Many Americans Dissatisfied with Managed Care, But Most Would Accept Limits on Patients’ Rights Bill, Survey Finds

Although almost 50% of Americans have had "some type of problem" with their health plan in the past year, they still rank a patients' bill of rights below other health care issues as a priority, according to a new survey from the Kaiser Family Foundation and the Harvard University School of Public Health. Further, 80% of Americans would support a patient protection law with only a limited right-to-sue, the survey says. The survey, based on phones calls with 1,205 adults ages 18 and older between July 2 and Aug. 8, finds that 62% of privately insured adults under age 65 gave their health plans grades of A or B. Forty-eight percent of respondents reported a problem with their insurer ranging from denial or delay of care to "difficulty seeing a physician," with "[s]ignificant minorities report[ing] difficulties ... that had consequences for their lives." The survey also finds that although Americans' views of the managed care industry have declined "substantially" since the industry came to prominence, their views have held steady recently, with 39% saying that managed care plans do a "bad job" serving consumers compared to 32% who say they do a "good job." On every measure, Americans' views about health plans have become more negative or remained steady since 1997.

Support for Patients' Rights
The survey finds that Americans generally support a patients' bill of rights, but "[f]or the most part," have "not yet focused on" details of the right to sue debate. "Many people continue to experience problems with their health plans, but the debate about patient's rights in the Congress is now hung up on details of the right to sue health plans that no poll can help policy makers resolve," Drew Altman, Kaiser Family Foundation president, said. The poll finds that 69% of respondents said it was "very or somewhat important" that a patients' rights bill include a right to sue, with 50% saying the lack of such a right would preclude the measure from being a "real" patients' bill of rights. Four out of five respondents signaled that they would accept a measure with restrictions similar to those in the bill (HR 2563) passed in the House earlier this month, such as limiting pain and suffering damages and banning punitive damages (Kaiser Family Foundation release, 8/30). While 81% said they supported a patients' rights measure, only 58% said they would favor a bill if it caused premiums to rise by $20 per month, and only 34% would support a bill that could cause employers to drop coverage (Silber, Contra Costa Times, 8/31). In addition, only 7% said that a patients' bill of rights is the "most important health issue" for Congress and the president to address, placing it below other priorities such as "making health care more affordable" (30%), lowering the cost of prescription drugs for seniors (15%) and improving coverage for the uninsured (13%). "After several years of congressional debate, the public still supports a patients' bill of rights, but it's not their top priority and they are not focused on the details," Robert Blendon, professor of health policy at the Harvard School of Public Health, said, adding, "Politicians are unlikely to be punished at the polls as long as a bill passes that has some right-to-sue provision" (Kaiser Family Foundation release, 8/30).

Patients' Rights Fueled by Politics
American Association of Health Plans spokesperson Susan Pisano, highlighting the portions of the survey favorable to insurers, said that "HMO-bashing politicians" were driving the patients' rights debate, not American consumers, the Washington Post reports. Noting that 62% of respondents gave their health plans high grades, Pisano said, "Despite everything, consumers report positive experiences." She added that politicians are "using" the patients' rights debate "as a platform to essentially denigrate health plans at every opportunity. ... Nobody in our community would say there aren't ways we can do better. ... But I think we've also gotten a bad rap in a public debate that's dragged on for five years" (Brubaker, Washington Post, 8/31). The full Kaiser Family Foundation/Harvard survey is available online. Note: You will need Abobe Acrobat to view both the press release and the survey.