Monday, April 13, 2009

Medical Reformers unite to get changes in health care

The Journal Record
Janice Francis-Smith
OK Capitol

April 14, 2009
OKLAHOMA CITY – None of the three people who spoke at Monday’s press conference were strangers to the lectern in the press room of the state Capitol. Each has paced the halls of the Capitol building for months, advocating for their particular issue. All have seen their favored legislation shot down by legislators who champion the financial health of one industry: insurance.

On Monday, the three announced they had banded together to form a new grass-roots advocacy group, Oklahomans for Health Care Reform. But a business advocate said such groups often develop when it appears likely legislation to alter Oklahoma’s tort laws will pass.

“We need to take back the insurance industry and make it patient-centric, not just profit-centric,” said Wayne Rohde. As a founder of the Oklahoma Autism Coalition, Rohde has worked for more than a year to force insurance companies to cover autism treatments. The legislation has come to be known as Nick’s Law, named for Rohde’s son.

The issue was derailed last year when the chairman of the House committee to which the legislation had been assigned refused to hear the bill. Former state Rep. Ron Peterson, R-Broken Arrow, former owner of an insurance agency, still frequents the Capitol in an advisory role. The issue was shot down again at the beginning of the 2009 session when members of the Republican majority voted against the measure. Under legislative rules, the issue can’t be brought up again for two years. Republican leadership opposes passage of any further insurance mandates, which they say drives up the cost of insurance premiums for everyone.

Nancy Thomason’s son, Cade, was not 2 years old when he died from brain cancer, she said. Thomason’s health insurer refused to pay for costs related to his participation in clinical trials that Thomason thinks could have helped her son. Last year, Thomason worked with state Sen. Andrew Rice, D-Oklahoma City, to pass a bill known as Stephanie’s Law, named for a young woman who has since died from brain cancer and who was likewise denied coverage for costs related to participation in clinical trials.

“People are dying, and they (insurance company executives) are only thinking about the bottom line,” said Thomason. A conflict of interest exists when lawmakers who work in the insurance industry serve as chairman and voting members of the committees where legislation involving the insurance industry is heard, she said.

Jeff Raymond of OKWatchdog has been to the Capitol arguing against the provisions of House Bill 1603, the comprehensive measure designed to revise Oklahoma’s laws regarding personal injury, or torts. The changes proposed would protect corporations and physicians from certain liability lawsuits, and would make it more difficult to file and pursue such a lawsuit.

“We’re not going away,” said Raymond. “We want to keep the people’s attention on it.”

Legislation successfully working its way through the process would make it very difficult to pass any additional mandates on insurance companies, requiring a two-year process and a list of actuarial studies. Other legislation would allow insurance companies to offer a bare-bones health care policy, stripped of all mandates and all but the most basic coverage for emergency care.

The three were joined at the press conference by state Rep. Eric Proctor, D-Tulsa, and state Sen. Kenneth Corn, D-Poteau. When insurance companies decide which treatments and procedures to cover and which to deny, the effect is that the company decides which treatments the patient – who rarely can afford to pay for treatment out of pocket – will receive.

“Those decisions should be made by a physician, not by some bean-counter in a basement somewhere,” said Corn. Corn has legislation pending that would make it unlawful for an insurance company to offer bonuses to employees who deny the most claims or who cancel the policies of those who have filed claims, as a California insurance company is accused of doing.

Other states have had success in setting standards for insurance companies, said Corn, and Oklahoma could follow their example. If federal legislation to allow insurance policies to be “portable” from state to state is successful, the question would become moot.

But until then, there is the possibility that insurance companies could choose to take their business to other states if Oklahoma’s laws become too restrictive for them.

“There is no law that says you have to stay here and write coverage,” said Mike Seney, senior vice president of operations for The State Chamber. “And the insurance industry isn’t like every other industry. We, as consumers, need their products, their services. I want my insurance company to do well, so that when I’m in a car wreck, or when a fire comes and wipes out my home, they’ll be able to cover it.”

A groundswell of resentment against insurance companies tends to accompany any efforts toward passing legislation to revise tort laws, which would reduce the amount of money trial lawyers may earn, Seney said.

“Those who oppose tort reform need to find somebody to wear the black hat, and they look to insurance companies,” he said. Regarding the claims of conflict of interest, Seney said lawmakers are elected because of the experiences they bring to the process, whether that experience be regarding the insurance industry or any other profession.

“It would be self-defeating for the state to elect these people and not listen to their experiences,” said Seney. On the other hand, legislators who make their living as trial lawyers have not recused themselves from voting on bills dealing with tort laws or with how much money they can make, he said.

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