EDITOR'S PAGE

Is This the Real Deal?

by  Rich Kirkner

Surprise! The House of Representatives did that to a lot of us when they approved the "Patient Rights Act of 1999." They bucked the orders of the House leadership, and left some of us hoping that representative government really does live in Washington.

This might be premature wishful thinking. The next stop for this key piece of legislation is the House-Senate Conference Committee. Will this be a committee of builders or butchers? Just because most of the House—and, it seems, most of your patients—want this legislation is no guarantee that it will live to meet the ink of the President's pen.

That means it's up to you, Doctor, to let your Congressman and Senators know which way you think the Conference Committee should go. Here are a couple reasons why you should consider giving the nod to H.R. 358 over the Senate version:

• It gives patients their choice of providers. It states specifically that a patient can get "primary care" from any "participating primary care provider." It also requires plans to have a "sufficient number, distribution and variety" of providers. That should make it more difficult for medical plans to lock out O.D.s.

Granted, this isn't the strongest language to guarantee optometry's inclusion in primary care. But like AOA Federal Relations Chairman Donald Williamson, O.D., says, it's a step in the right direction. Hopefully, something stronger will come out of conference (more wishful thinking). Don't bet the office on it, though.

• It hangs HMO bureaucrats on the hook for the care decisions in which they meddle. This is the key difference between the House and Senate bills. H.R. 358 would let patients sue their HMOs if they're harmed because the HMO denied appropriate care. The idea here isn't to actually have more lawsuits; the idea is to have doctors, not HMOs and MBAs, guide patient-care decisions.

Another reason it's important some form of legislation passes: Both the House and Senate bills would give you a tax write-off for the full cost of your health insurance if you're self-employed. That's an often-overlooked yet critical element for independent doctors. It's something you can take to the bank, and a small way government can help preserve independent practice.

I hope this legislation is the real deal when it comes to health-care reform, but the work isn't done. Senate leaders have threatened to drag their feet on naming conference committee members, or appoint conferees who are hostile to the House bill. Let your Congressman and Senators know that obstructionism and obfuscation are not options.