Washington Initiatives

Though Still a Priority, Reform May Take Back Seat as Privacy Issues Heat Up

Managed care reform — a.k.a. the patient bill of rights — is definitely a priority for Democrats, but is it at the top of their health care agenda?

Look for the Senate Labor and Human Resources Committee to give at least equal weight to legislation to protect the confidentiality of medical records. As mandated by the Health Insurance Portability and Accountability Act, if Congress fails to enact such a law by mid-1999, the Department of Health and Human Services must adopt privacy regulations without the benefit of legislative input.

That's not to say the Democrats aren't gearing up for a ferocious fight from the right over President Clinton's plan to require HMOs to tell consumers about how often their doctors have performed certain procedures, whether they have been sued for malpractice and how they are paid.

For some time now, Democrats have known that business would bring out its big guns to fight the Clinton proposal. The U.S. Chamber of Commerce is mobilizing its considerable resources, and the National Association of Manufacturers urged business leaders to wage war on the bill.

Meanwhile, Democrats are determined to show that they are united in their fight. How else do you explain the photo opportunity organized by the White House last month to endorse the administration's agenda? Among those in attendance: Vice President Al Gore, Senate Minority Leader Tom Daschle of South Dakota and House Minority Leader Richard Gephardt of Missouri.

Democrats don't want to cede this issue to the Republicans. Led by Texas Sen. Phil Gramm and Georgia's Charles Norwood in the House, the GOP has introduced its own managed care reform legislation. Gramm chairs the Senate Health Care Subcommittee.

Both Democrats and Republicans are jumping on this issue because of this emerging paradox: More Americans are enrolling in HMOs every day, while at the same time more Americans are expressing their displeasure — and sometimes disgust — at the operations of managed care organizations.

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