NorthwestJanuary 27, 1996

Hal Spencer of the Associated Press

OLYMPIA The patient has just learned her insurance won't cover a vital treatment for her cancer.

That kind of surprise is becoming too common in the era of managed health care, state senators contended Friday as they opened hearings on measures requiring insurers to fully disclose what applicants and subscribers can and cannot get from medical plans.

Similar bills are under consideration in the House. Prospects for passage this year are uncertain at best.

The proposals, presented at the Senate Health and Long-term Care Committee, drew strong backing from physicians, nurses and consumer groups, and "cautious opposition" from the insurance industry.

Mel Sorensen, a lobbyist for Blue Cross of Washington and Oregon, said state insurance regulations already require full disclosure, and courts have sided with the patient when insurance contract language is ambiguous.

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"This would duplicate what is already in law," he said, "And we think there is adequate disclosure."

But supporters said the reality is something else.

The current system requiring disclosure amounts to "a lawnmower engine powering a Cadillac," said Dr. Michael Schlitt, speaking for the Association of American Physicians and Surgeons.

The managed care system treats patients like "pets," and his files are filled with evidence that patients cannot get even the most basic information about what they are and are not entitled to receive.

Committee members appeared to side with Schlitt. Several had their own stories to tell about problems with their managed health plans.

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