Californians back health insurance code of conduct

A survey says many patients believe insurers have too much influence over medical practice.

By Victoria Stagg Elliott — Posted July 21, 2009

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The majority of patients are concerned about the sway insurance companies have over physicians and believe a code of conduct is necessary to guide this industry's behavior. This is according to a survey of Californians released July 2 by the Alliance for Patient Access and Healthy African-American Families.

"The results speak to the frustration with health insurance shared across the country. There's not any corner that is satisfied with the hoops and the obstacles that we have to go through for decent health coverage," said Roger Salazar, spokesman for both organizations. The alliance is an organization that trains physicians to advocate for patient access, while Healthy African-American Families is a Los Angeles-based patient advocacy group.

On behalf of the organization, EMC Research telephoned 606 people registered to vote in California. Approximately 88% believed insurers had too much influence on how doctors cared for their patients, and 80% supported the concept of a health care code of conduct. The vast majority wanted such guidance to keep patient care decisions in the hands of doctors, make health care service pricing transparent and allow patients to challenge the decrees of third-party payers. Those surveyed also wanted insurers to be held accountable for their actions and disclose incentives given to physicians.

"We have seen physician surveys say something similar. Patients are on their side. What patients want is for their relationship with their doctor to remain sacred," Salazar said.

Various codes of conduct already exist but have been established primarily by the companies themselves and trade organizations representing them. In response to continuing frustration on the part of physicians and patients, several states are considering legislation on such a code.

The American Medical Association also adopted policy at its November 2008 Interim Meeting committing it to devise a "Health Insurance Code of Conduct," seek compliance from health insurers and develop a means to monitor adherence. A progress report was presented at the June Annual meeting, and a version of the code will be introduced in November. The code is expected to address issues of clinical autonomy, health plan transparency, corporate integrity and patient safety. It also will complement the AMA National Health Insurer Report Card, which evaluates claim processing practices.

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