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Don's report archive

by Donald B. Ardell, Ph. D.
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Wellness in the Headlines
(Don's Report to the World)

A Patient's Bill of Rights

Wednesday January 10, 2001

The recent presidential campaign revisited a debate about a "Patients Bill of Rights." Varied interests groups lined up on one side or the other of this initiative. While a good case seemed to be made by those for it as well as those opposed to it, I made my decision on the issue by asking myself this question: "Which position seems to be best for empowering consumers?" What do you think?

My sense is that such a bill might do more harm than good! Of course, this would depend to a considerable extent upon what such a bill looked like by the time it was signed into law -- after all the committee and other deals were made, the lobbyists were satisfied, and the president mollified. But, as an enthusiast for personal accountability, I suspect that the current focus such bills upon RIGHTS without much attention to or inclusion of RESPONSIBILITIES is one of the last things America needs. After all, we already have lots of programs that offer rights without commensurate support for and recognition of accountability.

What's more, the patient rights debate disguises difficult choices that need to be made by public policy officials -- and most American families, about our health care or medical system. Some politicians are basically using the patient rights campaign to attempt an end run around these volatile but important underlying problems. I would be happier about the proposed patient rights if the politicians would acknowledge that, at some point in the care process, additional interventions may be futile or too costly and that available techniques are either unsafe or unproven and can be self-indulgent as well as dangerous.

The Patient's Bill of Rights initiative is a response to managed care and attempts to demonize these organizations for the hard choices made to control costs. Society has an interest in holding down costs; the individual, on the other hand, has a contrary interest to persuade governments or other interests to pay unlimited amounts for his or her care.

Studies show that managed care programs have improved quality. The fact that a doctor recommends a treatment approach does NOT mean it's always needed. That is one reason that the group most opposed to managed care are doctors -- it has adversely affected their incomes. Congressional efforts at more rights could cripple cost controls while patients rights remain hard to define and defend.

My self-management advice? Do all you can to stay out of the health care system as long as possible by living a wellness lifestyle. It is not always possible, of course, as accidents happen and diseases are inevitable for most due to genetics and living long enough for disorders of old age to occur. But, do your part to remain well and out of the health care system as long as possible. If you focus more on your responsibilities for staying healthy than your rights to medical care, you will have better outcomes, other things being the same.

Don't you agree? Whether you do or not, I'd love to hear from you. Thanks for visiting. Stay well and look on the bright side of life.

Domain: mental
Subdomain: factual knowledge

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