[Congressional Record Volume 142, Number 25 (Wednesday, February 28, 1996)]
[Extensions of Remarks]
[Page E225]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         INTRODUCTION OF THE PATIENT RIGHT TO KNOW ACT OF 1996

                                 ______


                         HON. EDWARD J. MARKEY

                            of massachusetts

                    in the house of representatives

                       Tuesday, February 27, 1996

  Mr. MARKEY. Mr. Speaker, I am pleased to join Dr. Ganske today in 
introducing the Patient Right to Know Act of 1996.
  When I was a boy, my mother told me, ``if you don't have anything 
nice to say, don't say anything at all.'' Now when my mother said that, 
she was not talking about protecting the feelings of health plans. She 
was talking about people, who sometimes, unfortunately, become 
patients. So she would be quite surprised to see this dangerous twist 
on her advice in some of the contracts between doctors and health plans 
we see today. Today, to protect the feelings of health plans, doctors 
are being asked to restrict what they say to their patients. This is 
wrong, just plain wrong. No doctor can practice good medicine in a 
muzzle.
  The fact is, when you're a patient, what you don't know can hurt you. 
That's why Congressman Ganske and I are introducing the Patient Right 
to Know Act. The Patient Right to Know Act will prohibit health plans 
from restricting communications between doctors and their patients 
about treatment options, their benefits and risks, and other issues 
related to quality of care. It will ensure that doctors are allowed to 
tell their patients why a plan decides to pay for, or deny, a 
treatment. Finally, it will bar plans from restricting doctors from 
talking to their patients about financial arrangements they have with 
the plans which might affect those patients' access to care.
  The impetus for our bill was the increasingly frequent reports of 
health plans trying to keep doctors from talking freely to their 
patients about their health care needs, or forcing doctors to sign 
contracts that include clauses restricting doctor-patient 
communications. I was deeply disturbed by these reports, because I am a 
great believer in the principle of informed consent and restrictions on 
communications between doctors and their patients make informed consent 
impossible. Attacks on informed consent--which is the most basic 
patient protection--simply cannot be tolerated in our society.
  I have worked on consumer protection issues for a lot of years now, 
and I look at it this way: Patients are really just consumers of health 
care. Like any other kind of consumer, patients need complete and 
accurate information about the products or services available if 
they're going to make good decisions about the health care they 
consume. The only difference is, we are not talking about toasters or 
washing machines here, we are talking about people's health and lives.
  Now Dr. Ganske here has an advantage, because while I was at law 
school, learning about the rule against perpetuities, he was in med 
school, learning how to make sick people well. So when Dr. Ganske is 
feeling a little under the weather, and he goes to see his family 
doctor, he's on a pretty level playing field. He knows what questions 
to ask. He's probably already read about the latest treatment for 
whatever is it that ails him.
  But the ordinary Joe is at a disadvantage. He does not get the New 
England Journal of Medicine at home. He places enormous trust in his 
doctor, and depends on his doctor to tell it to him straight. When a 
health plan tries to control or censor communications between its 
doctors and their patients, that critical bond of trust is broken.
  Silence isn't always golden. Although he who has the gold sometimes 
tries to demand silence--the fact is, in today's world, knowledge and 
information are the coins of the realm. Nowhere is this truer than in 
the realm of health care.
  Hippocrates said ``Health is the greatest of human blessings.'' 
Surely, it is the most precious although many of us do not realize this 
until we ourselves or someone we love becomes seriously ill. Then, we 
would give away anything we have--all of our worldly treasures--to make 
them well again. At that moment, our greatest ally is our doctor, and 
our most valuable asset is the information he can give us. That is why 
passing the Patient Right to Know Act is so important.

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