Press Release November 5, 1997	Contact: Adrienne Mitchem Kathleen McShea 202/462-6262 Consumer Union Washington, D. C. Office

New Poll Demonstrates Crisis in Confidence in Managed Care System

WASHINGTON -- A new national survey conducted by the Kaiser Family Foundation and Harvard University on public attitudes toward managed care confirms the views of Consumers Union that Americans are suffering a crisis of confidence about managed care's ability to provide health care services when they need it.

The survey shows a majority of Americans -- 59 percent -- believe managed care plans have made it harder for people who are sick to see medical specialist. Moreover, results indicate more than half of respondents 51 percent -- believe managed care has decreased the quality of care for people who are sick.

"There is a real crisis of confidence amongst consumers about managed care's ability to deliver health care when they or a member of their family is sick," said Adrienne Mitchem, legislative counsel, for Consumer Union, publisher of Consumer Reports magazine. "There is no better window on this crisis of confidence than the profusion of new state laws to protect consumers from a managed care system which is broken. This new poll shows that a majority of Americans want the government to take steps to protect consumers when it comes to managed care."

According to Mitchem, the time is ripe for Congress to move to ensure consumers receive the health care services that they are contracted to receive. The lynchpin to any congressional reform effort will be an independent grievance and appeals process. Consumers need to be able to appeal to an independent entity when their benefits are denied, limited, or terminated, not to the same body who denied their appeal.

"All of the other consumer managed care protections hinge on whether a independent grievance and appeals procedure is part of the reform package," said Mitchem. "Until this consumer protection is guaranteed, consumers will continue to suffer from a crisis of confidence about whether their managed care coverage will deliver services when they are sick."

The Kaiser/Harvard survey findings that most insured Americansregardless of whether they have managed care or traditional coverage give their own health plan a letter grade of "B" or higher misses the mark, Mitchem added, because most Americans are healthy and therefore have no contact with the health care delivery system. The American Academy of Actuaries data shows that 17 percent of adults have no, or minimal, health care expenditures each year. Of nonelderly Americans, 53 percent spend under $500 on health care in one year.

"The question should be how do the sick grade their managed care coverage," said Mitchem.

A survey of readers published in Consumer Reports last August found that 18 percent had to go outside the plan to obtain what they believed was care they needed.

The new poll surveyed 1204 adults between August 22 and September 23, 1997. The margin of error for this national sample was +/- 3 percent. It was conducted by Princeton Survey Research Association,