[Congressional Record Volume 144, Number 141 (Friday, October 9, 1998)]
[Senate]
[Pages S12238-S12239]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        PATIENT'S BILL OF RIGHTS

 Mr. HOLLINGS. Mr. President, because of my schedule I was 
unable to attend the vote to table the Patients' Bill of Rights. The 
tabling of this legislation was wrong. We are telling the American 
people that the insurance industry is more important than the patients. 
We must not let the insurance companies take the place of family 
physicians in deciding what is appropriate care for patients.
  Let me share with my colleagues a situation that occurred in South 
Carolina. Ms. Lisa Baughman lives in Charleston. She has a type of 
cancer called ``multiple myeloma.'' Her doctors at the Medical 
University of South Carolina are the best in the country at treating 
her particular condition, and they gave her chemotherapy in preparation 
for a bone marrow transplant.
  That is not a light matter, Mr. President. Anyone who has ever 
watched a friend or relative fight cancer knows it is serious and takes 
courage, prayer, and all the support you can find to go through that.
  Her doctors did what doctors have to do now. They called the 
insurance company and got ``pre-approval'' that the bone marrow 
transplant would be covered.
  But the day before the operation, the insurance company said she 
could not have the operation in her home town with her expert doctors. 
She would have to fly to another state because the insurer had a 
contract with a different hospital that was cheaper. This was literally 
the day before the operation. Can you imagine the mental anguish of 
going through chemotherapy, coming to the day before a bone marrow 
transplant, and then being told ``not now, not with your doctor, not in 
your state, not in your home town, who knows when''--all with your life 
hanging in the balance?
  Her doctors protested that she was too weak and needed immediate 
treatment. The hospital in Charleston offered to do the operation for 
equal or less payment than the out-of-state hospital. But the insurer 
would not yield and tried to fly her alone, holding her medical files 
in her wheelchair, to the other hospital. She got them to approve a 
relative to accompany her.
  When she arrived, there was no one to meet her at the airplane with a 
wheelchair, no hotel room reservation, indeed, no ``room at the inn.'' 
These things had been promised.
  So she eventually showed up at an appointment with the new doctor 
chosen by the insurance company to learn about her case. He said he 
couldn't do the operation for another three weeks, but that she should 
be getting her care in Charleston, South Carolina at the Medical 
University because they had the best people. In fact, he had been 
taught by the surgeon in Charleston.
  She had no choice but to fly home. She contracted pneumonia in her 
weakened condition and is in the hospital right now, trying to recover. 
Because of the delay, she has to go through chemotherapy again before 
she can have the operation.
  That should not happen in America. No one should be forced to go 
through chemotherapy twice because an insurance company overrides an 
expert surgeon's orders and delays critical medical treatment. It 
should not happen, and there is no one in this world who can do 
anything about it except the United States Congress.
  Because of a Federal statute insurers cannot be sued for making 
injurious medical decisions and are not accountable to many state 
requirements. I do not know what we tell someone like Lisa Baughman if 
we go home this year without fixing this problem we created.
  Congress has stood by and watched while ``managed'' health care has 
taken over. Perhaps that was the wisest course for a while, because we 
do not have all the solutions. But if we do not agree on basic 
groundrules for fairness, patients have no protection and it is a race 
to the bottom. We cannot blame HMO's, insurance, or anything else if 
the Congress continues to refuse to act.
  Let me list some of the groundrules that we should enact with the 
Patients' Bill of Rights:

[[Page S12239]]

  People trained in medicine, not accountants should make life and 
death medical decisions. Every patient should know their doctor is free 
to give his or her best advice and decide the best course of treatment, 
without restriction from the insurance company.
  Every patient should know that specialty care is available if needed.
  Citizens should know when they go to the emergency room, that their 
insurance will pay instead of haggling over the bill and denying 
payment afterwards. The last thing someone needs while rushing a sick 
child to the emergency room is a gnawing worry about payment.
  Women should be able to visit their OB/Gyn without going through a 
gatekeeper.
  People with longterm illnesses also should be able to see their 
specialists without getting a referral every time. People pay premiums 
to get health care, not a runaround.
  Some people say this is radical socialized medicine, but I think 
people see through that. This argument is an old red herring and it is 
starting to smell.
  What we are talking about with this Patients Bill of Rights is just 
the health care we always thought we had, but now it is being taken 
away. I have spent decades pushing medical research and building the 
medical research base in South Carolina. I was trying to build 
expertise in life-saving treatments in my home state so my constituents 
could be cared for, not so they could be denied and sent somewhere else 
on a day's notice.

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