Letter To Senator Nickles About Scope and the Right to Sue

Honorable Don Nickles
April 5, 2000
Assistant Majority Leader
United States Senate
The Capitol, S-208
Washington, DC

Dear Senator Nickles:

We are writing on behalf of state Public Interest Research Groups and consumers generally to urge you to uphold common sense patient protections as you chair the patients’ rights conference committee. While the conference has resolved some issues, we are concerned about the lack of discussion about two critical issues: the scope of the patient protections and how patients will be able to hold their health plan accountable.

U.S. PIRG believes that all patients deserve protections, therefore a patients’ bill of rights must apply to as many Americans as possible. The House bill has a broad scope, applying all protections to 161 million people, which includes all people with employment-based insurance, including state and local government workers and people who buy insurance individually. In contrast, most provisions in the Senate bill apply only to the 48 million people in private employment-based plans where the employer "self-insures." If the Senate’s version were to prevail, 112 million people would be left without adequate protections. It would be a tragic mistake for Congress to enact a patient protection bill that intentionally excluded so many Americans.

Another necessary component of meaningful managed care reform is legal accountability. Not only must patients who have been unfairly denied health care have access to an independent external review process, they must also have the ability to hold their managed care provider legally accountable. Managed care providers should not be held above the basic laws of accountability that apply to every other industry and to the rest of American society. Legal accountability acts as a critical deterrent to lapses in the quality of medical care provided. Patients should have the basic right to sue their health insurer when a health insurer’s decisions cause injury or death.

We urge you to prioritize these issues as you complete the work of the conference, and we urge you to complete this work as soon as possible. The lives and health of Americans are at stake.


Rachel Weintraub
Staff Attorney

cc: Senate and House conferees



©1999 Public Interest Research Groups