[Congressional Record Volume 144, Number 86 (Friday, June 26, 1998)]
[Senate]
[Pages S7230-S7231]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        PATIENTS' BILL OF RIGHTS

  Mr. DORGAN. Mr. President, it is my hope and the hope of many of my 
colleagues, that, when we return following the Independence Day break, 
we will take up a piece of legislation called the Patients' Bill of 
Rights.
  We have, over many weeks, come to the floor of the Senate to talk 
about cases around the country that illustrate the critical need for us 
to do something about a health care system that has increasingly herded 
people into managed care plans in which profit and loss, or the bottom 
line, becomes more important than a person's health care needs. That is 
why the American Medical Association and many others support the 
Patients' Bill of Rights that we have introduced. My fervent hope is 
that the Congress and the Senate will find time to address this issue 
in July.
  Let me talk just for a moment about a woman, Phyllis Cannon from 
Newcastle, OK. In September of 1991, Phyllis Cannon was diagnosed with 
acute myeloblastic leukemia. She underwent a regimen of chemotherapy, 
which her HMO did pay for, and her leukemia went into remission. But 
her doctor, her oncologist, fearing that her cancer would again 
surface, recommended that she undergo an analogous bone marrow 
transplant. However, her HMO contended that this procedure was still 
experimental for first remission patients, and it refused to pay for 
the bone marrow transplant, even though a bone marrow transplant 
procedure was covered under the terms of her plan.
  Phyllis Cannon's oncologist fought vigorously for this procedure. He 
supplied the HMO with the latest medical literature on the procedure, 
knowing that an urgent transplant was critical for Phyllis' health. 
But, once again, the HMO denied coverage. Phyllis, her husband Jerry, 
and the doctor continued to fight, and finally, after another month had 
passed, the HMO relented and said it would pay for the bone marrow 
transplant.
  But the HMO officials, once they had agreed to cover the transplant, 
didn't notify Phyllis of the decision until a month later, and by then 
it was too late. The leukemia had returned, and Phyllis died 6 weeks 
later.
  Because Phyllis received her health care coverage from her employer, 
her HMO was protected under a law called ERISA. Employer-sponsored 
plans, like the one covering Phyllis, are governed by ERISA, which 
gives HMOs immunity from the harmful effects their decisions might 
have. So, for Jerry Cannon, ERISA left him no chance to hold the HMO 
accountable for its decision which led to his wife's death. And this 
story, one more story, of Phyllis Cannon, demonstrates the need for a 
Patients' Bill of Rights.
  Increasingly, as health care becomes more a function of profit and 
loss, it is straying from the central purpose of health care.
  Let me share with my colleague what Phyllis' husband Jerry said. This 
is a picture of Jerry holding a photograph of his wife.

       [Telling my wife that the HMO was not going to provide the 
     transplant she needed] just devastated her. She gave up after 
     that. Oh, it was horrible. Once I got off the phone, I could 
     see all hope leave her.

  This is just one person, one person among thousands and tens of 
thousand in this country who now fear a health care system in which 
they are herded into this big chute called HMOs or managed care, and 
some insurance company accountant in a back room 500 miles away will 
make a decision about whether a medical procedure is covered. And when 
they make a mistake in that back room of the insurance office, no one 
can hold them accountable. If the doctor makes a mistake, that doctor 
is accountable. But the health care plan has no accountability.
  In fact, they have special protection under the law. We suggest as 
the remedy a Patients' Bill of Rights supported by the President, by 
the American Medical Association, and by a vast array of groups around 
this country that represent patients.
  Let me describe one more time, as I have before when I have come to 
the floor to talk about this issue, why the American people are 
demanding we do something about this problem.
  There was a story in the paper several months ago about a woman who 
was injured quite severely by a fall from a horse. Her brain was 
swelling, and bystanders called an ambulance to take her to the 
hospital. While this woman was in the ambulance, with her brain 
swelling, she said, ``I don't want to go to hospital X,'' which was the 
nearest hospital. ``I want you to take me to hospital Y,'' which was 
further away.

[[Page S7231]]

  She survived this brain injury and was asked later, ``Why did you, 
while you were in this ambulance suffering from a serious injury, ask 
to be taken to the hospital that was further away?'' She said, 
``Because I had read a lot about the hospital that was closest, and it 
was all about profit and loss, all about the bottom line. I didn't want 
to be wheeled into an emergency room in that hospital and have someone 
look at me in terms of dollars and cents, in terms of profit and loss. 
That is not the way I wanted to be treated as a patient.''
  Our Patients' Bill of Rights says that every patient has a right to 
know all the medical options available for treatment of their disease, 
not just the cheapest option. Our Patients' Bill of Rights says that 
people have a right to go to an emergency room when they have a medical 
emergency. You think that is something that is understood across this 
country? It is not. There are plenty of instances when people are not 
getting coverage for emergency room visits.
  Our Patients' Bill of Rights says that when someone is in need of a 
specialist to treat their disease, he or she has a right to see that 
specialist. You think that is routine in managed care organizations 
today? I am sorry to say it is not.
  And our Patients' Bill of Rights--unlike the bill that was unveiled 
just yesterday, I believe, in the other body--says patients have a 
right to sue their health plan if its decision harms them. We take away 
the special exemption that is given these organizations so that when a 
health plan makes medical judgments that can deny someone like Phyllis 
the cancer treatment she needs the folks who made that decision are 
made to take responsibility for it. That is why President Clinton and a 
good many in Congress, Republicans and Democrats, say it is time to do 
something about this issue.
  I suppose that one can make the case, ``Well, there's only so much 
money in the system.'' Doctors make the case that they want to practice 
medicine in the doctor's office, in the hospital room.
  I have met with a good many doctors in my State to talk to them about 
the health care system. Increasingly, they tell us that managed care 
organizations are taking the decisions out of the doctors' offices and 
out of the hospital rooms, and making them instead in some insurance 
office hundreds of miles away by someone who knows nothing about the 
patient and nothing about the patient's needs.
  Doctors are angry about that, and justifiably angry in my judgment. 
It is time--long past the time--to pass a piece of legislation that 
says to these organizations, there are certain basic rights that ought 
to be available to every American when they are ill, when they are in 
need of help from the health care system.
  Among those rights, as I just mentioned, is the right to understand, 
from your health care provider, all of the options available to you to 
help treat you, not just the cheapest option available that the managed 
care organization is willing to provide. Those are the kinds of things 
that we will address and discuss and hopefully deal with when we bring 
a Patients' Bill of Rights to the floor.
  Again, I am pleased to say this is not one of those issues that is a 
partisan issue. There are Republicans and Democrats who feel strongly 
and have spoken aggressively on the floor of the Senate and the House 
about this issue.
  The power to schedule here in the Congress is a very important and 
very significant power. We hope that those who have the power to 
schedule will put on the agenda of the U.S. Senate the Patients' Bill 
of Rights. No, not some watered down, lukewarm version like was 
introduced yesterday that is designed only to allow Congress to say it 
dealt with this issue. I am talking about a real Patients' Bill of 
Rights, one that addresses and solves the health care problems that 
Americans are forced to deal with every day and that, regrettably, 
Jerry Cannon and his poor wife Phyllis discovered a few years ago in a 
very tragic way.
  We can solve these problems, and we should. We owe it to Phyllis and 
Jerry and the other families around this country who confront this 
every day in the doctors' offices and in the hospital rooms.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. Under the previous order, the Senator from 
Utah, Mr. Hatch, is recognized to speak for up to 10 minutes.

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