Why should you care about changes in health care delivery in this country?

Today, when you or a member of your family needs medical care, you should have the right to choose your own doctor. When you need a medical specialist, you should have the freedom to select a physician with many years of specialized education and specialty certification. This additional training enables the specialist to best diagnose and treat your special medical problems.

Today, you and your family can choose your own specialist and have direct access to the best health care in the world. You are in charge of your health care.

Some managed care health plans, however, limit your choices to obtain timely specialty care.

Some managed care plans provide financial incentives or monetary bonuses for health care providers who do not refer you and your family for the specialized care you need. Others charge you an expensive penalty to permit you to seek health care outside your health care plan.

Any changes in health care delivery that are offered to you or selected by you must not offer you less than you have today. Your health care plan must not impose limits on your rights, choices, and ultimately, the quality of your medical care.

One way to keep your right to choose your physician and see a medical specialist when you want to is to seek out and enroll in a "point-of-service" plan of a health maintenance organization (HMO) or preferred provider organization (PPO).

Most people are healthy when they enroll in a health care plan and may select a plan primarily on the basis of its cost. However, the value of your health care plan is determined by the quality of the care it provides when you are ill.

It is important that managed care plans in their marketing tell the truth about the care they provide and that they clearly tell you about restrictions they will put on your ability to choose your own doctor or get specialized care if you need it.

The major advances in medical care in the last 50 years-from heart surgery to total joint replacement-have been the result of specialists dedicated to improving your quality of life.

Everyone knows the value of specialty medicine. When your child has a congenital heart defect, the child needs the care of a pediatric cardiologist; when a cataract clouds your vision, you need the care of an ophthalmologist; and when you tear a ligament in your knee, you need the care of an orthopaedic surgeon. That's common sense.

Specialty medical care is essential if you are to have quality medical care. Every year surgical specialists diagnose and treat 70 million Americans who are experiencing new medical problems. Their lives are improved by the specialists, scientific knowledge and expert treatment.

Specialists, working with you and your family doctor, provide the best health care in the world.

• restrict your freedom to choose a qualified doctor to provide specialized medical care needed by you or your family
• limit your ability to obtain timely or needed specialty care by offering financial incentives to health care providers which encourage them not to make the referral for specialty care needed by you or your family
• restrict the length of time you or your family may receive specialty care and prohibit well-accepted medical treatments for certain rare and special medical conditions

Some advocates of managed care believe that restricting the amount of care provided by specialists saves money. This assumption undermines the quality of the medical care that you will need. Timely access to appropriate medical specialists saves money. You get back on your feet and return to a productive life faster, and with fewer complications when specialists provide the care you need when you need it.

Patients want the best medical care available. Specialty doctors want to ensure that you get the best medical care, too.

• Freedom to see a medical specialist of your choice, and to receive that care for as long as it is reasonable
• Timely, appropriate referral to a medical specialist based on your doctor's best medical judgment and your medical condition not based on the financial considerations of your health plan about making the referrals
• The ability to receive medically necessary out-of-network care, treatment, or services from another health care plan when quality dictates a plan that clearly and truthfully discloses limitations on your ability to choose your specialist or receive specialty care.

If you are asked to become a member of a managed care medical plan, you can and should protect your right to see a medical specialist of your choice.