Like most voters in IN-07, I'm frustrated by how long politicians have allowed our current health care crisis to fester. I wasn't very old at the time, but I remember how disappointed my parents were when President Clinton's health care proposal foundered in the House in 1993. Given how much of a political debacle "universal health care" turned into, I guess I wasn't too surprised that few substantive efforts at reform developed over the course of the decade. Even vitally needed practical reforms like the "Patient's Bill of Rights" similarly ran ashore in Congress after intense lobbying from HMOs and other corporate medical providers. I was, however, surprised to learn that Dr. Woody Myers, a current candidate for the House in IN-07, lobbied Congress on behalf of Ford Motor Company and the American Benefits Council - an HMO industry group - to oppose virtually every provision of the Patient's Bill of Rights. After all, Dr. Myers tells voters that he'll push to make sure there is "universal coverage for all Americans," but when testifying before Congress on behalf of HMOs and Corporate interests he insisted that "market-based solutions" were best.
In 1997, President Clinton, perhaps spurred on by horror stories of HMOs denying desperately needed care for budgetary reasons, appointed a committee to formulate a set of rights all Americans should enjoy when dealing with their health insurance providers. In 1998, the committee released its product - the Patient's Bill of Rights - and Democrats immediately began drafting legislation to see it encoded in law. Hopes were high. The proposed legislation enjoyed substantial public support and was backed by the American Medical Association. In particular, the AMA favored the bill's approach to "medical necessity." HMOs consistently used arbitrary definitions of "medical necessity" to deny medically appropriate treatments - the definition they applied being essentially whatever the HMO thought was cost effective. The Bill of Rights would have ensured that Doctors, not insurance bureaucrats, would have the final say over what was "medically necessary." There's a whole lot more after the jump.
Given that the AMA and wider medical community seemed to be squarely behind allowing doctors rather than HMOs to make potentially life-saving medical decisions, the health insurance industry needed a fresh face to come to their defense. Dr. Woodrow Myers, then Director of Health Care Management for Ford, provided that face, volunteering to testify in a three-month span twice before a House subcommittees chaired by John Boehner and once before a Senate committee. Dr. Myers defended various onerous HMO practices. He defended the infamous "gag rules" which permitted HMOs to force Doctors not to discuss all treatment options with patients. He defended the right of HMOs to be immune to lawsuits even if a denial of treatment claimed the life of a patient. He even defended the right of HMOs to be the ultimate arbiters of "medical necessity," even when their opposition to a particular type of treatment was based only on "excessive" cost. At every turn, Dr. Myer argued that the government should stay out of the way. HMOs should be given free reign. In practice, this meant that HMOs could deny care whenever and however they liked no matter what the consequences to the patient's health. Have no fear, he assured sick Americans everywhere, the free-market would provide.
Woody Myers got his way. The Health Insurance Industry got its way. The Republicans in Congress got their way. President Clinton, the Democratic Party, and the American People all lost. The Patient's Bill of Rights did not pass.
By the time a bi-partisan version of the Patients Bill of Rights again appeared in Congress, again failing in 2001, Dr. Myers was no longer just indirectly shilling for the Health Insurance Industry. Now he was making millions working directly for an HMO as an executive at Wellpoint. As it turns out, no Patient's Bill of Rights meant big bucks Wellpoint and for Dr. Myers. Nevertheless, in April of 2008, the City Attorney of Los Angeles filed a $1 Billion lawsuit against Wellpoint alleging a "wide range of unlawful, unfair and fraudulent acts and practices that deny consumers requiring an expensive medical procedure or course of treatment the benefits promised by Defendants' IFP coverage, rendering that coverage largely illusory." Dr. Myers was, of course, a Managing Director at Anthem Blue Cross of California, a named defendant in the lawsuit, during the time period the suit covers.
Dr. Myers spouts a lot of high-minded rhetoric about his desire to serve the people of Indiana - to make them his "patients" as he puts it. What a load of garbage. The reality is that Dr. Myers hasn't been committed to serving the public interest in matters of health for quite some time. Quite the contrary, Dr. Myers actively campaigned against legislation that would have prevented HMOs from engaging in life-threatening denials of care against the advice and wishes of medical professionals. Dr. Myers then made millions as an executive for an HMO that may have engaged in thousands of "unfair, unlawful and fraudulent" denials of care. This is the guy who is going to bring "universal coverage"? Would Dr. Myers even vote for a Patient's Bill of Rights today? If two-letters after your name were all it took to prove that you cared about the health and well-being of your constituents, Dr. Myers would be golden. Unfortunately, his record suggests that his medical credentials belie a history of looking out for HMOs first and people second. I simply can't believe a word that Dr. Myers says when it comes to health care issues.
(A note on sources: Sheila Seuss Kennedy has a transcript of Dr. Myers' testimony to a House subcommittee. In it he defends a law known as ERISA which the Patient's Bill of Rights would have modified. ERISA gave legal immunity to health insurers and HMOs for denials of care that led to a patient's death or injury. The transcript does not, however, give much detail about Dr. Myers views on "medical necessity." Dr. Myers' testimony before the Senate committee on Health, Education, Labor, and Pensions was primarily concerned with "medical necessity." I found it on lexis-nexis. It's too long to post here, but I'd be happy to forward it to anyone on request.)
Crossposted at Tyrion's Point and Blue Indiana.