Coalition Seeks Support for Referendum

Boston Globe

Tapping into the same populist outrage against health maintenance organizations and for-profit medicine that has led California and Texas to pass patient protection measures, Massachusetts activists yesterday called for similar protections here.

“Our health-care system is unraveling before our eyes,” said John O’Connor, cochairman of the Coalition to Defend and Improve Health Care, at a news conference in front of the office of the Massachusetts Association of HMOs. “What we need is a health-care bill of rights.”

The coalition, which includes hundreds of doctors, nurses, and other health-care advocates, and a Nobel Peace Prize recipient, is pushing for a referendum to protect patients’ rights and is gathering the required 57,000 signatures to put it on the ballot in November 2000.

Also riding the wave of populist outrage against HMOs is Secretary of State William F. Galvin, who is testifying before the Legislature’s Joint Health Care Committee at 11:30 a.m. today on his proposal to give the state more regulatory powers over managed-care plans.

Nationwide, concerns about HMOs denying patients care and cost-containment pressures forcing hospitals to cut staffing to unsafe levels have led to a variety of bills being filed in state legislatures and in Congress.

Within the last several weeks, California became the first state to sign into law a measure requiring the setting of a minimum nurse-to-patient standard and the second to give patients the right to sue their HMO, following in Texas’s footsteps.

In Massachusetts, both houses of the Legislature have passed a version of a comprehensive HMO overhaul bill, and the differences are now waiting to be resolved in a conference committee, once the state budget is finished. If the differences do not get resolved by the time the Legislature recesses in mid-November, the legislation will carry over into next year, under the new two-year lawmaking cycle.

The Senate version of the bill has some stronger patient protections than the House version does, including giving patients the right to sue their HMO, said Senator Mark C. Montigny, the New Bedford Democrat who chairs the Ways and Means Committee and has pushed the Senate version of the HMO bill.

“I’m hopeful that this year, Massachusetts will be doing an aggressive patient-protection bill,” Montigny said. “I refuse to throw in the towel on a weak bill.”

But one piece of Massachusetts legislation already looks dead for this session, a bill to ensure a minimum level of nursing care, even though California just enacted a similar law. The Legislature’s Joint Health Care Committee recently referred it to study, which effectively kills the bill.

Pushed by the Massachusetts Nurses Association and filed by Representative Christine Canavan, a Brockton Democrat, and Senator Marc R. Pacheco, a Taunton Democrat, the bill was opposed by the Massachusetts Hospital Association.

“We believe that individual hospital staffing should be based on patient need and nurses’ judgment, not on an arbitrary number,” said Judy Glasser, a spokeswoman for the hospital association.

Because the legislative process is so slow and subject to politics, the Coalition to Defend and Improve Health Care is planning to go straight to the voters in November 2000 with a statewide referendum that would call for universal health-care access, a patients’ bill of rights, and a moratorium on nonprofit HMOs and hospitals converting to for-profit entities. Among the coalition’s members are Dr. Bernard Lown, who shared the Nobel Peace Prize in 1985 for his work on nuclear disarmament.

Members of the coalition will be gathering signatures at malls in Eastern Massachusetts on Saturday and at the Head of the Charles Regatta on Sunday.

Joining the coalition’s O’Connor at yesterday’s news conference were Jamie Court and Francis Smith, coauthors of a new book titled “Making a Killing: HMOs and the Threat to Your Health.” Court was part of the successful legislative efforts in California, and Smith is on staff at the Newton-based Institute for Civil Society, a nonprofit that supports community-based solutions to social problems.

After the news conference, they went up to the fourth-floor offices of the Massachusetts Association of HMOs to drop off a copy of their book and urge that most of the state’s HMOs stay nonprofit and that quality of care be maintained.

In a statement in response to the visit, the association said its HMOs “are among the highest-ranked in the United States for quality of care and member satisfaction” and that the debate over for-profit versus nonprofit “misses the point about the most pressing health policy issue today: About 650,000 people in Massachusetts and 44 million in the country are uninsured.”