Concerns aired at hearing will help strengthen new state law
Ken Olsen - Staff writer
Last spring, Brenda Gildehaus' insurance company told her it wouldn't cover the cost of her rehabilitation because she has a chronic disease -- multiple sclerosis.
After three major bouts with the crippling ailment, she had to wheel to a podium Tuesday at a hearing on patients' rights in a borrowed wheelchair.
"I struggle every day with my insurance company," Gildehaus said. And although the company might not realize it, "I am not a net gain or loss. I am young, a wife and a human being.
"It's not like I want a Cadillac to drive to town," Gildehaus said. "I just want to have a wheelchair."
She believes insurance companies unjustifiably give better coverage to people with one-time injuries than people with persistent illnesses, she testified.
Gildehaus was one of a half-dozen people to testify at the Spokane hearing on the Patient's Bill of Rights, held by the Washington insurance commissioner's office Tuesday at Spokane City Hall. Such testimony will be used in writing the rules to enforce the law, passed last winter by the Washington Legislature.
And the bill of rights will address exactly the concerns people like Gildehaus expressed, said John Conniff, the deputy state insurance commissioner who conducted the hearing. Among other things, the bill will require insurance companies to use "reasonable medical evidence" when denying care.
"If you are going to say no, say why. You have to be able to point to something (medically) solid," Conniff said.
The bill also establishes an independent review board to hear citizen appeals when they are denied care. And it expands privacy requirements so only the doctor, insurance company and patient know what treatment a patient receives.
Others testifying at the Spokane hearing said they worry about how privacy protection mandates will affect medical care.
Dr. Rod Trytko, president of the Spokane County Medical Society, said a national standard -- like the one being developed by the U.S. Department of Health and Human Services -- is essential.
However, he cautioned against a rule so restrictive that it hampers essential communication among physicians.
David Bunting, an economics professor at Eastern Washington University, addressed the requirement that companies provide more details about what a policy covers. He predicted insurance companies will respond by burying customers with information they have neither the time nor the expertise to analyze.
The commission should adopt rules that keep the information readable, meaningful and relevant, he said.
Meanwhile, Frank Yuse, of the Senior Legislative Coalition, complained the bill of rights is insufficient. Senior citizens are losing more coverage in Eastern Washington as Medicare HMOs pull out, he said.
"Senior citizens are upset, angry and confused," Yuse said. "Health care is a human right, not a marketing commodity.
"A true patient bill of rights has to make insurance complete and affordable."