ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Wednesday, July 3, 1996 TAG: 9607030018
SECTION: EDITORIAL PAGE: A-12 EDITION: METRO
IF DOCTORS are forbidden to tell their patients about tests and treatments that the bean-counters don't want to pay for, by all means, their patients should know.
After all, the promise offered by managed care, that cost savings won't come at the expense of quality health care, is the promise of the marketplace: Consumers will vote with their pocketbooks. Quality plans will prosper; lousy plans will fail (before they hurt you and yours, one must hope).
For the marketplace to work, however, consumers, sometimes referred to nostalgically as patients, have to be able to make informed choices. In this case, that means they have to know if their physicians are working under gag rules imposed by some health-maintenance organizations.
The American Medical Association wants to require doctors, by law, to tell. HMOs and insurance companies object - and well they should, for what both sides surely expect is that patients thus informed will grab their pocketbooks and stampede out the door to some health plan that at least will allow them to hear about all of the medical options available, no matter how expensive.
The AMA hopes, of course, that requiring doctors to reveal HMO gag rules will put an end to this attempt to reduce health-care costs by reducing, rather than increasing, patients' knowledge of their health-care options.
Another option, besides disclosure, is legislation in the House that would ban gag clauses from physicians' contracts with managed-care organizations, which is ultimately what the AMA is after.
The health organizations say these clauses do not bar doctors from discussing clinical information, only from criticizing the managed-care companies or disclosing proprietary financial information. But if company policies are seen as contrary to patient interests, what are conscientious doctors to do?
They can quit the HMO, of course. But doctors shouldn't be forced to make a choice between their patients' welfare and their own job security. If that means HMOs start getting complaints from consumers demanding better or different services, well, that's the way the marketplace works.
LENGTH: Short : 44 linesby CNB