Giving patients healthy protection; House vote: Rebuff of GOP leadership shows level of public discontent with health insurers.


YOU CAN count on it: Public ire over restrictive health-insurance policies will be a major issue in next year's presidential and congressional elections. That's why 60 Republicans bolted party ranks to side with House Democrats in passing a broad patient's protection bill last week.

Unless Republicans on a House-Senate conference committee show the same kind of pragmatism, the GOP could be handing Democrats a potent weapon for next year's campaign.

Health insurers have failed to deliver quality care while controlling costs. Too often, attempts to cut expenses have meant suffering for patients. To borrow from the movie "Network," frustrated Americans "are mad as hell and won't take it anymore."

Republican leaders make a valid point: Giving patients the right to sue managed-care companies could enrich lawyers without ensuring better care for patients. Indeed, there is scant chance a strong right-to-sue provision will emerge from the conference committee, which will be dominated by Republicans opposed to a tough patients' protection bill.

Far more important, though, are provisions in the Senate and House versions requiring health plans to set up a rapid-appeals process through outside experts when treatment is denied. That would give patients a powerful tool to wield against penny-pinching insurers.

Some 2.5 million Marylanders, who work for multistate companies governed by federal laws, would gain health-care protections. Other Maryland citizens are already covered by a state law that went into effect in January giving the insurance commissioner power to overturn insurer decisions in some cases. The commissioner can also impose penalties against insurers that flagrantly violate patients' rights.

Giving consumers a way to appeal poor medical decisions by health insurers ought to be the focus of congressional negotiations, which could drag on into next year. Such a timetable would put even more pressure on conferees to come up with a bill with enough reforms that President Clinton will sign it into law.

Otherwise, Republicans on the campaign trail could become targets of an electorate that's fed up with ever-tighter restrictions on their medical care.

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