[Congressional Record Volume 145, Number 46 (Tuesday, March 23, 1999)]
[House]
[Page H1574]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




      THE HANDLING OF THE MANAGED CARE ISSUE IN THE 106TH CONGRESS

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from New Jersey (Mr. Pallone) is recognized for 5 minutes.
  Mr. PALLONE. Mr. Speaker, the managed care issue was left unfinished 
in the 105th Congress. On the House side, the Democrats' Patients' Bill 
of Rights was defeated by just five votes when it came to the Floor for 
a vote. It was considered on the Floor as a substitute to the 
Republican leadership's managed care bill, which did pass and which, in 
my opinion, was worse than having no reform at all.
  The Republican bill was a thinly-veiled attempt to protect the 
insurance industry from managed care reform, and not a single Democrat 
voted for it. It was a show of solidarity on the Democratic side unlike 
any in the last Congress, and for a very good reason. The Democrats' 
Patients' Bill of Rights is the best, most comprehensive managed care 
reform bill in Congress today. It was reintroduced in February by the 
gentleman from Michigan (Mr. Dingell) with over 170 cosponsors and the 
support of over 170 patient, physician, medical, and consumer groups.
  We are hoping to have this bill moved through the regular committee 
process at some point this year. Unfortunately, in the last Congress 
the Republican leadership, fearful of what might happen if it allowed 
the regular committee procedures to take their course, bypassed the 
committee process.
  Mr. Speaker, the big question in this Congress, once again, centers 
on how the Republican leadership is going to proceed with the managed 
care issue. If the preview we got last week in the Senate is any 
indication, the American people are once again going to be sold out by 
the Republican Party in an act of appeasement to the insurance 
industry.
  Last Thursday the Senate Health, Education, Labor, and Pensions 
Committee repeated the same charade we witnessed last year and approved 
a managed care bill designed to protect the insurance industry and not 
the patients. During consideration of that bill, Democrats offered 22 
amendments, and 20 of them were rejected.
  Included among the rejected amendments were measures to increase 
access to emergency care, to increase access to specialists, to 
establish a minimum hospital stay for women who have had mastectomies, 
and to provide people who have life-threatening illnesses with access 
to clinical trials.

  Every single one of these provisions is in the Democrats' Patients' 
Bill of Rights, and every single one of them is opposed by the 
insurance industry.
  The insurance industry-GOP alliance was also successful in protecting 
the two most important impediments to managed care reform. That is, 
one, the prohibition on the right to sue your health plan if you are 
denied needed care and your health suffers as a result; and two, the 
insurance companies' present ability to define ``medical necessity''.
  Democrats on the Senate committee offered amendments that would have 
given patients the right to sue health plans, but not one Republican 
voted for it, nor did any Republicans vote for the Democratic amendment 
to allow doctors and patients and not the insurance companies to 
determine what is medically necessary. In other words, Mr. Speaker, 
under the plans approved by the Republicans in the Senate, insurance 
companies will have no incentive whatsoever to stop denying needed care 
because they would be able to do so with impunity.
  Following up on the momentum to quash meaningful managed care reform 
started by the Senate Republicans, yesterday two anti-managed care 
coalitions announced that they are launching a massive ad campaign to 
quash managed care reform. We have seen this before. Yesterday's 
Congress Daily reported that the Business Roundtable is planning to 
spend more than $1 million on radio advertisements. The Health Benefits 
Coalition, the other group mentioned in yesterday's Congress Daily, 
intends to follow the lead and spend $1 million on anti-managed care 
television ads over the coming congressional recesses.
  Let there be no doubt, Mr. Speaker, the Republican leadership and big 
business are working hand-in-hand to prevent patients from getting the 
protections from abuse that they clearly need. The unfortunate thing, 
Mr. Speaker, is that this is what the American people want. They want 
the Patients' Bill of Rights, they wanted managed care reform.
  This is the issue that more of my constituents talk to me about on a 
regular basis on the street, writing me letters, calling the District 
offices. They realize that right now they do not have the protections 
that they need as patients to have good care, to have good quality 
care.
  The easy thing and really the best thing for us to do here for the 
patients, for the consumers, for the American people, is to pass the 
Patients' Bill of Rights in its entirety and without delay. The 
Republicans may have the money and they have big business on their 
side, but the Democrats have what counts: that is, the support of the 
American people. The Republicans, in my opinion, Mr. Speaker, would be 
wise to listen to what the people are saying.

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