[Congressional Record Volume 144, Number 91 (Friday, July 10, 1998)]
[Senate]
[Pages S7962-S7963]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          NEED FOR HMO REFORM

 Mr. DORGAN. Mr. President, our health care system is in a 
state of crisis--a crisis of confidence. Many Americans no longer 
believe that their insurance companies can provide them with the access 
to care or quality of service they need.
  Today I continue our series of stories describing how some managed 
care plans seem to have put cost saving before life-saving. The 
experience of Vaughn Dashiell is just one more example of the pressing 
need for Congress to act now to protect the rights of patients.
  Vaughn Dashiell lived with his wife, Patricia, and their three 
children in Alexandria, Virginia. Vaughn owned and operated his own 
printing company.
  On November 20, 1996, Vaughn stayed home sick from work suffering 
from a sore throat, dry mouth, and tunnel vision that limited his sight 
to 18 inches. He tried to get an appointment to see a doctor within his 
HMO network, but was told that none were available at his designated 
facility. Vaughn was able to speak only to the HMO-employed nurse on 
duty over the phone. She could have told Vaughn to go to an emergency 
room for treatment, but instead, told him to make a regular appointment 
although none were available.
  As Vaughn's symptoms worsened, he called his HMO again requesting 
permission to see a doctor somewhere, or to go to a nearby emergency 
room. Vaughn was told only to wait and that he would receive a call 
back from a doctor on duty. When the doctor on duty was consulted, he 
agreed that Vaughn should go to an emergency room, but neither made a 
call himself, nor followed up to see that Vaughn was contacted. That 
night, Vaughn was not contacted, not by the nurse, the doctor, or any 
other HMO staff regarding his condition and requests for care.
  The next morning, Patricia found Vaughn incoherent, with his ``eyes 
rolling''. She hurriedly called the HMO, hoping for an answer to 
Vaughn's problem. They advised her to call 911.
  Vaughn arrived at the hospital at 9:18 am in a diabetic coma. His 
blood sugar level was more than twenty times greater than the normal 
level. Just over two hours after being rushed to the emergency room, 
Vaughn was dead from hyperglycemia. He was only 39 years old.
  This should not happen in America. Health insurers should not be 
allowed to put profit before patients. Vaughn Dashiell's condition 
would have been treatable and curable if the health plan had enabled 
him to get the care he needed. But for an HMO driven by cutting costs, 
the needs of the patient did not come first. Had this HMO not placed 
their patients in the hands of a system weak in oversight and follow-up 
and instead allowed Mr. Dashiell the opportunity to see a doctor when 
he first felt threatened, he might still be alive today.

[[Page S7963]]

  Mr. President, we must take up and pass meaningful patient 
protections this year. We have a bill, S. 1890, that would prevent 
tragedies like this from occurring. Under our plan, Vaughn would have 
had guaranteed access to needed care, especially in the case of an 
emergency. Under our bill, members of HMOs would be able to go to an 
emergency room without seeking their plan's approval if they felt their 
life was in danger.
  This is only common sense. It should not be controversial. I will 
appeal once again to the Republican leaders of this body: Please bring 
our Patients' Bill of Rights to the floor for action. The President has 
promised to sign it into law. We are wasting valuable time.

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