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Patient care stirs campaign debate

Challenger Leslie Scales argues that a patient's doctor should have the final say in medical disputes, not an insurer's physician as an Anna Cowin-sponsored law requires.


© St. Petersburg Times, published November 1, 2000

BEVERLY HILLS -- Leslie Scales is complaining that Anna Cowin is misleading audiences about health care legislation that Cowin sponsored.

The law requires insurance companies to have doctors involved in care disputes. Scales, a Democrat who is challenging the Republican incumbent in state Senate District 11, said Cowin is leading people to believe that their doctor will have the final say. That is not the case.

Scales has said that, if elected, she would push for "a patient's bill of rights that makes sense to you." One of those rights: a patient's doctor, not the insurance company, will have the final say concerning care.

"I want to make it possible for patients and their doctors to make decisions," said Scales, a Marion County School Board member and Democrat.

Under the current law, insurance companies can employ doctors who, although licensed in Florida, are located in another state. Those doctors essentially serve as bureaucrats, not medical experts, Scales argued.

"It's not real good protection for Florida patients," she said.

During an interview, Cowin defended her bill.

At issue, she said, were so-called "adverse determinations." That's when a health insurance provider refuses to authorize a treatment, procedure or hospital admission that the patient's doctor thinks is necessary.

Cowin, whose husband is a physician, said she was frustrated that clerks made these decisions. She wanted doctors involved, so she pushed for legislation requiring insurance companies to have physicians handle the task.

Scales' criticism -- that someone other than the patient's doctor is involved in these coverage decisions -- is understandable but a bit naive, Cowin said.

"The insurance company has to be involved," Cowin said. "The trick is, you want it to be a doctor."

District 11 includes Citrus County east of County Road 491, as well as all of Lake County and parts of Sumter, Marion and Seminole counties.

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