[Congressional Record Volume 145, Number 46 (Tuesday, March 23, 1999)]
[House]
[Page H1572]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         PATIENT BILL OF RIGHTS

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Texas (Mr. Rodriguez) is recognized for 5 minutes.
  Mr. RODRIGUEZ. Mr. Speaker, it is long time past that the Congress 
needs to act and act quickly on managed care. Individuals and families 
are increasingly apprehensive about how they will be treated when they 
are sick.
  A survey last year found that an astonishing 80 percent of Americans 
believe that their quality of care is often compromised by their 
insurance plan to save money, and too often their beliefs are well 
founded.
  The Patient Bill of Rights introduced by the gentleman from Michigan 
(Mr. Dingell) and Senator Kennedy last Congress would have ended these 
particular problems, but we had some difficulties and were not able to 
pass a particular piece of legislation.
  The managed care plan needs to be passed and we need to look at it 
this year and not allow it to continue. Managed care reform is needed 
by all Americans, especially those in minority communities.
  Let me just highlight one area of concern, access to specialists. The 
need for specialists is critical for individuals who suffer chronic 
illnesses. Diabetes, for example, is a disease rampant among a lot of 
individuals but specifically disproportionately hits Hispanic 
populations. Many do not know that it is a truly treatable disease and 
that one needs to have access to specialists in order to be able to 
treat some of those items.
  I do not know if everyone recognizes it, but diabetes is a treatable 
disease. It is something that can be prevented. With some recent 
studies, we can identify some of the problems early in life, but we let 
it go. One of the greatest causes of this particular disease is 
blindness and loss of limbs.
  According to the Center for Disease Control and prevention, every 
year approximately 16 million people suffer from diabetes alone. Of 
these, 1.2 million alone are Mexican Americans.
  We see the same problem with cervical cancer. Hispanic women 
especially are disproportionately affected by the disease that is 
completely preventable also, yet there is limited access to the proper 
specialists in this area.
  We all recognize the growing population of elderly in this country 
and the need to look at coming up with some appropriate managed care 
systems.
  Without adequate care and medical supervision, diabetes and those 
with cervical cancer suffer grave consequences. It is a shame because 
these illnesses can be treated and prevented.
  Too often today, managed care is mismanaged care. Decisions on health 
care should be made by doctors and their patients, and not the 
insurance company or their accountants or those individuals that are 
looking at the profit margins.
  We appeal to the Republicans, and we appealed last year and this year 
we again appeal to the Republicans, to allow us to go back to the 
constituency and allow us to do the changes that need to take place.
  The Republicans will say that the Congress passed managed care reform 
last year. I would ask, what have we had? No real reform, but it is a 
simple truth. The fact is that we need reform and it needs to happen 
now.
  What we passed here on the House floor was only the fleeting shadow 
of real reform. Real reform would have included guaranteed access to 
needed health care specialists and, as I mentioned before, access to 
emergency room services, continuity of care protection and access to a 
meaningful and timely appeals process, both internally and externally.

  We should take a page out of the book of the Texas State legislature. 
At the State legislature in Texas we passed managed care reform 
legislation that addressed the real needs of Texans. There was a scare 
that this reform would drive up insurance rates. In fact, insurance 
rates were raised a modest $2.00.
  Contrary to popular belief, the HMO liability law has not flooded the 
courthouse with new lawsuits. It has actually diverted lawsuits and 
saved money by using an independent review process and solving problems 
before they go to the Court. About half of the cases in Texas that are 
reviewed have led to partial or complete overturns of the HMO 
decisions.
  Now it is time for us to pass real managed care reform. It is up to 
us to come to the plate. It is up to us to make sure that those 
individuals have access to health care the way they should. It is up to 
us to make sure that they can see the doctor that they choose to see 
and not who they want to send them to. It is up to us to make sure that 
we have a system that is responsive and addresses the needs of those 
individuals that are hard-hit.
  For too long we have waited and we have recognized the problem of the 
HMOs and the fact that they have not been responsive at all. So it is 
time for us to come to that point.

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