Managed Care Reform

Problem || Solution || Method || Links

The Problem:

The current health care system in the United States is failing. Forty-five million people, over one third of all Americans, have no health insurance and one third of all Americans are inadequately insured. Health Care costs are increasing at a pace which far exceeds inflation. Health maintenance organizations ("HMOs") were established as a cost effective alternative to traditional fee for service medicine. HMOs have reported financial losses and as a result are increasing premiums and denying previously offered services. Increased health care premiums have led employers to shift the cost of health care onto their employees. While consumers are bearing more of the burden of their health care costs, they are frequently denied needed medical treatment by their HMO and are increasingly dissatisfied with the care they are receiving. Final decisions regarding treatment are being made by insurance bureaucrats and not doctors. Consumers who have been wrongfully denied care have no recourse but to continue pleading their case to their HMO. HMO's are exempt from lawsuits and are not held accountable to their patients nor to the law. Americans are continuously frustrated by their HMO and the cost, quality and options of the medical care they receive. A systematic overhaul of the existing managed care system is necessary to protect consumers.

The Solution:

In response to this health care crisis, U.S. PIRG support a strong Patients’ Bill of Rights (such as the Norwood/Dingell Bill, H.R. 2723 passed in the House last October). A real, meaningful Patients’ Bill of Rights must include the following elements:

The Method:

Through direct lobbying and grassroots support, we will urge Congress to pass a strong Patients’ Bill of Rights and urge the President to veto any legislation that does not embody the above elements.

Opposition to real managed care reform is made up of health insurance special interests and employer groups such as the Chamber of Commerce. A group of several employer and insurance groups contributed more than $1.3 million to members of Congress during the first six months of this year.

Our coalition members in the fight for managed care reform include other consumer groups, labor unions, doctors, nurses and other practitioners.

Our strategy includes lobbing members of Congress directly and through mail, urging them to vote for strong patient protections. We will urge the president to veto the bill, if the conference committee creates a bill that does not offer patients strong protections.


Press Releases and Letters to Congress