The right to choose your health care provider; a constitutional necessity.

• Author: Wieland, Glen D.

Floridians for Health Care Choice has mounted a substantial constitutional petition drive to add even more language to the Florida Constitution. The language of the amendment is intended to allow all citizens of Florida the right to choose their own health care provider.(1) The intent appears to prevent insurance companies, managed care arrangements, HMOs, and similar health care agencies from forcing the participants to select physicians from a limited list. The arguments on both sides are very compelling. Also compelling is the question of whether the proposed amendment would survive a Supreme Court challenge.

Managed care type providers claim that they can save employers' premium dollars by more closely controlling medical costs through selected provider networks and "gatekeeper physicians." These "gatekeeper physicians" are primarily family doctors who make decisions regarding the necessity of treatments of their patients. They also control the referral of patients to specialists. Through this process, they claim that the quality of medical care, as well as availability of care, would increase.

Managed care medical plans have the ability to evaluate the credentials and qualifications of all participating physicians and providers, thus insuring quality. Proponents of managed care believe the average patient does not have the information or does not seek the information to make an informed decision on the quality or credentials of the provider. Patients typically make decisions on their provider based upon the "likability factor."

Savings in medical care costs are supposedly passed on to the consumer, usually the employer, which allows employers to continue to provide health insurance benefits to employees. In the not so distant past, health care premiums were increasing at an alarming rate. This caused many employers to drop or reduce health care coverage available to employees. Employees were not able to afford to buy their own individual policies and ended up without health care insurance. HMOs and managed care arrangements were the answers to the problem. These arrangements claimed to have stabilized costs and held the line on health care premiums.

Opponents of managed care medical systems, which require plan participants to select from a predetermined list, claim that the quality of care is sacrificed to achieve lower costs. Opponents believe that medical care will be restricted, leading to some serious medical problems going undiagnosed or untreated to save costs. "Unnecessary tests" have been cut out by the primary gatekeeper physicians. Of course, those who were allowed to have that one test that saved their life would never say it was "unnecessary." Opponents believe that...