[Congressional Record Volume 140, Number 45 (Thursday, April 21, 1994)]
[Extensions of Remarks]
[Page E]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: April 21, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
   HEALTH CARE QUALITY IMPROVEMENT ACT AMENDMENTS OF 1994, H.R. 4274

                                 ______


                             HON. RON WYDEN

                               of oregon

                    in the house of representatives

                        Thursday, April 21, 1994

  Mr. WYDEN. Mr. Speaker, 7 years ago, President Ronald Reagan signed 
into law the Health Care Quality Improvement Act of 1986, that 
established the National Practitioner Data Bank to keep track of 
disciplinary and malpractice actions against physicians and other 
licensed health professionals.
  The data bank was the first national system designed to keep 
incompetent medical providers from slipping through the cracks in the 
American system for ensuring quality medical care. By helping to weed 
out substandard physicians, the data bank is a tool to reduce the 
number of botched surgeries, missed diagnoses, adverse drug reactions, 
and resulting high medical bills.
  The 1986 law requires hospitals and health maintenance organizations 
[HMO's] to check the data bank for information on doctors they might 
hire or grant privileges to. This obligation is backed-up by real 
financial incentives for hospitals and HMO's to watchdog the physicians 
they allow to be part of their team. Under the law, hospitals and HMO's 
are legally responsible for acting on the basis of the information in 
the data bank. If a hospital or HMO fails to check a doctor's record in 
the data bank, they are nonetheless accountable for knowing what is in 
the data bank.
  Setting up the data bank has been an enormous and unprecedented 
undertaking. It took years to get necessary appropriations and to work 
out the bugs in the new system. But this year, the National 
Practitioner Data Bank won the prestigious Federal Leadership Award for 
excellence in government information technology. According to the 
judges, the data bank can now be accessed electronically by hospitals 
and HMO's, error rates have been reduced, and the time needed to 
respond to hospital and HMO inquiries submitted on paper have been 
reduced to only 5 days. All this has been accomplished while 
administrative costs have been cut by 75 percent.
  Within the next 30 days, three major committees of the House of 
Representatives are likely to finish work on national health reform 
legislation that may completely restructure the health care system in 
this country. Many aspects of health reform are uncertain. But this 
much is clear: Tomorrow's consumers are going to be asked to be more 
involved in the choice of their health care and their providers.
  In my judgment, if the reformed health system is to be built on the 
principle of consumer choice, consumers must have ready access to 
reliable, comparative information on quality. It's not enough to give 
consumers information on the quality of health insurance plans. A plan 
may be the key component of the health care system to economists and 
providers, but consumers are more interested in the quality of care 
provided by doctors, hospitals and clinics. In fact, when they can 
afford to, people choose their health plans because of which doctors 
the plan will let them see.
  No matter how elegant the new health care system is in its 
conception, it will fall apart if it's built on top of a rotten 
foundation of skimpy and fragmented information on cost and quality. At 
the very least, consumers have a right to know more about which health 
care providers they may wish to avoid. Unfortunately, Americans today 
have more performance information available to them when purchasing 
breakfast cereal than when choosing a heart surgeon.
  The last thing consumers need or expect from national health reform 
is for the Federal Government to withhold vital quality information 
from them. Yet, that is exactly what is going on today. For example, 
consumers are denied access to information in the Government's 
possession that would reveal whether the doctor treating them is one of 
the 13,000 doctors disciplined by a medical licensure board or hospital 
peer review committee in the United States in the past 2 years.
  This information is contained in the National Practitioners' Data 
Bank, but the consumer whose taxes are deposited in the Treasury to pay 
for the data bank are not allowed to withdraw information from it.
  The public has a tremendous and justifiable appetite for information 
on disciplinary actions and other indicators of poor quality care. At a 
minimum, this means that the National Practitioner Data Bank must be 
open to the public.
  In a health reform debate filled with partisan maneuvering and 
sniping, Mr. Klug and I are undertaking a bipartisan, common sense 
initiative to let the public know the names of doctors who have paid 
multiple malpractice payments, or who have been sanctioned through 
hospital disciplinary actions or State licensure boards.
  The legislation was are introducing today would open up the National 
Practitioner Data Bank, and will help consumers avoid some of the worst 
providers and repeat offenders. As the principal sponsor of the 
legislation creating the data bank, I intend to push for enactment of 
this legislation in the health reform legislation being marked up this 
month by the Energy and Commerce Committee.

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