted approach."
Doherty and others vehemently disagree with the poll's findings.
The main problem, Doherty says, is that the poll phrases the "issue as
either/or: one, an independent appeals mechanism, or the other, suing. In fact, McCain-Kennedy . . . is not an either/or situation . . . and most people would find it highly misleading to present the issue in that way."
Doherty argues that McCain-Kennedy forces patients to first go through an independent appeals process and then the courts. AAHP asserts the bill would allow patients to bypass independent review and go directly to the courts.
Allowing patients to sue their health plans is also about fairness, Doherty says.
"The fact is that everyone can be sued except the health plan," he says. "There are problems with the tort system, but if doctors are held accountable, shouldn't the health plans (be)?" The ACP-ASIM favors making health plans liable and dealing with tort reform as a separate issue.
Thomas Reardon, M.D., immediate past president of the AMA and a general practitioner in Portland, Ore., also took issue with the poll.
"I don't put much credibility in it (the poll) because of the way they worded the question," Reardon says. "If you ask a physician if they prefer an appeals process over a lawsuit, they would say 'heck yes."' But doctors still want patients to have the courts as a last resort, he adds.
Virginia Latham, M.D., a Concord, Mass., internist and the president of the Massachusetts Medical Society, agrees. "Physicians tend to feel that patients are not as well served by a prolonged process in the courts as opposed to a quick process," Latham says.
To get a patient bill of rights passed in Massachusetts, doctors ultimately allowed the legislation to pass without the right to sue. Yet, "It's not that we don't think it's (the right to sue) a good idea, but what is politically feasible," Latham says.
McCain-Kennedy is the key patient rights bill, although a similarly worded bill has been sponsored in the House by Reps. John Dingell (D-Mich.) and Greg Ganske (R-Iowa). Sens. Bill Frist, M.D., (R-Tenn.) and Jim Jeffords (R-Vt.) are working with the White House to craft an alternative bill, says Doherty.