- The Washington Times - Tuesday, March 27, 2001

President Bush's efforts to encourage civility and bipartisanship in Washington have a special resonance for health care, where the debate in recent years has largely been marked by their absence. With a new administration and a new Congress still working out their relationship, we have a rare chance to improve the climate. Let's not miss this opportunity.

In particular, the patient-protection debate needs some fresh air. What started out as a real effort to solve a matter of real concern how to make sure patients get the coverage and benefits they're entitled to, while still giving health plans and other providers the flexibility to organize care effectively has long since become a forum for professional ax-grinders.

Trial lawyers, who have had unsurpassed influence in Washington in recent years, have also had the most to gain from making health care an arena for confrontation rather than cooperation. So they've done their best to create the impression that every encounter between a health plan and a patient is a potential disaster, and that the solution is to sue first and explore other solutions later.

Nothing's easier than scapegoating, so this belligerent approach to policy-making has met with considerable success, picking up support from confrontation mavens in Hollywood and in the media as well as among Washington policy-makers. In a very real sense, the original debate has been hijacked and pummeled beyond recognition.

What would happen if we listened less to lawyers and more to consumers? Well, first thing, we'd hear that they don't want more confrontation. They want to be confident that there's a system in place that enables them to resolve coverage disputes quickly and fairly, allowing them to get the health care they need, when they need it.

In survey after survey, consumers say they prefer such an appeals system over more litigation. A fresh approach would be to give consumers what they want.

And what about doctors? It turns out that they, too, prefer delivering care over going to court. A recent survey of physicians found that 75 percent prefer an independent medical appeals process over new lawsuits as the way to resolve coverage disputes. Most of the doctors surveyed think (and they're in a position to know) that the existing medical liability system has been bad for the practice of medicine that it's unfair, raises costs, leads to defensive medicine, hurts doctor-patient relationships, reduces reporting of medical errors, and acts as a barrier to improving the quality of care.

It's encouraging, then, to hear Mr. Bush speaking, as he did last week, of how undue reliance on litigation "clogs the courts, consumes time and money, undermines the trust between doctor and patient [and] drives up insurance premiums for everyone." Perhaps this is the moment to listen to patients, doctors, and common sense.

Consider the urgent challenges facing us: to find ways to insure more Americans, to strengthen Medicare, to keep health care affordable. This is an enormous agenda. It would be shameful to let it get bogged down yet again in the all-too-familiar swamp of partisanship.

This year let's try substance instead of sound bites. The nation deserves no less. Is Washington up to the challenge?

Karen Ignagni is president and chief executive officer of the American Association of Health Plans (AAHP). AAHP is the nation's leading trade association representing the managed care industry.


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