As this concept is developed, a number of issues undoubtedly will need to be addressed. First, none of the ombudsman funding should be used for policymaking advocacy but instead should be used exclusively to provide direct services to consumers. Second, the creation of publicly supported consumer assistance programs should complement, not supplant, already existing services—such as those currently provided by some employers and public agencies. And third, a balance needs to be drawn so that consumer assistance programs, on the one hand, serve all consumers, no matter the source of the health coverage, and on the other hand, have the capability and specialized expertise to serve people with significantly divergent needs.
The revolution in health care has been unsettling for the American public. As more and more people experience denials of care or learn about such denials from friends, relatives, and the news media, the public becomes increasingly apprehensive. Consumers who have lost the right to choose their physicians or health plans experience or hear about improper denials of care and are bewildered and don't know what they can do to protect their families.
Consumers need a set of uniform national protections that are guaranteed to them as purchasers of insurance. Such protections are affordable and would add little to the cost of providing care. They would provide predictability and uniformity by establishing a floor of national standards applicable to everyone. They would restore public confidence in the health care system. Finally, they would enable managed care to realize its potential for simultaneously controlling health care costs while providing high-quality care to all consumers.
-274-
