Hawaii trails
in patients’ rights
Isles lack 10 protections
By Pete Pichaske
deemed essential in managed-care
plans, a national survey says
Star-BulletinWASHINGTON -- Hawaii has fewer protections for health-care consumers than most other states, according to a groundbreaking survey released here today.
The study by Families USA, a nonprofit organization that lobbies for better health care, found that Hawaii had only three of the 13 consumer protection laws the group identified as essential for users of managed-care health plans. And all three had been instituted only in the past year.
Fifteen states had fewer protections, according to the survey, which Families USA called the first-ever of state managed-care laws.
"On health reform, Hawaii is generally way ahead of most other states, so it is a little curious they've lagged behind on this," said Judith Waxman, Families USA government affairs director and the report's author. "It seems they are finally waking up to the need."
In Honolulu, Dr. Arleen Jouxson-Meyers, founder and president of the Hawaii Coalition for Health, said, "As of yesterday with the (governor's) signature of the patient bill of rights, Hawaii's protections for patients must have gone up substantially from the three in the report."
She said the new law calls for a task force that "will ensure that over the next year we will provide patients with all of the 13 protections."
The 13 protections measured by Families USA cover such issues as access to physicians and prescription drugs, continuity of care, and the disclosure of alternative treatments.
The three required in Hawaii are the right to go to an emergency room and have the managed-care plan pay for the treatment; the right to appeal denials of care through an independent review process; and, barring plans from using gag rules that prevent physicians from disclosing treatment options.
The third is the most common of the 13 protections, the survey found, and is the law in 45 states.
Vermont, with 11 of the laws, leads all states, according to the survey; South Dakota was the only state that had adopted none.
Advocates of tighter controls on managed-care plans, commonly known as HMOs, immediately seized on the study as ammunition for their arguments.
"There's very little consistency from state to state," said Rep. John Dingell, D-Mich., who is pushing for a "patients' bill of rights" that would require all managed-care plans to offer certain protections to subscribers. The report "underscores the arguments" for his proposal, said Dingell.
All four of Hawaii's Democratic congressional lawmakers -- Sens. Daniel Akaka and Daniel Inouye, and Reps. Neil Abercrombie and Patsy Mink -- have endorsed Dingell's proposal.
