NY Lt. Governor Calls for a Halt to HMO Abuses

HMO abuses are the single largest health problem in America today,"said New York State's Lieutenant Governor Betsy McCaughy Ross. New Yorkrecently became the first state in the nation to ban "drive-throughmastectomies," when it approved legislation outlawing the "outrageous"policy held by some health-care plans.

Requiring women to leave the hospital hours after undergoing a modifiedradical mastectomy is only one example of HMO abuse, noted Lt. GovernorRoss, who spoke last month at the annual meeting of the Huntington BreastCancer Action Coalition in New York.

Also unfair are laws that allow health insurance plans to refuse paymentfor treatment considered experimental, remarked Lt. Governor Ross, whensuch treatment might be a patient's only chance to stay alive.

Requiring insurance companies to pay for experimental treatment willbenefit future generations, too, she added, because "today's experimentoften does become tomorrow's proven cure."

Results demonstrated by once "experimental" treatment provedthat lumpectomy is effective therapy for breast cancer, avoiding the needfor many women to endure a radical mastectomy. Further, the cure rate forchildhood leukemia now approaches 90%, because most children with cancerare treated with "state-of-the-art" therapy provided in clinicaltrials, said Lt. Governor Ross.

Although no one plans to become ill, 4 of 10 Americans will developcancer. "If you have cancer, high-dose chemotherapy, bone marrow transplants,and other such treatments still classified as experimental could be youronly chance of extending your life," the Lt. Governor urged, adding"your health insurance plan should be there to support you."

She emphasized that "delay can be as deadly as denial" andaddressed patients' rights to a fair and timely right of appeal outsideof their health-care plans should they be refused coverage for necessarytreatment.

New York's mandate against drive-through mastectomies is an importantfirst step, according to Lt. Governor Ross, but more action is needed toprotect against unfair insurance company practices.

The Lt. Governor also recently announced legislation to require insurancecompanies to pay for care in clinical trials if a doctor deems it a seriouslyill patient's best chance for survival.

"Putting profit ahead of patients must be stopped," said theLt. Governor, who added, "We need to rewrite insurance company regulationsso that they are fairer to the patient and the patient's family."

The Huntington Breast Cancer Action Coalition is a grassroots organizationon Long Island committed to intervention and prevention of breast cancer.