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HMO bill 1999 Differences Between HMO Bills (1999) .c The Associated Press Differences between Senate Democratic and Republican versions of a ''patients' bill of rights,'' as shown in votes Thursday, all won by Republicans: WHO IS COVERED? Democrats: Would have covered all Americans who have private health insurance - an estimated 161 million people. Republicans: Many provisions only apply to 48 million Americans who are in plans that are regulated only by federal law. This includes greater access to emergency rooms, specialists, medications and the right to choose a health plan that allows them to use doctors who are outside a defined network. RIGHT TO SUE Democrats: Wanted to let patients who are harmed by the denial of care sue their health insurance companies and collect damages. Current law only allows patients to recoup the cost of denied treatments. Republicans: No new rights to sue. OBSTETRICIANS AND GYNECOLOGISTS Democrats: Would have let women see OB-GYN doctors without prior approval and designate them as a primary care physicians. Republicans: Allow women to see them without prior approval, but not to designate them as primary care doctors. Only applies to federally regulated plans. EMERGENCY ROOM CARE Democrats: Wanted to require health plans to pay for reasonable care even if the hospital is outside the network. That includes care needed to stabilize patients and follow-up care after they are medically stable. Republicans: Altered provision to more closely match Democrats, but only applies to federally regulated plans. CLINICAL TRIALS Democrats: Would have required health plans to pay the routine health care costs associated with clinical trials. Republicans: Only included cancer patients. MEDICAL NECESSITY Democrats: Would have given doctors more say over what care is provided by forcing health plans to pay for medically necessary care. They defined that as care consistent with generally accepted principles of professional medical practice. Republicans: Allow plans to continue determining what care is medically necessary. MASTECTOMY Democrats: Required that health plans pay for overnight hospital stays if doctor and patient want it. Republicans: Added virtually identical provision. Unlike other aspects of the GOP bill, applies to all Americans with private health insurance, about 161 million people. CONTINUITY OF CARE Democrats: Allow patients who are pregnant or undergoing a course of treatment to keep their doctors for 90 days, even if the doctor leaves the network. Republicans: Similar, but only applies to patients who are pregnant, terminally ill or institutionalized. TAX CHANGES Democrats: No provision. Republicans: Allow people who are self-employed to deduct the cost of health insurance and create a new deduction for long-term care. Allow more medical savings accounts, which let people to set aside money, tax-free, to pay for routine care if they buy a high-deductible insurance policy in case of an emergency. APPEALS Both require health plans to allow patients to appeal denials, first through an internal process and then to experts outside the plan. But Republicans would only allow for appeals based on medical necessity, not procedural issues. INFORMATION DISCLOSURE Both require health insurance companies to disclose details about what they cover and how they operate. AP-NY-07-15-99 1838EDT Copyright 1999 The Associated Press. The information contained in the AP news report may not be published, broadcast, rewritten or otherwise distributed without the prior written authority of The Associated Press. All active hyperlinks have been inserted by AOL.

Bureaucratic waste us health care Half of bankruptcy due to medical bills Health care administration 300 perc canada { August 21 2003 } HMO bill 1999 Justices limit suits against HMOs { June 22 2004 } Privatization of medicare { June 27 2003 } Privatizing medicare Tort reform helps insurance not doctors Files Listed: 8

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