THE WHITE HOUSE
Office of the Press Secretary
PRESIDENT CLINTON RELEASES STATE-BY-STATE REPORT THAT UNDERSCORES IMPORTANCE OF A FEDERALLY-ENFORCEABLE PATIENTS' BILL OF RIGHTS AND RENEWS CALL ON CONGRESS TO PASS LEGISLATION THIS YEAR May 28, 1998 Today, the President is releasing a state-by-state report that
underscores the need for a Federal patients' bill of rights by showing that even if every state enacted all the patient protections recommended by the President's Advisory Commission on Consumer Protection and Quality into law, 122 million Americans could still lack protections. The report also underscores the particular importance of the protections for women in the patients' bill of rights. In addition to releasing this report, the President will renew his call on Congress to pass a federally enforceable patients' bill of rights before its adjourns this year.
Millions of Americans Do Not Have the Patient Protections Recommended by the Quality Commission. Although 44 states have enacted at least one of the protections recommended by the President's Quality Commission, millions of Americans lack many of these protections because of the extent to which the Employee Retirement Income Security Act of 1974 (ERISA) preempts state-enacted protections. Because of ERISA, state laws cannot require self-insured plans (plans directly underwritten by employers) to provide critical patient protections. Indeed, ERISA can even prevent state laws from having the full effect even in health plans directly regulated by states. In short, a patchwork of non-comprehensive state laws cannot provide Americans with all the protections they need because states do not have full authority over the 122 million Americans who are in health plans governed by ERISA.
A Patients' Bill of Rights is Particularly Important to Women. Approximately 60 million women are in ERISA health plans and therefore need Federal legislation to be ensured of receiving the full range of protections recommended by the Quality Commission. Women are particularly vulnerable without these protections because they are greater users of health care services, they make three-quarters of the health care decisions for their families, and they have specific health care needs that are directly addressed by a patients' bill of rights.
Over 60 percent of physician visits are made by women, and women make three quarters of the health care decisions in American households. Without adequate patient protections, women will be unable to effectively navigate through the nation's rapidly changing health care system.
Women in managed care plans are increasingly dissatisfied with the quality of care. Nearly 70 percent of privately insured women ages 18 to 65 are in managed care plans. Almost two-fifths of these women worry that they will not be able to get speciality care when they need it. And 27 percent of these women worry that they will be denied a medical procedure they need.
Without a patients' bill of rights, women may not receive important preventive services. The consumer protection that gives women direct access to an obstetrician/gynecologist is not only necessary to make sure that pregnant women get the care they need, but is also important to ensure that women get important preventive services. Studies show that gynecologists are almost two times as likely as internists to perform timely, needed women's preventive services.
The President Renews Call on the Congress to Pass a Patients' Bill of Rights. The President called on Congress to enact the Quality Commission's recommendations to ensure high quality care for all patients. These recommendations include: providing patients with access to easily understood information; providing access to specialists, including specialists for women's health needs; ensuring continuity of care for those undergoing a course of treatment for a chronic or disabling condition; access to emergency services when and where the need arises; disclosing financial incentives that could influence medical decisions; prohibiting "gag clauses"; providing anti-discrimination protections; and providing an internal and external appeals process to address grievances with health decisions. The President is pleased that there is growing bipartisan support to pass these long overdue protections.
Dr. Regina Benjamin, family physician and AMA board member Vice President Gore
Ricka Powers, recently diagnosed with cancer President Clinton