Press Release November 20, 1997	Contact: Adrienne Mitchem Kathleen McShea 202/462-6262 Consumer Union Washington, D. C. Office

"Consumer Bill of Rights" Provides Hope for Reform"
An End to Managed Care's Lock on Being Both Judge and Jury?

WASHINGTON -- A presidential advisory panel examining the status of consumer protections in the managed care industry won praise from Consumers Union for urging policy makers to give patients an important new lever to ensure fair settlements when disputes arise over medically necessary care.

The tool? An external independent grievance and appeal process, which CU called "the heart of reform."

"Consumers Union believes the managed care industry, which has an unfortunate track record of skimping on care to increase profits, should not be both judge and jury when it comes to settling medical care disputes with their patients," said Adrienne Mitchem, legislative counsel to Consumers Union, publisher of Consumer Reports magazine. "The most important thing policy makers can do to address the crisis in confidence Americans now have in the managed care system is to give patients who feel short-changed by the current system a truly independent way to determine when more medical care is necessary. It is essential for consumers to have a right to reverse medical decisions that unjustly delay, deny or terminate care."

While Mitchem praised the package for offering "straight-forward and common sense proposals" to bring enforceable standards and fairness to patients in the managed care system, she also noted that the need to wait for this panel's recommendations may have inadvertently delayed action. "We're hopeful this proposal now creates bipartisan momentum to move legislation quickly in 1998," she said. "The current managed care system is fraught with problems. With enforceable standards, managed care providers who give their patients quality care and embrace the consumer protections recommended by this panel will not fear they are operating at a disadvantage."

A recent poll by the Kaiser Foundation and Harvard University found that 59 percent of those surveyed believe managed care plans have made it harder for people who are sick to seek a medical specialist. A majority of respondents also believe managed care has decreased the quality of care for those who are sick.