Proposition will protect patients, save money

Published: Friday, November 1, 1996

Friday, November 1, 1996

216 YES:

Insurance company 'gag rules,' bonuses will be illegalBy Ralph Nader, Kit Costello and Harvey Rosenfield

Are you in an HMO or a "managed care" health plan? If so, you should pay careful attention to Proposition 216. Backed by California's nurses and consumers, the Patient Protection Act would protect you and your family against insurance company abuses that could seriously harm you.

Many Californians don't realize that HMOs and insurance companies: give bonuses to doctors for withholding or delaying treatment, limiting referrals to specialists and hospital admissions; permit their bureaucrats to override the medical decisions of your doctor; impose "gag rules" that censor what doctors or nurses can tell you about the treatment you need ... or if they get bonuses; force you out of the hospital before you're fully recovered mothers of newborn infants within as little as eight hours, stroke victims after three days (whether they can walk or not); are replacing registered nurses and other health professionals at bedsides with low-wage "care buddies," who have only a few days of minimal training.

The HMOs say these shocking changes in our health-care system are necessary to "cut costs." But there's no shortage of funds when it comes to the big insurance companies and for-profit hospital chains gobbling up community clinics and doctor's practices $22.7 billion has been spent on mergers and acquisitions in California since 1993.

This is money that could be going to provide better quality care. But under the direction of CEOs like U.S. Healthcare's Leonard Abramson, who paid himself a nearly $1-billion bonus when his company merged with Aetna, the money is going to the privileged few ... and Wall Street.

More importantly, unsafe cost-cutting results in deaths and injuries. For example, a senior citizen died after six hours in the emergency room of her HMO because she did not receive an expensive drug that emergency room doctors receive bonuses to ration. A young boy is permanently blind and disabled because HMO doctors refused to order an $800 CAT scan that would have diagnosed an easily treatable brain infection.

Proposition. 216 will:

1. Outlaw bonuses and "gag rules" that force doctors and nurses to choose between you, the patient, and the HMO and silence them from being honest with you.

2. Establish safe staffing levels in hospitals, clinics and nursing homes and ban the use of untrained personnel for patient care.

3. Require HMOs to give you a second opinion before they can deny treatment that your doctor has ordered.

4. Establish a watchdog group, voluntarily funded and accountable only to consumers, to make sure the initiative's provisions are properly implemented.

In a desperate effort to frighten voters, the powerful insurance industry is spending millions of (your) dollars in advertising against Proposition 216.

Here's the truth: Proposition 216 will save California taxpayers, consumers and businesses $1 billion a year. The insurance industry not taxpayers will pay all the costs of enforcing Proposition 216 through penalty fees on wildly excessive HMO salaries, multibillion dollar hospital mergers and medical service reductions.

Vote "Yes" on Proposition 216.