don's report archive

by Donald B. Ardell, Ph. D.

Wellness in the Headlines
(Don's Report to the World)

A Patient's Bill of Rights was a hot issue in the years leading up to and during the recent presidential campaign. It has not gone away, in fact, such a bill has been passed by both houses of Congress and is now being reconciled by the two chambers.

Are you up to date on this? What's your view? Personally, I think some of the proposed reforms (from a wellness perspective) might be helpful, but I can't get very enthusiastic about such a bill. Why? Because overall such a bill might do more harm than good! As an enthusiast for personal accountability, I suspect that the focus upon "rights" without sufficient attention to responsibilities is one of the last things America needs. What's more, the patient rights debate disguises difficult choices that public policy officials need to make, along with 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.

There are other problems, as well. The current bill seems to bestow special privileges for some at the expense of others. In a society with private markets, it is dangerous to require some companies, such as health insurance organizations, to provide certain benefits, and to mandate longer hospital stays and more coverage for an ever widening variety of treatments. The medical system is already far too expensive and bloated -- this will worsen matters and seems unrelated to any kind of patient "rights." What rights are they thinking about? The rights of taxpayers to go broke?

How will insurance companies absorb the extra costs associated with these required new services that are heaped on as part of a patient's bill of rights? This legislation is not about patient rights -- it's more associated with the push for nationalized health care. This issue deserves discussion, but it should be done in an above-board matter so that everyone interested in the matter can influence what is really at stake. I think more concern should be shown for the rights of all potential patients, better known as taxpayers.

The Bill of Patients 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. A genuine bill of patient's rights would give everyone the right to be free from government interference. We all need freer markets in the health care sector, not more mandated services.

Managed care has been the target for the "patient's rights" lobby, with allegations of diminished quality being the battle cry. Yes, many 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 is 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 wellness advice? Do all you can to stay out of the health care system as long as possible by living a self-managing 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. If you focus more on your responsibilities for staying healthy than your patient rights to medical care, you should have better outcomes, other things being the same.

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

(Note: This essay will be filed in the archives in the MENTAL DOMAIN under the skill area of factual knowledge. Additional articles related to this theme may be found there.)

(Ed. Note: Views expressed in this and other columns are those of the author and not necessarily those of the SeekWellness Editorial Board.)

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