Friday, November 1, 1996
216 Â 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 Â
$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.