Editorial – A close call for patients

Published on

The San Francisco Chronicle

The Busy U.S. Supreme Court also delivered a strong ruling for patients’ rights Thursday. The justices upheld laws in 42 states — including California — that assert a patient’s right to get a second opinion when a health maintenance organization denies a physician-recommended treatment.

It was a close call, with four of the nine judges dissenting. Justice Clarence Thomas, one of the dissenters, said the second-opinion requirement “undermines the ability of employers to provide health-care coverage for employees.”

While cost-containment is essential to maintaining the affordability of health care, it must be balanced against the need to protect the basic quality of care for patients. Second opinions are an essential element of sound medicine, and the high court’s upholding of the California law is welcome, though it is no substitute for a national standard set by Congress.

Meanwhile, in Sacramento, HMOs appear to be successfully fighting a proposal by Sen. Martha Escutia, D-Whittier, that would give patients the option of whether to take claims against their HMO to arbitration or the courts when denial of treatment results in substantial harm to a patient. Most California HMOs require patients to agree to take any legal claims to mandatory arbitration at the time of enrollment.

Escutia’s SB458 is a key to HMO accountability. It stalled in the Assembly Health Committee this week on a 6-6 tie, with five Democrats abstaining — which had the effect of a “no” vote. Abstainers from this region were Wilma Chan of Alameda, Rebecca Cohn of Saratoga and Simon Salinas of Salinas.

Patients should not be forced to forgo their legal rights as a condition of getting medical treatment. Escutia’s bill is expected to come up for reconsideration Tuesday. Will Chan, Salinas and Cohn bother to vote on this important matter of patient’s rights?

Consumer Watchdog
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