4 out of 5 CA Voters Demand Health Insurer "Code of Conduct"

SACRAMENTO, Calif. (Map) - AfPA; HAAF Urge State Leaders to Support Principles to Govern Health Insurer Behavior

SACRAMENTO, Calif., July 2 /PRNewswire-USNewswire/ -- Nearly nine out of ten voters (88%) believe that health insurance companies have too much influence over how doctors care for their patients and four out of five (80%) voters support the concept of a "Health Insurer Code of Conduct" that would provide a series of guiding principles for health insurance companies with respect to how they deal with patients, doctors, and businesses. These were among the key findings in a survey of 606 registered voters in California released today by the Alliance for Patient Access (AfPA) and Healthy African-American Families (HAAF).

"California voters think the state of healthcare in California is bad and getting worse," said Dr. Jack Schim, Chairman of the California Alliance for Patient Access. "This survey tells us that Californians demand the health insurance industry keep financial concerns from affecting decisions about patient care. That's why they, like the AfPA, support a Health Insurer Code of Conduct."

AfPA and HAAF also released a joint letter they sent to all California Legislators, statewide officeholders, and candidates for statewide office, urging them to join Californians in publicly supporting a California Health Insurer Code of Conduct.

"President Obama and others are in the middle of a National Health Care debate," said Loretta Jones, Executive Director of the Los Angeles-based Healthy African-American Families. "But what often gets lost in the debate is the role of health insurers in making a bad situation that much worse. Health insurance bureaucrats, red tape, denial of care, rescissions, and price-gouging are among the reasons 93 percent of voters are deeply concerned about the rising costs of health care and why nearly a third put off doctor visits or skip medication to save money."

This week, a New York Times editorial on health care reform highlights the need to hold health insurance companies accountable, noting that:

"Congressional committees heard a lot this month about the devious schemes used by health insurance companies to drop or shortchange sick patients. It was a damning portrait -- and one Americans know from painful personal experience -- of an industry that all too often puts profits ahead of patients... No matter what happens, strong regulatory oversight will be a must to ensure that insurers skilled in denying coverage don't find new ways to evade just claims."

("Insurance Company Schemes," New York Times, 6/29/09).

Healthcare decision-making has shifted to health plans rather than doctors, which has compromised the doctor-patient relationship. In the medical field, stakeholders are required to follow a voluntary ethical code of conduct. These guidelines create a checks and balance system to ensure proper care and safety of patients, doctors, nurses, and the like. AfPA and HAAF believe that health insurance companies should also follow a code of conduct, and California voters agree.

The American Medical Association House of Delegates is currently drafting a National Health Insurer Code of Conduct that will address restrictive practices of the managed care industry that undermine the integrity of doctor-patient relationships. The AMA is scheduled to adopt this code in November 2009. Among the other findings in the survey:

-- 90% of California voters would support a code of conduct if it includes provisions that keep patient care decisions in the hands of doctors. -- 87% of voters are more likely to support the code of conduct if patients are given more rights when it comes to their healthcare, including allowing consumers to compare insurance plans; giving patients the ability to challenge decisions of insurance companies and increased price transparency (86% more likely to support). -- 88% of those polled are more likely to support a code of conduct if it would put a set of guiding principles in place by which insurance companies could be held accountable for their actions.

-- 84% percent are more likely to support a code of conduct if it would require insurance companies to disclose incentives to doctors. Almost all voters (92%) believe that patients have the right to know if their doctor is getting financial incentives, and 73% believe health insurance companies should not be allowed to offer incentives to doctors based on treatment factors.

The survey was conducted by EMC Research of Oakland, CA from May 7-14, 2009 and has a margin of error of +/- 4 percent. (Please see survey memo attached)

The AMA code currently being drafted will set forth clear and concise principles addressing both medical policies and payment issues, as well as create a mechanism to monitor compliance by managed care companies.

A Code of Conduct would ensure patients are always put before profits. It would create clinical autonomy, allowing physicians to make decisions based on patient needs without artificial barriers; transparency; the disclosing of information regarding health plan benefits and policies that will help facilitate patient decisions; corporate integrity and patient safety and wellness.

For more information, please visit www.insurepatientaccess.org.

MEMO

TO: Alliance for Patient Access

FROM: Sara LaBatt; EMC Research, Inc.

RE: California Voter Study - Health Insurance Code of Conduct

DATE: July 2, 2009

This memorandum summarizes findings from a telephone survey of 606 California registered voters conducted by EMC Research May 7-14, 2009.

Key findings:

-- California voters think that the state of healthcare in California is bad and getting worse. -- Financial concerns about health insurance and healthcare are high on the minds of voters. -- Voters in California believe health insurance companies have too much control over patient care, and that the industry should have to follow a different set of rules to keep financial concerns from affecting decisions about patient care. -- The concept of a code of conduct for the health insurance industry is very popular, and requires very little explanation.

-- Key components of a health insurance code of conduct include making sure doctors are the ones making patient care decisions, increasing patient rights, and accountability measures.

Expanded findings:

The state of healthcare in California is bad and getting worse.

Over half of California voters (55%) say healthcare in California has gotten worse in the last 5 years, while just 13% believe it has gotten better. The uninsured are particularly pessimistic, with 66% saying healthcare has gotten worse.

One out of five California voters (21%) thinks the healthcare system in California is in crises, and another one-third (34%) say it is in serious trouble. A third (34%) say it is in some trouble, while just 8% say it is not really in trouble at all.

Financial concerns about health insurance and healthcare are high on the minds of voters.

The most important healthcare issues, according to California voters responding to an open-ended question, are the cost of healthcare (21%), the cost of health insurance (13%), access to health care (11%), and the uninsured (10%). Almost everyone (93%) is concerned about the rising costs of health care, and 82% are worried about having to pay more for their healthcare or health insurance. Almost two in five voters (38%) say they have had to put off a doctor visit or skip taking a medication to save money.

Voters in California believe health insurance companies have too much control over patient care, and that the industry should have to follow a different set of rules to keep financial concerns from affecting decisions about patient care.

Nearly nine out of ten voters (88%) believe that health insurance companies have too much influence over how doctors care for their patients. Almost all voters (92%) believe that patients have the right to know if their doctor is getting financial incentives, and 73% believe health insurance companies should not be allowed to offer incentives to doctors based on treatment factors.

Nearly three-quarters (73%) believe that a pharmacist should not be allowed to switch a patient to a different medication than the one that was prescribed by their doctor.

Of those who registered an opinion, nearly two-thirds (60%) are opposed to the practice of step therapy -- where patients have to try and fail on treatments in the order set by the insurance company before they are allowed to try the treatment that works for them.

A wide majority (72%) of California voters agree with a statement that says health insurance companies should have special rules about what steps they should be allowed to take to save money and protect their bottom line so that their financial policies do not affect medical decisions. Nearly half (48%) of those voters express "strong" agreement with this statement.

The concept of a code of conduct for the health insurance industry is very popular, and requires very little explanation.

When asked how they feel about the implementation of a code of conduct for the health insurance industry, four out of five California voters (80%) support the idea, with 52% strongly supporting it. Opposition to the idea is at just 11%. The uninsured are even more supportive, at 88% supporting the idea, while 82% of Democrats support the idea.

Even with support starting at a very high level, listing components of the code of conduct further boosts support to 87%, while dropping opposition to 9%. Among Democrats, support rises to 90% after hearing the components, and 92% among female Democrats.

Key components of a health insurance code of conduct include making sure doctors are the ones making patient care decisions, increasing patient rights, and accountability measures.

Keeping patient care decisions in the hands of doctors is the most popular component of the health insurance code of conduct. Ninety percent of voters are more likely to support the code of conduct knowing that that component is included, including 70% who are much more likely to support.

Another popular concept is giving patients more rights when it comes to their healthcare, including allowing consumers to compare insurance plans (87% more likely to support), giving patients the ability to challenge decisions of insurance companies (86% more likely to support), and increasing pricing transparency (86% more likely to support).

Accountability measures are also popular components. Eighty-eight percent are more likely to support a code of conduct knowing it would put a set of guiding principles in place by which insurance companies could be held accountable for their actions. Eighty-five percent are more likely to support a code of conduct knowing it would force insurance companies to follow a clear set of rules, and 84% percent are more likely to support a code of conduct knowing it would require insurance companies to disclose doctor incentives.