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Q: Health care for senior citizens ( Answered,   0 Comments )
Question  
Subject: Health care for senior citizens
Category: Health > Seniors
Asked by: aghabog-ga
List Price: $100.00
Posted: 23 Sep 2002 16:17 PDT
Expires: 23 Oct 2002 16:17 PDT
Question ID: 68231
I am looking for a "Senior health care bill of rights" or a bill of
rights for other segments of the population that might be "tweaked" to
include seniors
Answer  
Subject: Re: Health care for senior citizens
Answered By: sublime1-ga on 23 Sep 2002 19:26 PDT
 
aghabog...

A search for healthcare "bill of rights" turns up
20,600 references, so, yes, there are models you can
use. Most of those from that search are authored by
individual hospitals, treatment centers, or states.

For example, the Bloomington Hospital in Indiana, has theirs
on this page: http://www.bhhs.org/rights.html  and states:

"Patient Bill of Rights"

"As a patient at Bloomington Hospital you have the right:
# To considerate and respectful care,
# To be informed about your condition and treatment in
understandable terms,
# To receive information from your physician necessary 
to give informed consent prior to the start of any 
procedure or treatment,
# To refuse treatment and be informed of the medical 
consequences of your actions,
# To every consideration of privacy concerning your 
own medical care program,
# To expect that all communications and records pertaining
to your care will be treated as confidential,
# To request hospital services and to be completely 
informed if transfer to another hospital becomes necessary,
# To obtain information as to the relationship of this
hospital to other health care and educational institutions,
# To be advised when the hospital proposes to engage in,
or perform, any human experimentation affecting your 
care or treatment,
# To expect continuity of care and to be informed of 
home health care requirements prior to discharge,
# To examine and receive an explanation of your bill 
regardless of source of payment,
# To know which hospital rules and regulations apply 
to your conduct as a patient,
# To expect equal medical treatment regardless of race, 
creed, national origin, age, handicap, veterans status 
or gender."

You will find that most of them are similarly generic.

I'm not sure how patient rights would be differentiated
in regard to seniors, as most of them are written in a
manner which includes the concerns of seniors.

There is, of course a strong movement toward a National
Healthcare Bill of Rights, especially now that there is
a trend toward for-profit managed-care HMOs, which are
proving to provide a lesser quality of care than prior
providers. A search for healthcare "National Bill of Rights"
gave a link to an extrememly thorough discussion of the
subject by George J. Annas, J.D., M.P.H., who notes:

"...in early 1973, the American Hospital Association issued
 a patients' bill of rights. Although the 12-point bill
 was vague and general, it was the first such document
 and included many basic concepts of patients' rights,
 such as the rights to receive respectful care, to be
 given complete information about diagnosis and prognosis,
 to refuse treatment, to refuse to participate in
 experiments, to have privacy and confidentiality
 maintained, and to receive a reasonable response
 to a request for services."   ...from:
http://www.bumc.bu.edu/www/sph/lw/pvl/lim/national-98-mar5.htm

As it turns out, George himself was the author of that
initial patients' Bill of rights, as noted in footnote
3, at the bottom of that page. I highly recommend that you
read the entire discussion on that page, however, some of 
the highlights, in terms of patient rights, are:

"... in his January State of the Union address, President
 Bill Clinton called on Congress to enact a national
 bill of rights in health care. The President said,
 "You have the right to know all your medical options,
 not just the cheapest. You have the right to choose
 the doctor you want for the care you need. You have
 the right to emergency room care, wherever and whenever
 you need it. You have the right to keep your medical
 records confidential.'"...

..."The most important of all patients' rights, the right
 to informed consent, was firmly established in 1972
 in a series of court opinions."...

..."patients' rights based on autonomy quickly became
 the norm"...

..."in Roe v. Wade. The Court held that pregnant women
 have a constitutional right of privacy that includes
 their right to continue or terminate a pregnancy in
 the absence of the state's ability to demonstrate a
 countervailing and compelling state interest. The
 case has also come to stand for the proposition that
 the Constitution limits interference by the state in
 the doctor–patient relationship."...

..."the rights to receive respectful care, to be given
 complete information about diagnosis and prognosis,
 to refuse treatment, to refuse to participate in
 experiments, to have privacy and confidentiality
 maintained, and to receive a reasonable response
 to a request for services."...

..." the right to refuse any medical treatment,
 including life-sustaining treatment. Moreover,
 a patient, while competent, is authorized by statute
 to designate another person to make treatment decisions
 for the patient, should he or she become incompetent
 (a health care agent or proxy), and the patient can
 make his or her wishes known in advance through a
 living will."...

..."Patients were also granted access to their medical
 records, and the right to basic emergency care was
 protected. Proposals for patients'-rights advocates
 or ombudspersons were not adopted, however, and
 patients were generally left on their own to exercise
 their rights. They had recourse to the courts only
 when their rights had been violated and they had been
 harmed."...

He goes on to note that the managed care companies are
attempting to treat us as consumers, vs patients, so
the focus has shifted somewhat from defining patient
rights, as such, to protecting consumer rights. He goes
on to suggest his proposal for the essentials of a National
Bill of Rights:

"Many of our rights as patients have already been articulated
 by the courts. Nonetheless, they often remain difficult for
 patients and providers alike to understand and are
 especially difficult for sick people to exercise. Thus,
 enumerating all the essential rights in one document will
 facilitate an understanding of these rights and make it
 easier for patients to exercise them in their dealings
 with physicians, hospitals, and health plans. To this
 end, I believe a federal bill of patients' rights must
 include the five core provisions outlined below."

"The Right to Treatment Information"

"The patient has a right to informed participation
 in all decisions involving his or her health care,
 including a clear, concise explanation, in lay terms,
 of all proposed treatments, the reasonable medical
 alternatives (whether or not they are covered by the
 plan), the risks of death and serious complications
 associated with each alternative (including no
 treatment), likely problems of recuperation, and the
 probability of a successful outcome (including the
 physician's experience with the treatment and its
 outcomes). The patient has a right to know the
 diagnosis and prognosis in as much detail as he or
 she desires, as well as the existence of any research
 protocols that are relevant to the patient's condition
 and their availability. A competent patient will not
 be subjected to any procedures or tests without first
 providing informed consent. For procedures that entail
 a risk of death or serious disability, all aspects of
 informed consent will be explained on a written form
 requiring the signature of the patient or the person
 with the authority to make treatment decisions for
 the patient, if the patient is incompetent."

"The patient has a right to know the identity,
 professional status, and clinical experience
 (including success rates) of all persons responsible
 for his or her care. The patient has a right to know
 about all financial arrangements and incentives that
 might affect his or her care. Any patient who does
 not speak English has a right to an interpreter."

"The Right to Privacy and Dignity"

"The patient has a right to privacy of both person
 and information with respect to all medical and
 nursing personnel, allied health care professionals,
 health plan and facility staff members, and other
 patients. All patients must be treated with dignity
 and without regard to race, religion, sex, sexual
 orientation, national origin, disability, age,
 socioeconomic status, or source of payment. The
 patient has a right to all the information contained
 in his or her medical record and has a right to
 examine the record on request, correct mistakes,
 and receive a copy of it. No one not directly
 involved in a patient's care or in quality assurance
 should have access to the patient's medical records
 without a written authorization by the patient that
 is dated and limited in time and that specifies the
 medical information to be disclosed. Further
 disclosure of medical information without
 authorization is prohibited. The patient has a
 right not to be touched or treated by any particular
 physician or health care provider, including medical
 and nursing students."

"The Right to Refuse Treatment"

"The patient has the right to refuse any drug, test,
 procedure, or treatment, whether the purpose is
 therapy, research, or education. A patient may not
 be discriminated against or denied any benefit by
 a health plan or health care professional because
 of the refusal to be touched or treated by a
 particular provider. A patient has the right to
 execute a health care proxy or a living will to
 direct treatment or nontreatment if the patient
 is no longer capable of making health care decisions,
 and health care professionals are obligated to honor
 these advance directives."

"The Right to Emergency Care"

"The patient has a right to prompt and competent
 attention in an emergency. The patient may not be
 transferred to another facility without his or her
 consent and, in any event, not before the patient's
 condition has been stabilized and it has been
 determined that the transfer is in the patient's
 best interests because of superior medical care.
 If the patient does not agree to the transfer,
 he or she may not be transferred."

"The Right to an Advocate"

"The patient has the right to the services of an
 independent patients'-rights advocate with the
 authority to help the patient assert all the rights
 specified in the bill of rights. In addition, a
 patient in a hospital or other health care facility
 has the right to reasonable visitation, parents
 have the right to stay with their child, and
 relatives have the right to stay with patients 24
 hours a day. The patient has the right to have a
 friend or relative present during all consultations,
 examinations, and procedures, including the
 induction of anesthesia."

"Additional provisions of a national patients' bill
 of rights will involve contract-based consumer
 protection. How specifically such provisions are
 spelled out will depend on the extent to which
 Congress believes health-plan contracts must be
 regulated. In any event, the following obligations
 of health plans should be included. No health plan
 may interfere with or limit communication between
 the patient and his or her health care provider.
 Health plans must provide members with a reasonable
 choice of qualified primary care physicians and
 reasonable access to specialists. Health plans must
 disclose to members any and all financial
 arrangements that might encourage physicians to
 limit or restrict care, referrals to specialists,
 or recommendation of noncovered treatments. Health
 plans must provide payment for emergency services
 under circumstances that a prudent layperson would
 consider an emergency. Health plans must provide
 timely access to an independent appeals mechanism
 for denial or termination of benefits."

"The patient has a right to a copy of the entire
 contract for his or her insurance or health plan
 and to competent counseling in selecting a health
 plan. The patient has a right, regardless of the
 source of payment, to examine and receive an
 itemized and detailed explanation of all services
 rendered. The patient has a right to timely prior
 notice of termination of eligibility for coverage
 or denial of a health care benefit, with an
 opportunity to contest the termination or denial
 in a timely and fair manner before an independent,
 qualified, and neutral decision maker."

Keep in mind that these are his proposals for a National
Bill of Rights, some of which have, and have not, been
included in current state or provider statements of 
patient rights.

A search on George, or Annas GJ, produces an astonishing
491 hits, one of which lists his works extensively. I
believe you'll find him an inexhaustible reference on 
this subject, as indicated here:
http://www.bumc.bu.edu/Departments/PageMain.asp?DepartmentID=95&Page=6685

Another right, which is less commonly discussed, is 
among the patient rights outlined by the Veterans
Administration in the US Code, on this page:
http://www.access.gpo.gov/uscode/title38/partv_chapter73_subchapteriii_.html
"Nondiscrimination against alcohol and drug abusers
 and persons infected with human immunodeficiency virus."

I think this should provide the basis for formulating
a comprehensive bill of rights for Seniors. Additionally,
you may want to look at some of the Bills proposed by
Congressman Carolyn McCarthy in PDF format here:
http://www.house.gov/carolynmccarthy/seniors.pdf
or viewable in your browser here:
http://216.239.53.100/search?q=cache:ADlpaj_cMxUC:www.house.gov/carolynmccarthy/seniors.pdf+HR+274+Seniors+Healthcare+Bill+of+Rights&hl=en&ie=UTF-8


Searches done, via Google:

healthcare "bill of rights"
://www.google.com/search?num=50&hl=en&lr=&ie=UTF-8&oe=UTF-8&safe=off&q=healthcare+%22bill+of+rights%22&btnG=Google+Search

healthcare "national bill of rights"
://www.google.com/search?num=50&hl=en&lr=&ie=UTF-8&oe=UTF-8&safe=off&q=healthcare+%22national+bill+of+rights%22

seniors healthcare "national bill of rights"
://www.google.com/search?num=50&hl=en&lr=&ie=UTF-8&oe=UTF-8&safe=off&q=seniors+healthcare+%22national+bill+of+rights%22

Annas GJ. The rights of hospital patients
://www.google.com/search?num=50&hl=en&lr=&ie=UTF-8&oe=UTF-8&safe=off&q=Annas+GJ.+The+rights+of+hospital+patients


If you would like further information in regard to
this question, please feel free to post a request
for clarification BEFORE rating this answer.

sublime1-ga

Clarification of Answer by sublime1-ga on 24 Sep 2002 11:00 PDT
aghabog...

In view of your interest in legislative bills, as
evidenced by your newest question:
https://answers.google.com/answers/main?cmd=threadview&id=68403

I thought I would point you to this website, which is
"a website for senior citizens and those who care about them"
http://www.therubins.com/index.htm

It includes a page dedicated to legislation regarding senior
healthcare, here:
http://www.therubins.com/legal/index.htm

One of the pages on the above page lists
"Prescription Drug Related Legislation Introduced
 in the 107th Congressional Session" here:
http://www.therubins.com/legal/pend107.htm

On that page is a bill titled
"Seniors' Health Care Bill of Rights of 2001",
however its scope is narrower than what you are
seeking, and is described to be:
"To amend title XVIII of the Social Security Act
 to provide incentive payments for multi-year
 contracts entered into by Medicare+Choice
 organizations, and for other purposes."

I also searched on the House of Representatives
website, and found responses regarding "senior
healthcare" on the following page:
http://wwws.house.gov/search97cgi/s97_cgi?action=FilterSearch&QueryZip=senior+healthcare&SourceQueryZip=&Filter=member%5Fsrch%5Fflt%2Ehts&ResultTemplate=allresult%2Ehts&QueryText=senior+healthcare&Collection=comms&Collection=members&Collection=other&Collection=coxreport&ViewTemplate=memberview%2Ehts&ResultStart=1&ResultCount=10

and "senior rights" on this page:
http://wwws.house.gov/search97cgi/s97_cgi?Action=FilterSearch&filter=member_srch_flt.hts&Collection=comms&Collection=members&Collection=coxreport&ResultTemplate=allresult.hts&ViewTemplate=memberview.hts&SearchPage=%2FMemberSrch.html&QueryText=senior+rights&ResultCount=10


Searches done, via Google:

rights of seniors to healthcare
://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=rights+of+seniors+to+healthcare

Searches done on the House of Representatives site:
http://www.house.gov/house/searchall.htm

senior healthcare
http://wwws.house.gov/search97cgi/s97_cgi?action=FilterSearch&QueryZip=senior+healthcare&SourceQueryZip=&Filter=member%5Fsrch%5Fflt%2Ehts&ResultTemplate=allresult%2Ehts&QueryText=senior+healthcare&Collection=comms&Collection=members&Collection=other&Collection=coxreport&ViewTemplate=memberview%2Ehts&ResultStart=1&ResultCount=10


I believe you will find the Rubins site to be an 
invaluable asset to your efforts.

sublime1-ga
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