(2/28/98 Baltimore AFRO-American Newspaper)
by Congressman Elijah E. Cummings
Less than one year ago, I was appointed ranking minority member of the Civil Service Subcommittee of the House of Representatives’ Government Reform and Oversight Committee. As ranking minority member, I represent the interests of more than 85 million federal employees and federal retirees throughout this nation. As the United States Representative for the 7th Congressional District of Maryland, I am directly responsible for thousands of these employees and retirees who are residents of my district.
Upon my acceptance of this position, I set out to continue the fight for Cost of Living Adjustments, annual pay raises, and the stabilization of Medicare and Medicaid benefits for federal employees. I have also supported passage of a Consumer Bill of Rights for those who are members of managed health care programs. Passing such a law is the only way to ensure that Americans will gain access to the consumer protections necessary to help them navigate through a changing and complicated health care system.
Due to a very important announcement made by President Bill Clinton on February 20, 1998, we are well on our way to ensuring that all Americans will reap the benefits of such a law. The President announced that he has signed an Executive Order establishing the "Patient Bill of Rights" for employees, retirees and their families enrolled in federal health care programs. This means that one-third of the American population will enjoy guaranteed access to high quality, appropriate care; access to emergency services when and where the need arises; confidentiality of medical records to ensure that certain medical information is not disseminated without the consumers’ permission, while also gaining the right to access and amend their own medical records; and, an established grievance and appeals procedure for consumers to resolve their differences with their health plans and health care providers.
Vice President Al Gore has reported that federal health plans such as Medicare, Medicaid, the Indian Health Service, the Federal Employee Health Benefits Program, the Department of Defense Military Health Program, and the Veteran’s Health Program are already largely in compliance with the Patient Bill of Rights. However, the President has taken additional steps to ensure that each health plan comes into substantial compliance by no later than December 1999. He has directed each of his cabinet members involved in the implementation process to personally oversee the changes to be made.
The President has charged the Secretary of Health and Human Services with not only the responsibility for bringing the Medicare and Medicaid programs up to the requirements of the Bill of Rights, but also for guaranteeing that consumers have access to needed specialists. In addition, President Clinton has demanded that participants in these programs be given more of an opportunity to participate in treatment decisions.
The President has also charged the Director of the Office of Personnel Management with the responsibility for ensuring that all 350 participating carriers of the Federal Employee Health Benefits Plans come into contractual compliance with the Bill of Rights; particularly, with regard to access to specialists, continuity of care, and access to emergency room services. He has also required that regulations be passed to prohibit practices that restrict physician-patient communications about medically-necessary treatment options.
The Secretary of Veterans Affairs is expected to implement an appeals process throughout the Veteran’s Health System for those consumers covered by veterans health benefits. The President has issued a deadline of September 30, 1998. Furthermore, he expects the Secretary to direct a policy that would make sure beneficiaries of the Veteran’s Health Plan are provided information consistent with the Patient Bill of Rights by the fall of this year.
In addition, President Clinton has charged the Secretary of Defense with the role of establishing a similar appeals procedure throughout the military health system by September 30, 1998. He has also required the issuance of a policy directive. This directive would allow female beneficiaries in the military health plan, who suffer from chronic medical conditions, to gain access to primary care managers with specialized training in women’s health issues. Furthermore, the President wants to make sure that military plan physicians are allowed to discuss with their patients all treatment options. This assurance would prohibit "gag clauses" in contracts between the physician and the insurance provider.
Finally, the Secretary of Labor must propose regulations that will strengthen the appeals process of the Employee Retirement Income Security Act (ERISA) health plans. These regulations will ensure that problems regarding urgent care are resolved within 72 hours and within 15 days for non-urgent care.
President Clinton’s actions were partly in response to the growing public dissatisfaction with this nation’s managed health care systems. These systems, better known as HMOs or PPOs, typically place numerous restraints on the number of options and the amount of information health care patients can receive from their physicians. Some managed care plans have severely compromised this country’s level of quality medical care. That’s why the President has again issued his challenge to Congress to pass legislation this year that would make the Patient Bill of Rights the law of the land.
As a member of Congress, I, too, formally challenge my Congressional brethren to pass the Patient Bill of Rights so that all Americans can experience the peace of mind that such protections would bring.
-The Honorable Elijah E. Cummings represents the 7th Congressional District of Maryland in the United States House of Representatives.