[Congressional Record Volume 144, Number 100 (Thursday, July 23, 1998)]
[Senate]
[Pages S8886-S8887]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        HEALTH CARE LEGISLATION

  Mr. NICKLES. I appreciate my colleague yielding for a moment. I sat 
here and waited for awhile for my colleague from Massachusetts to 
speak, and then the Senator from Delaware decided to speak. I wanted to 
make a couple of comments concerning the health care legislation.
  One, I regret maybe some of the tone of some of the debate that has 
been made. I am very interested in trying to come up with a reasonable 
time agreement to take up this legislation. We have offered to do that. 
We have offered to give a vote on both the Democrat and the Republican 
proposals. I understand my colleague wants more time. He probably would 
like to spend a month on it. I heard him say it is the most important 
legislation we have before the Senate. I think I heard him say the same 
thing about the tobacco legislation. We spent 4 weeks on tobacco 
legislation, and we are not going to spend 4 weeks on this. The Senate 
is scheduled to be in session about 5 additional weeks, so we don't 
have the luxury of time that maybe we have had in the past.
  My colleague from Massachusetts made the comment and said we tried to 
bring this up 18 months ago. That is not correct. His bill was 
introduced on March 31. Three days later, he was trying to pass a 
sense-of-the-Senate resolution, saying we will pass it this year. We 
have agreed to bring it up this year. We have agreed to give it 
adequate time for debate. We have not agreed to spend an unlimited 
amount of time on this.
  I want to respond to a couple of the statements that were made 
concerning the Republican proposal. Much to my chagrin, I had hoped my 
colleague, and colleagues on the other side, would try to find out what 
is good and maybe see where we can move forward, but instead he has 
trashed our proposal. I resent that, or I regret it--I guess regret 
would be the more proper terminology.
  We have 49 cosponsors of this legislation. We had a task force that 
met for months, 7 months, to formulate positive, constructive health 
care legislation, legislation that would help alleviate some of the 
problems in the health care industry, legislation that would help 
protect those people who don't have protections in health care.
  I heard my colleague say their plan only affects 48 million Americans 
and exempts two-thirds. That is absolutely not correct. The facts are, 
every single ERISA-covered plan, every single employer-sponsored health 
plan in America would have an appeal process. It is a different process 
than our colleagues on the Democrat side have followed, but for a good 
reason. We don't want to drive up health care costs.
  What we want to do is make sure people who are denied health care 
will have an appeal to where they can get health care--not that they 
have to go to court to get a health care decision--so they can have an 
appeal through an outsider who has nothing whatever to do with their 
case and have it be reviewed immediately or expeditiously if there is a 
serious health care problem. They can even have an outside appeal. We 
put in ``binding decision'' on the outside appeal. The decisions would 
be binding. The plan would have to pay if someone said, ``Wait a 
minute. We thought we were waiting for coverage and we didn't get it.'' 
They would have an internal appeal and an external appeal and that 
applies to every single employer-sponsored plan in America. We have 
heard different numbers. It is about 125 million Americans who would be 
covered under those plans--every single one--unlike my colleagues' 
plan; I looked at his. I just want to say that it is the right to sue 
for more. Under the Democrat bill, their idea is that we are going to 
get more health care by having more suits. We are going to sue people. 
You can already sue a health care plan to get a covered service. They 
want to sue for more.

  In the Democrat proposal, they have 56 new causes of action where you 
can sue. It would be an invitation for litigation, to not only sue the 
health care plan but to sue the employer as well. I have been in the 
private sector, I have been an employer, a small employer--maybe a 
little larger; I went from a few employees to 100 employees. If you 
make employers liable for suits on health care plans, they will drop 
health

[[Page S8887]]

care plans very quickly and you will have an increase in the number of 
uninsured that will be in the millions. You will also have costs. CBO 
estimated that the Democrat bill would increase health care costs by 4 
percent over what they are already estimated to cost, at 5.2 percent. 
That is a 9.2 percent cost increase if we enact the Democrat bill. That 
would cause millions of people to lose health insurance. I don't think 
that is smart.
  So I want to just make sure that our colleagues are aware of the fact 
that we are willing to have a significant, credible debate. We are 
willing to consider various alternatives. We are not willing to get an 
unlimited amount of time. Earlier, my colleague had offered his bill on 
an appropriations bill. I said it didn't belong there. Maybe we should 
have left it there. We could have offered some substitutes.
  One way or another, we are going to take up this issue. It is our 
intention to take it up prior to the August break. That is the majority 
leader's call. We understand that we have a lot of appropriations bills 
to do, and that must be done. I know my colleagues on the 
Transportation Committee are ready to go to work. I won't delay them 
much longer. We will have adequate time to debate the pros and cons of 
this bill.
  I heard some other allegations--that they don't do anything. The 
Senator from Delaware said, ``They have all this lip service. They 
provide for emergency care, gag clauses, and access, direct access to 
OB/GYN and pediatricians, but that doesn't do anything.'' I disagree. 
We protect the unprotected. We don't have the philosophy that we should 
preempt States who are, in many cases, doing a better job than the 
Federal Government. There is a presumption on the Democrat side that 
the Federal Government can do it better than State government. Let's 
protect the unprotected, cover the plans that don't have protections 
often by the State.
  My State has 24 mandates. They have a lot of things that aren't in 
the Democrat plan or Republican plan, and they are doing quite well. 
They are considering many more. Most States are looking at the 
Patients' Bill of Rights, and 36 States have already enacted several 
others, and 45 States already have a gag clause. Maybe some people 
think Washington, DC, should decide what kind of communication should 
or should not be made by physicians, and so on.
  My point is, I think we have tried to craft a very careful, balanced, 
good proposal that won't escalate costs, that won't have undue 
mandates. The Democrat proposal has 359 mandates. Maybe instead of 
calling it the Kennedy bill, the Patients' Bill of Rights, they should 
call it the Kennedy bill of mandates, because it is this idea that the 
Government in Washington, DC, should dictate everything.
  So I look forward to the debate. I look forward to resolving this 
issue and trying to come up with a good, responsible bill that won't 
drive up health care costs, that won't add layers and layers of 
bureaucracy and regulation and red tape, that won't really deter 
quality health care.
  Our bill, I might mention, has a lot of things to deal with improving 
quality health care. I compliment Senator Collins, Senator Frist, 
Senator Jeffords, and others who worked to put a lot of quality 
provisions in this health care, whether you are dealing with women's 
health, or dealing with research, trying to get research out to States 
and rural areas that would really improve quality health care--not a 
Federal definition that we know best, but trying to really advance 
technology and get that information to patients, to various areas 
around the country that would actually improve the quality of health 
care in America today.
  I thank my colleagues who are managing this bill. I hope they will 
have success in moving this bill forward. I look forward to the debate 
and, hopefully, a debate next week on the so-called Patients' Bill of 
Rights.
  Mr. JEFFORDS addressed the Chair.
  The PRESIDING OFFICER. The Senator from Vermont.
  Mr. JEFFORDS. Mr. President, I ask unanimous consent to speak for 3 
minutes as in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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