[Congressional Record Volume 145, Number 49 (Monday, April 12, 1999)]
[House]
[Pages H1848-H1855]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                  SUPPORT THE PATIENTS' BILL OF RIGHTS

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 1999, the gentleman from New Jersey (Mr. Pallone) is 
recognized for 60 minutes as the designee of the minority leader.
  Mr. PALLONE. Madam Speaker, last Friday House Democrats across the 
country called on the Republican leadership to bring the Patients' Bill 
of Rights to the floor for a vote. Over a hundred Democrats nationwide 
held events in their districts to encourage their constituents to sign 
on to an electronic petition urging the Speaker of the House, Dennis 
Hastert, and Senate Majority Leader Trent Lott to take immediate action 
on the Patients' Bill of Rights. In Washington I joined with a number 
of my Democratic colleagues from the House in a similar event before 
boarding a bus to Philadelphia, where we joined President Clinton at a 
rally in support of the Patients' Bill of Rights. In echoing the call 
of the House and Senate Democrats, President Clinton encouraged all 
Americans to log on to the Internet and sign the electronic petition to 
the Speaker and Senate majority leader. So far 13,600 people have 
signed this petition.
  The reason, Madam Speaker, so many people have already signed the 
petition I think is clear. The managed care issue was left unfinished 
in the 105th Congress. On the House side the Patients' Bill of Rights 
was defeated by just five votes when it came to the floor, and 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 a very 
bad piece of legislation. This Republican managed care reform or so-
called managed care reform was a thinly-veiled attempt to protect the 
insurance industry from managed care reform, and not a single Democrat 
voted for it, and I think it was a show of solidarity on the Democrats' 
part that none of us voted for that what I consider very unfair bill 
which would not have done anything to reform managed care.
  Last Friday's event illustrates that support amongst Democrats for 
passing the Patients' Bill of Rights is as strong as ever, and let me 
assure my colleagues that it needs to be. The Republican leadership in 
the House has reintroduced a bill that is virtually identical to what 
it moved last year, and on the Senate side the so-called HELP committee 
recently approved a sham managed care bill that does not allow patients 
to sue insurance companies, but does allow insurance companies, not 
doctors and patients, to define medical necessity.
  Attempts to improve this bill were rebuffed by Republicans, who 
rejected 20 to 22 amendments offered by Democrats. Amendments rejected 
by Republicans included proposals to expand the access to emergency 
room care, expand access to specialists, establish minimum hospital 
stays for women undergoing mastectomies for breast cancer, and to 
provide access to clinical trials where appropriate for patients with 
life-threatening conditions.
  I wanted to talk a little bit tonight about an editorial that 
followed up on the Democrats and what the Democrats and the President 
were emphasizing last Friday. The New York Times made observations in 
an editorial on Saturday that were very similar to what I said tonight 
and basically noted just how hollow the Republican approach to managed 
care reform is, and I would quote from the New York Times editorial on 
Saturday:
  ``Just about everyone on Capitol Hill professes interest in producing 
legislation that protects patients from unfair health practices, reads 
the editorial,'' and it goes on, ``yet it is the Democratic proposal 
that more fully reflects the recommendations of a presidential advisory 
commission to improve health plan quality. The Senate Republican bill 
is too limited to accomplish this purpose.''
  Listing the myriad of problems with the Senate Republican bill, the 
New York Times editorial goes on to note, and I quote, that most of its 
provisions would apply only to 48 million individuals covered by plans 
in which large employers act as their insurers, leaving 110 million 
people in other plans unprotected. And the New York Times notes that 
the Republicans in the Senate have drawn a completely arbitrary line 
between people who get their insurance from their employer and people 
who do not, and for reasons that I cannot explain, Republicans think 
only people who get their insurance from their employer should be 
entitled to patient protections.
  The protections that are afforded to individuals who qualify, 
moreover, under the Senate Republican bill constitute no protection at 
all, and again I refer to the New York Times editorial on Saturday 
which notes that, quote, ``Appeals to an external reviewer will be 
allowed only when an insurer refused to pay for a procedure on the 
grounds that it was not medically necessary or is experimental. Because 
the Republican bill would allow insurance plans to define what 
treatment is medically necessary, this provision is absolutely 
meaningless for patients. In fact, it is worse than the current law, 
because if you set up an external appeals process that uses the plan's 
definition of medical necessity, that would even make it more difficult 
to hold health plans accountable for their actions. It basically adds 
another layer of bureaucracy that patients have to confront before they 
go to court.''
  Other shortcomings, and I am not going to go through all them, Madam 
Speaker, but other shortcomings noted by the New York Times editorial 
include the Republicans' failure to guarantee access to specialists and 
the failure to allow patients to sue health plans.
  For all of these reasons, this New York Times editorial concludes 
that the Democrats' Patients' Bill of Rights, quote, ``would be 
substantially stronger in allowing external review of coverage of 
disputes, in defining medical necessity, and in giving enrollees 
greater rights to take health plans to court.'' And the fact of the 
matter is, Madam Speaker, the Patients' Bill of Rights would be 
substantially stronger in every other aspect of managed care reform as 
well.
  The point I am trying to make, and I think the point that we, as 
Democrats, were trying to make on Friday with our press conference and 
our rally with

[[Page H1849]]

the President and our petition on the Internet is that there is a 
pronounced difference between what the Democrats are proposing with the 
Patients' Bill of Rights and the sham managed care reform that has been 
brought up by the Republican leadership.
  Now given all that, I want to say that the biggest problem we have is 
of course getting the Patients' Bill of Rights passed, and the 
obstacles are substantial. The insurance industry is working hand-in-
hand with the Republican leadership to duplicate last year's successful 
effort to kill managed care reform. Industry opponents of the Patients' 
Bill of Rights recently launched two separate million-dollar 
advertising campaigns to undercut support for managed care reform, and 
the House Republican leadership looks like they are just attempting 
another dog and pony show to somehow indicate that they care about this 
issue.
  The latest information, and this is the thing that most upsets me, 
the rumors flying around Capitol Hill, are that instead of a 
comprehensive managed care reform, the Republicans may bring up 
different patient protections in pieces, bits and pieces over the next 
2 years. In other words, instead of bringing the Patients' Bill of 
Rights to the floor, they would bring a bill that would only deal with 
emergency room care or external appeals or whatever.

  This approach really should concern everyone that supports managed 
care reform because it is a means by which the Republicans hope to 
avoid a debate on the significant aspects of managed care reform, like 
the right to sue, like medical necessity. In other words, they are 
trying to claim that they are doing something about managed care 
reform, and they are really not. If this piecemeal approach is adopted, 
we should be very concerned because I think that the issue of managed 
care reform is going to be ignored. The issues that the public really 
cares about will be left off the table essentially.
  Madam Speaker, I think it is important that we keep raising this 
issue, that we cannot deal with managed care reform in a piecemeal way. 
We have to deal with it in a comprehensive way. That is what the 
Democrats are doing, that is what we will continue to do as we move 
forward over the next few weeks and keep pushing to have this bill be 
brought to the floor.
  And I have some of my colleagues that are here joining with me 
tonight. Some of them were at the rally that we had in Washington and 
came on the bus. Others had events in their districts on Friday to 
indicate support and to get people to sign on to the Internet and on to 
the petition that we have.
  I first would yield to the gentlewoman from North Carolina, who has 
been very active as a cochair of our Democratic Health Care Task Force 
on this issue.
  Mrs. CLAYTON. I thank the gentleman from New Jersey for having this 
special session where we can discuss and share with the Nation, but 
also share with our colleagues the significance of our bill.
  I just wanted to share with you and those who are listening that I 
have heard from many of my constituents who have expressed their 
support for the Patients' Bill of Rights legislation. One told me of a 
disturbing story. My constituent was suffering with chest pain and 
needed to go to an emergency room immediately. By having done so 
without prior approval from his insurance provider, he was forced to 
pay his bill himself.
  Another constituent shared a story about a child who was born with an 
otherwise preventable disease. The HMO doctor received financial 
incentive to delay the treatment, resulting in serious repercussion to 
the infant and his family. Still another told a story of his wife who 
had mastectomy and then was told she had to leave the hospital the very 
day, even though the anesthesia had not worn off.
  These are really not made-up stories, they are stories that happen 
over and over again. They are real-life experiences happening to the 
least among us, happen to ordinary people, the people you would not 
think of.
  We need management care reform now. We need a Patients' Bill of 
Rights now. Currently managed care is eroding the protection that we 
are supposed to be guaranteed. What can we in Congress do to restore 
what we set out to do in the first place? Well, our goal should be to 
provide health care for all people across this country.
  Make no mistake about what we talk about here is not really health 
care reform, but it is significant, it is significant. This is a 
national challenge that will grow out of control if we do not begin to 
at least do what we can do by having managed care.
  We need managed care because to make it more accountable and 
affordable and accessible for all people. We also need health care for 
those people uninsured, and I want to make sure as we talk about the 
Patients' Bill of Rights, we should not misunderstand that the number 
of people who are uninsured has grown since 1994, not less. So the 
Patients' Bill of Rights is really trying to make sure those of us who 
are fortunate enough to have insurance, to hold accountable the 
insurance company.
  So, the first step towards this goal must be, indeed the first step 
at least, the first step should be to pass the Patients' Bill of 
Rights. That is a congressional challenge. We have an opportunity here.
  So H.R. 350 ensures that treatment decisions are made by a patient's 
doctor, not an insurance company. The insurance company should not tell 
you that you are able to leave the hospital after an operation. Your 
doctor should tell you that. With this Patients' Bill of Rights, the 
insurance company will no longer be able to control the length of stay 
in the hospital. This bill holds managed care plans accountable when 
their decision to withhold or limit care injures patients.

                              {time}  2145

  This bill allows patients to seek an outside specialist at no 
additional cost, whenever the specialists, in their plan, cannot meet 
their medical needs. This bill extends important protection for women 
in managed care.
  Women will be able to stay in the hospital for more than one day when 
they have a mastectomy or need to have other procedures that require 
that. This bill gives women direct access to OB/GYN services without 
limitation.
  Furthermore, patients have the right under this bill to appeal 
denials on limitations of care to an external independent entity 
whenever their life or health is jeopardized.
  To achieve the type of health care that is suitable to all, we must 
provide health care efficiently and effectively while continuously 
minimizing costs.
  The Patients' Bill of Rights is a very reasonable proposal for 
managed care reform. This bill ensures that patients have rights. 
Patients deserve to have rights.
  Other bills being pushed do not address most of the issues contained 
in H.R. 358, especially not the Patient's Protection Act which was 
passed in the 105th Congress.
  If we are going to support a managed care reform, it should really, 
truly be reform and we should do it right. Let us not repeat what 
happened last Congress.
  Think about the people, all the people, not just a few.
  Health care professionals support the Patients' Bill of Rights. Many 
consumers and individual groups support the Patients' Bill of Rights. I 
support the Patients' Bill of Rights and I urge all of my colleagues on 
both sides to join me in ensuring that patients receive what they 
deserve. Their constituents throughout America certainly are telling 
them that.
  Let us meet the national challenge. Our challenge is indeed to 
provide health care for all of our citizens across the country, for 
those who have insurance coverage, although inadequate and unaffordable 
and especially those who have no insurance at all. We must give people 
the rights they deserve. We must give people the rights they deserve 
and should have. Let us meet our congressional challenge by taking the 
first step, by passing the Patients' Bill of Rights.
  On February 9, when those who were in Washington going to 
Philadelphia, we began our crusade across the Nation but we began it in 
North Carolina.
  In the First Congressional District, we used a four county 
telecommunication. I communicated with four people on the Internet. Not 
the Internet, but information highway, to tell them about the Internet.

[[Page H1850]]

  I had doctors there, nurses there. I had patients there. On one site 
I had 45 people. On the other site I had 32 people. On another site, I 
had 19 people and another site I had only seven people. Not only that, 
we also talked to doctors' offices at the same time.
  We had doctors' offices signing their patients up. We had hospitals 
signing their patients up. We went to the police department and talked 
to the chief of police. He had his 78 people sign up. We went to the 
social services department and asked, are you insured? Do you have 
health insurance? Do you care about this? Of course they cared about 
it.
  Teachers cared about that. We went to our churches the day following 
that and said if they did not have a computer there is a computer in 
the church. Tell your people to sign up. We told them use this 
technology. Go to your libraries.
  It was a tremendous success. My understanding, to date there are more 
than 13,000, but I want to say I know that in North Carolina we knew at 
the end of Friday we had over 750 people, so now we ought to have over 
1,000.
  North Carolina is not the only one in it. It is an easy process. When 
people understand this, indeed they want to sign on, but we need to do 
more.
  See, this bill represents managed care reform, but we also need 
health care reform. At least we ought to do this and do it right.
  Madam Speaker, I encourage all my colleagues to join me in supporting 
and ensuring that patients, patients, have a real bill of rights. 
Apparently that is what the people want and indeed that is what the 
people deserve.
  Mr. PALLONE. Madam Speaker, I wanted to thank the gentlewoman from 
North Carolina (Mrs. Clayton) for her comments.
  Let me say, the gentlewoman has said it so well that this is really a 
common-sense approach. There is nothing miraculous here. If people 
understand what we are talking about with these patient protections, 
they want to sign the petition, they agree with us. I think that is 
what the gentlewoman and so many of our colleagues saw last week when 
they participated in this petition drive.
  The gentlewoman said it so well. There are actually HMOs, good HMOs I 
should say, who actually support these patient protections. Some of 
them implemented some of the patient protections. Then there are other 
bad ones that have not. So we do not want to assume that this is not 
something that even some of the HMOs support, to be honest. Physicians 
support it.
  One of the interesting things, because I know that the gentlewoman 
has been involved with the Indian Physicians Association, IPA; they 
were here a couple of weeks ago, just before our holiday break, and 
spoke to a lot of us, and it was interesting because some of the 
physicians and some of the people that were at that Indian physicians 
day also owned HMOs and they were very supportive of the Patients' Bill 
of Rights.
  So I think, as the gentlewoman points out, if we get the word out, 
people understand it and they want to support this bill. They want to 
sign the petition. They want Republicans to bring this bill to the 
floor.
  The other thing I wanted to mention, and I think the gentlewoman is 
so right when she talks about, we are dealing here with managed care 
reform, but there is the larger issue of the uninsured and so many 
people that no longer are insured that even were insured a few years 
ago. Again, I kind of feel like I am preaching to the choir because the 
gentlewoman has been involved with our health care task force for a 
long time now, and we tried to address the problem of the uninsured 
unfortunately in a piecemeal way.
  I do not like piecemeal approaches for managed care reform any more 
than I do for trying to cover everybody. I would rather have universal 
health care coverage, but ever since the President brought forth a 
proposal and the insurance companies fought that so hard and killed it 
4 or 5 years ago, we have had to try to deal with coverage in a 
piecemeal way.
  We did the Kennedy-Kassebaum bill. We did the Kids Health Care 
Initiative. We had the Near Elderly Initiative. I know that the 
gentlewoman has been involved with all of these things as part of our 
task force. Those things have had some success, but again they show 
that a piecemeal approach is not adequate. There really cannot be a 
piecemeal approach to managed care reform or to health insurance 
coverage.

  But again the political realities set in, so we do the best we can.
  So I am glad the gentlewoman mentioned it because it is obviously 
true. There are more people uninsured today than there were 5 years 
ago.
  Madam Speaker, let me point out that it is the gentlewoman from 
Connecticut (Ms. DeLauro) who started this whole petition drive that 
was so successful last Friday. She came up with the idea of having the 
bus trip to Philadelphia with the President's rally and having our 
Members around the country deal with this on the Internet so 
effectively. It was a tremendous success, and I want to congratulate 
her for doing it.
  Ms. DeLAURO. Madam Speaker, will the gentleman yield?
  Mr. PALLONE. I yield to the gentlewoman from Connecticut.
  Ms. DeLAURO. Madam Speaker, I want to thank my colleague from New 
Jersey (Mr. Pallone) for yielding. I am proud to join with the 
gentleman.
  Before my colleague, the gentlewoman from North Carolina (Mrs. 
Clayton) leaves the floor, it was really very exciting. We had Members 
everywhere doing things, and the use of the technology not only to be 
on the Internet superhighway, but to use telecommunication or 
teleconferencing to gather in people just speaks volumes about what it 
is that we can do to reach out to people in this country.
  Mrs. CLAYTON. Madam Speaker, will the gentleman yield?
  Mr. PALLONE. I yield to the gentlewoman from North Carolina.
  Mrs. CLAYTON. Madam Speaker, I just want to say how the interaction 
works. My colleague, the gentlewoman from California (Mrs. Capps) is on 
our health task force and she brought up the idea of using the nurses. 
Well, I want to say in our conference I happened to have one conference 
on the university campus, so I extended it out to the school of 
nursing. The dean came over and brought others, and the American Cancer 
Association. So we were able to use it.
  One place we had at a community college where the university people 
came over. Another place, we had another community college we had 
relatively very few, about nine people, but they had gone out and 
gotten 60 names of people who wanted to participate. So those seven 
people multiplied almost five times.
  So I want to thank the gentlewoman for thinking of this idea. I would 
not have thought of using the nurses if she hadn't mentioned it.
  I want to thank the gentlewoman from Connecticut (Ms. DeLauro) for 
being creative and forcing me to use the technology we have. This is a 
unique way of getting the grass-roots participation, using technology, 
democracy at its best, I think, for whatever cause. This certainly is a 
worthy cause so I thank the gentlewoman for that.
  Ms. DeLAURO. There were kind of two bites at the apple. One was the 
old fashioned highway where we get on the bus, which was great. It was 
a really terrific experience. The press conference here was great. Then 
using the Internet, and the extent to which our colleagues all over the 
country participated, it was just the beginning, which is really what 
is very exciting about it because I think that people understand that 
they can engage, that they really can be a part of what is happening 
and their voices can be heard in this body.
  I think that that is one way of providing the best of the 
opportunities for the public to participate in the process of 
formulating good public policy, which is what essentially we are trying 
to do here.
  I just would make one more point because the other thing, and both of 
my colleagues, the gentlewoman from North Carolina (Mrs. Clayton) and 
the gentleman from New Jersey (Mr. Pallone) mentioned this, when one 
thinks about it, just only a few years ago we were really consumed with 
the notion of how we were going to insure at that time the 38 million 
or 39 million people in this country who were uninsured, and today, 
quite frankly, we are just trying to deal with a holding action for 
people who do have insurance and making sure that they have

[[Page H1851]]

the access that they need and are provided with the health care that 
they are paying for.
  We have kind of been sidetracked from looking at folks who do not 
have any insurance yet, and what we need to be doing is to try to deal 
with both parts of this equation, because it is so serious.
  The whole point of all of this is just to say to patients and to 
people who have health insurance today that the decisions that are 
going to be made regarding your health care are decisions that are 
going to be made by physicians, by doctors, by health providers, in 
conjunction with you, the patient, and you are going to have a voice in 
this effort as well. It is not going to be an area in which the 
bureaucrats are going to have the final say.
  My colleagues have gone through all of the parts of this effort and 
what is involved. This is very simple. It is very basic. It is a 
common-sense approach to health care, and that is if one needs 
emergency room care, they can get emergency room care. If one happens 
to have a specialist and is being treated for an illness and it happens 
that their employer changes the insurance coverage, that in fact they 
are guaranteed a continuity of the care that they have received and 
they can continue to see the physicians that were taking care of them 
under one particular plan and they can continue that under another 
plan.
  We have all been the recipient of countless numbers of people who 
have told us the horror stories that they are going through, which is 
why this piece of legislation enjoys such a breadth of support.

                              {time}  2200

  It enjoys a breadth of support on both sides of the aisle, except 
that we have found that this body, for some strange reason, and I do 
not fathom it, and the President commented on it on Friday in 
Philadelphia, which is the fact that we have to resort to going the 
route of a petition nationally to get people to make their voices 
heard, to bring to life that which they believe out there on both sides 
of the aisle, because illness and health care is not a partisan issue, 
it affects everyone.
  In fact, we have not had the opportunity in this body to be able to 
debate, to talk about, to in fact have the kind of attention brought to 
this issue that needs to be brought to it because in some way the 
leadership of this House has been blocking the passage of the Patients' 
Bill of Rights, when in fact there is tremendous and strong support for 
this effort nationwide.
  So what we have done is that we kicked off this nationwide online 
petition drive, and I would just say that now, with the click of a 
mouse, and in the article that came out about my participation in this 
effort, the report is wonderful in a sense of the kind of, I should be 
more technologically competent, but this is a way to get engaged in it. 
I was fumbling around with the mouse to get it right. My kids, our 
kids, all of our kids and young people can do this in a heartbeat, but 
that is what we have to do. We have to take advantage of the 
opportunities to be able to use this.
  We also had people that joined with us on Friday and over the 
weekend, health care providers. More than 40 medical and patient 
advocacy organizations took up the call for strong HMO reform, but they 
put the petition drive on their websites.
  I want to urge my colleagues here tonight, those of us who engaged in 
these efforts, and there were about 80 or more Members who engaged in 
this effort, that individually we need to sign up and to make our 
voices heard. We can do that in a very, very easy way. We are thankful 
to Families USA for allowing us to engage in the website. That is, 
House Members need to just do www.FamiliesUSA.org, so that we 
individually can make our voices heard on this issue and sign up.
  I want to mention the reason we went to Philadelphia, because I think 
it is important. There was real symbolism in going to Philadelphia. It 
is basically where our Bill of Rights was founded, our Declaration of 
Independence, our Constitution. This is where our Founding Fathers had 
a vision for this Nation and the laws that this Nation would rest on.
  It is unfortunate that our health care system comes up short when it 
is measured against the standards that were established at the birth of 
this great Nation. The Republican leadership in this House want to have 
a Declaration of Independence, but they do not want to have the 
Constitution as part of it.
  The Constitution, we can declare our support for a Patients' Bill of 
Rights, but we have to establish the laws to make it a reality. That is 
what our job is here today. That is what we are about, is to try to 
establish the laws that make this a reality. Without that, we are not 
going to be successful. Without those laws, that is not what our 
Founding Fathers wanted, and it is not good enough for our families 
today.
  What we have to do is to take into consideration the health and well-
being of the people we represent. That is what this effort is all 
about. We are going to continue to make the case. We will continue to 
have our colleagues and their own communities try to use whatever 
outreach mechanisms they can to engage the people in this country; to 
say to the people, and as the President said to the folks in 
Philadelphia, but more to the country, we need to have your voices in 
this process. That is the way in which our government works. That is 
what our democracy is about. That is why we have tried to engage in 
this effort.
  I think it was a good effort. We had a lot of fun doing it on Friday, 
but it was only the beginning and the outset of the process.
  I want to thank my colleagues for joining in tonight, and my 
colleague, the gentleman from New Jersey (Mr. Pallone) for holding this 
special order so we could carry on the debate and the discussion. I 
thank him very much.
  Mr. PALLONE. I want to thank the gentlewoman. Let me just say that 
she made a good point. She talked about the bus and the grass roots 
effort and the Internet, but she also made the point that it is kind of 
too bad that we have to do all of this.
  The reason, and I am going to be very partisan about it, the reason 
is because the Republican leadership refuses to bring this bill up. We 
all remember very well that in the last session of Congress the only 
way we were able to get a vote on the issue at all was because of a 
discharge petition. We actually had to get the majority of Members of 
the House, or close to it, on a discharge petition, because they would 
not consider the bill in committee. They would not have any discussion 
or hearings on it. Only through the forced mechanism, if you will, of 
the discharge petition were we able to bring it up. It is true that 
there are some Republicans on the other side that support us, but their 
leadership will not bring it up.
  I go back to what we discussed earlier, which is that the reason for 
that I am convinced is because of the insurance industry. It is the 
money and the power and the influence of the insurance industry on the 
Republican leadership that makes it impossible for this to come up, or 
that is the reason it is not coming up.
  I resent the fact that over the last few weeks the industry has 
doubled its efforts now, with the ads on TV, with the ads in the print 
media, and basically we are seeing the same thing we saw last year to 
try to kill this bill.
  The thing that is incredible about it, one of the things they were 
alleging in some of the ads I saw was about the cost. They keep saying 
that if we have these patient protections, it is going to cost too 
much.
  One of the things that I did not mention about the New York Times 
editorial, which was right on point, I thought, it was in the next day 
after our rally, was that they say at the very end, it says, ``The 
insurance lobby is already embarked on a media blitz to defeat any new 
regulations as too costly. But consumer protections under the 
Democratic plan would increase the health plan costs by only a 
tolerable 2.8 percent, according to Congressional Budget Office 
estimates made last year, or slightly more if lawsuits against ERISA 
plans are permitted in state court. Health plans should be made to 
deliver what they promised, their enrollees, and held accountable when 
they fail.''
  The bottom line is that every indication we have seen in every State 
that has passed some of these protections on a State level is that it 
has either no increased costs, or so minimal that it makes it not even 
relevant. I just resent the fact that this insurance industry 
advertising campaign and blitz is

[[Page H1852]]

trying to basically throw out falsehoods about what we are doing here 
today.
  Ms. DeLAURO. Just a final comment, because we have so many folks on 
the floor to speak tonight.
  The fact is that with accountability, it is, again, common sense. If 
there is a particular entity that is going to engage in a medical 
decision and participate in that decision, and by some manner, by 
something it goes wrong, where there is an error, and to be a 
participant in that decision and then to say that you have no 
responsibility just does not make any sense.

  You cannot have it both ways. You cannot be initiating medical 
decisions, making them on procedures, on prescription drugs, on the 
whole variety of areas, and then, if something goes wrong, then, my 
gosh, you can walk away and say, I have no culpability at all, no 
responsibility. That is not right, and that is, I think, one of the 
prime reasons why there is so much of a resistance to bringing this 
effort up.
  But people who in good faith are the recipients of those medical 
decisions, by whomever they are made, need to have an opportunity to 
redress anything that may go wrong with those decisions.
  Mr. PALLONE. I agree.
  Madam Speaker, I yield to the gentlewoman from California (Mrs. 
Capps), who again is a member of our task force, and has heightened 
this issue so many times for us, for her colleagues in the House.
  Mrs. CAPPS. I want to thank my colleague, the gentleman from New 
Jersey (Mr. Frank Pallone), and to say what a pleasure it is to be here 
with fellow colleagues from around the country, really; North Carolina 
we have heard from, and Connecticut, and we will be hearing from Texas 
and other places.
  Mr. Speaker, last Friday I joined a nationwide effort to build 
support for the Patients' Bill of Rights. It was a privilege to do 
this, and to know that I was in concert with our efforts in my district 
out in the Central Coast of California, where I was in line with and 
online with those around the country in what we might call an old-
fashioned petition drive, democracy in action.
  I was at one of the excellent institutions of higher learning in my 
district, and took advantage of state-of-the-art computer facilities 
and was able to lead an online grass roots petition drive to encourage 
students to speak out on the importance of managed care reform.
  We went to Santa Barbara City College, and the school of nursing was 
our host there, and invited other students to join us. We had quite a 
lively discussion as we logged on, because we began to talk about the 
fact that this is democracy in action, and this is the way that 
citizens of all ages, young students as well as middle-aged students 
and older people, could hear and discuss together the issues, but also 
make their wishes known to their representatives, not just their 
individual one, but to the leadership of this House, and to those of us 
in Congress who are in a position to take action on behalf of these, 
our constituents.
  The computer lab stayed open, as it is available for all students. 
After our discussion was concluded and we had finished, it only takes a 
minute to do this, then people could go on their way and spread the 
word, and others could come in during the day. They talked about going 
home and telling their families about this opportunity that they would 
have as well.
  So my hat is off to nursing students and my nurse friends there at 
City College and the other institutions that have allowed this to 
happen, the Learning Resource Center there.
  As we were talking about the need to do this action in Congress, it 
came up, why? What has happened? How come it is out of whack and out of 
control the way it is?
  In California, managed care has been a way of life for a great number 
of years. We began to think back, and it came into being, the HMO, as a 
way to counteract, and I was a nurse there for a long time in the 
schools, and I recall that all of us as patients, nurses, whatever our 
role, we are familiar with the high cost of health care, and that it 
began to rise so exponentially in the seventies and eighties, and there 
really was a need to curb it. It looked like a good thing was 
happening.
  So as I have tried to get a handle on it and explain it to my student 
friends the other day, I describe it as a pendulum swung out of control 
to too high cost, at one point, and then swinging too far the other way 
as the excesses, really, of managed care have now come home to hit us, 
and to hit so many people really personally and tragically, or in 
serious ways.
  Our job is to bring the pendulum back to the center again. Of course, 
the center is patient care; the need for the consumer, the patient, and 
that relationship with the doctor or other health care provider that is 
the heart of what health care is all about. It is a picture, too.
  Some of the students said, well, they wanted to institute prevention 
and have opportunities for learning about taking care of our bodies, 
and learning about how to really be effective and responsible health 
care consumers.
  Yes, in the beginning we had a lot of this impetus, but again, as the 
cost-cutting has come into play so strongly it has seemed that many of 
these good ideas that we saw, and perhaps still do, have fallen by the 
wayside. Now we hear about only so many visits for physical therapy, or 
so many opportunities. It is not with the patient's need or well-being 
in mind, even within the setting of managed costs, but this is really 
too far into that corner.
  I have been hearing from constituents as long as I have been in 
office, and before that as a nurse in the school district I heard from 
families, about their real issues and about where these decisions need 
to be made. These voices of my constituents and others here need to be 
heard in Congress. We need to take action on behalf of patients and the 
recipients of health care.
  I heard stories on Friday at Santa Barbara City College of even young 
people already having medical necessity determined by the insurance 
provider, and seeking redress and not being able to find it. They are 
frustrated. They want to express their concerns.
  Medical decisions need to be made by patients and their doctors. 
Patients need to have all the information they need to make these 
critical decisions. There are some plain truths in health care.
  Mr. Speaker, this historic measure will guarantee patients basic 
rights by allowing people to choose their doctor, to end oppressive gag 
rules so patients have access to all critical treatment options, and to 
establish medical necessity, to have medical standards for quality of 
care.
  Most importantly, this bill will hold HMOs accountable by giving 
patients critical legal recourse when insurance companies deny 
necessary medical coverage. If patients can sue their doctors for poor 
care, they should be able to sue insurance bureaucrats who determine 
medical decisions.
  Mr. Speaker, last week we saw people all across the country and in my 
district take part in a movement to restore common sense to health 
care. These people have often felt isolated from the political process. 
They could log onto the Internet as a means of raising their voices. So 
far, thousands of people across the country have logged onto the 
Families USA website, and this will continue as citizens across the 
country want to lend their support to the Patients' Bill of Rights.

                              {time}  2215

  The American people have spoken and they are speaking, and now 
Congress needs to listen to them. I thank the gentleman from New Jersey 
(Mr. Pallone) for giving me the opportunity to share my experience.
  Mr. PALLONE. Mr. Speaker, I thank the gentlewoman and she talked 
about the preventive nature of these patient protections, and I think 
that is so true. And I think also one of reasons why we find that they 
do not increase costs is because they are prevention and ultimately 
they reduce costs. In fact, even the right to sue, which was mentioned, 
every time we have looked at this in the States that have implemented 
these kinds of patient protections and allowed the ability to sue, it 
even serves as a preventive measure because the HMOs take precautions 
because they do not want to be sued and they do not want to have huge 
damages recovered against them.
  It is very important for us to keep that in mind, that all of this is 
preventive and ultimately that is why it does

[[Page H1853]]

not cost additional money and I think in the long run saves money.
  Mr. Speaker, I yield to the gentlewoman from Texas (Ms. Jackson-Lee) 
who has been involved in the Kids Health Care Initiative and Kennedy-
Kassebaum and now the Patients' Bill of Rights.
  Ms. JACKSON-LEE of Texas. Mr. Speaker, I thank the gentleman for his 
leadership and the wiseness of this special order and I enjoyed hearing 
my colleague from North Carolina, my colleague from Connecticut, and 
now California; and I will soon be hearing from my colleague from 
Texas. We all must have had some sort of signal on this issue.
  I know of the great leadership of the gentlewoman from California 
(Mrs. Capps) and her long years of service as a nurse. In fact, we were 
so happy to have her involvement and instruction to us on this very 
important issue even as a newer Member of Congress, and we appreciate 
it.
  The reason why I think we have ESP is that I went to a school of 
nursing in my district, having been raised by a nurse. My mother was 
involved in hospital work for many, many years, and I knew that her 
prime concern was the care of the patient.
  This is one of the most common-sense bills I have ever read. And I 
want all who are listening to know that we who are speaking have read 
it and believe that it is only fair to put ``patient'' back in health 
care and medical care. And that is what the Patients' Bill of Rights 
does.
  It was so refreshing to be at the Prairie View A&M College of Nursing 
with Dean Brathwaite and Professor Bernard and others and to see 60 or 
so nursing students, including, I am told, one of the largest classes 
of male nursing students, talk about their concern about patient care.
  So we began the process by educating and discussing these elements, 
how important it is for these young nurses to have the ability to be 
part of the decision-making process, to listen to the patient, to share 
the patient's information with the physician and let that be the prime 
decider of how their health care should be determined, rather than a 
bureaucrat sitting behind a desk and, I hate to say it, maybe using the 
Internet or the computer to say no because we are trying to use the 
Internet for a good reason. But I have heard from so many of my 
constituents to say that they just got a cold call saying they cannot 
have this service, they cannot have this specialty service.
  One of the issues that I think is so very important in the Patients' 
Bill of Rights for women is the direct access to obstetricians and 
gynecologists. Heretofore, we have had to spend a long time arguing 
about the importance of the OB/GYN relationship between patient and 
physician. Unfortunately, this is only made clearer in the Patients' 
Bill of Rights by way of giving the woman an option of seeing a family 
physician for general health concern and access to an OB/GYN for 
routine annual examinations.
  One of the most devastating cancers is ovarian cancer, and in a 
recent article it was determined that there is a new test that could be 
utilized on a yearly basis for women to catch ovarian cancer early. In 
the present health structure that would be a distant opportunity or 
possibility for women now who may not have direct access to their OB/
GYN.
  This fits very well, this Patients' Bill of Rights, with this new 
medical find, this new technology, to provide an early detection of 
ovarian cancer. This works out perfectly because it gives women the 
access to their OB/GYN.
  This idea of not being able to have an immediate review when it has 
been denied does not make sense. Patients are fishing for someone who 
they can ask. Their child needs this service, they need a specialist. I 
think the Patients' Bill of Rights is common sense. It is common sense 
not to discriminate against someone because of race, color, ethnicity, 
religion, age, mental or physical disability, sexual orientation, 
genetic orientation, or source of payment.
  The Patients' Bill of Rights answers the concerns of so many 
Americans who have said they have been denied because they have a prior 
or previous existing disability; they have been denied because of age, 
and no one tells them that it is age, but they have a guess that that 
is the reason why they have been denied; because they live in a certain 
community, which may be urban or rural; they may come from a certain 
racial background.
  We know in certain racial populations there are histories of high 
blood pressure. In the African-American community, histories of stroke. 
And, therefore, these individuals have found themselves being subject 
to denials for coverage because of certain traits that are obviously 
not within their power sometimes to change.
  So I was very pleased to be able to join with the student nurses at 
the Prairie View A&M University College of Nursing to join on April 9, 
Friday, as many were in Philadelphia and Washington. I hope that the 
gentleman from New Jersey got the word that we were signing on on the 
Internet. The nursing students could not wait.
  We also announced that the Texas Association of Nurses added their 
name to the list of supporters of the Patients' Bill of Rights along, 
of course, with the American Medical Association and the National 
Nursing Association as well. We were so enthusiastic that if the 
gentleman would beg our pardon, we were going to combine new technology 
with old fashioned ways.
  Friday, this coming week, we are going to announce an effort in our 
churches so that churches on Sundays will be able to have handwritten 
petitions. They may not be able to sign up on the computers on Sundays 
when the members come to church, but we will have handwritten petitions 
that we will be adding to the superhighway and they are looking forward 
to doing that in my district. So I welcome that. I do not want to deny 
anyone the opportunity to sign up and we are going to have that effort.
  I thank the gentleman from New Jersey very much for holding this 
special order. Let me encourage my colleagues in a bipartisan way, in 
the spirit of Hershey which I participated in, let us ensure that the 
61 percent of patients who complained about the decreased amount of 
time they spend with their doctors get relief. Let us ensure that the 
59 percent who complained about the difficulty in seeing medical 
specialists get relief. And let us ensure that the 51 percent who 
complained about the decreased quality of health care for the sick get 
relief.
  Mr. Speaker, the way to get relief is if we pass this Patients' Bill 
of Rights in a nonpartisan or bipartisan manner and respond to the 
health crisis that is going on in America.
  With that, I thank the gentleman again for giving me this 
opportunity. Certainly, I want to join in acknowledging and thanking 
the gentlewoman from Connecticut (Ms. DeLauro) for this idea, and 
hoping that we will see the fruits of our labor very, very soon.
  I rise today to add my voice in support of the Patients' Bill of 
Rights. The Patients' Bill of Rights sets a Federal standard to ensure 
that Americans will have basic consumer protection in their health care 
plans.
  Last Friday, like many of my Colleagues, I met with the nursing 
students of the Prairie View A&M University College of Nursing where we 
discussed the negative imput of the present HMO structure on their 
ability to give patient care. We must reform managed care so the 
patients' needs are first priority and not the whines on of an HMO 
adminsitrator.
  Those students and staff along with myself enthusiastically signed 
onto the Internet to push for their bill to come to the floor. We must 
pass a Patients' Bill of Rights this session.
  I support the Patients' Bill of Rights because I believe Americans 
deserve quality health care from their managed care plans. I have 
received many letters from constituents that express their 
dissatisfaction with the care that they received from HMOs.
  Texans and all Americans want a Patients' Bill of Rights because we 
want quality care from HMOs. A Kaiser Family Foundation study found 
that 73 percent of voters believe that patients should be able to hold 
managed care plans accountable for wrongful delays or denials.
  The same study also found that 61 percent of patients complained 
about the decreased amount of time doctors spend with patients; 59 
percent complained about the difficulty in seeing medical specialists; 
and 51 percent decreased the quality of health care for the sick.
  There are 13 essential consumer protections contained in the 
Patients' Bill of Rights. Some of the basic tenets include:
  Oversight through Federal and State governments and other entities to 
monitor the quality of care given to patients. Patients 

[[Page H1854]]

should know that there is active oversight, and not rubber-stamping of 
the care they receive.

  Direct access to Obstetricians and Gynecologists for women. The 
unique health needs of women should be addressed in any health care 
plan. Women should have the option to see a family physician for 
general health concerns and access to an OB/Gyn for routine annual 
examinations.
  Uniform licensing standards for all health plans. All plans should 
meet national standards of care and should be licensed to operate in 
the states where they do business.
  Nondiscrimination in the delivery of services on the basis of race, 
color, gender, ethnicity, national origin, religion, age, mental or 
physical disability, sexual orientation, genetic information, or source 
of payment. No one should receive substandard care on the basis of 
these factors.
  Ability to make informed choices about the various options and the 
level of care. Patients should have all of the information necessary to 
make decisions about their care including alternative treatments.
  Unlimited access to emergency care and to specialists when necessary. 
Emergency care should be available at any time without prior 
authorization for treatment. If a specialist is needed, patients should 
be able to receive his/her services.
  Additionally, as chair of the Congressional Children's Caucus the HMO 
system today sometimes hurts health care for children by denying these 
young patients the specialists care they need. Mental health services 
are also vital to children and more attention needs to be given to 
providing such services to children since now \2/3\'s of American 
children do not have access to mental health services or pediatric 
specialists.
  Simply stated, the Patients' Bill of Rights provides consumers with 
the basic protections that are necessary to ensure that they receive 
quality care.
  The Patients' Bill of Rights should not be controversial for any 
Member of Congress who is serious about protecting patients from 
insurance company abuses. The choice is clear. We should stand with 
patients, families, and doctors, not with the well-heeled special 
interests that put profits ahead of patients.
  Mr. PALLONE. Mr. Speaker, I thank the gentlewoman from Texas and 
assure her that we heard these voices loud and clear on April 9 when so 
many people signed on to the Internet. As so many of our colleagues 
said, we are going to keep going and with her help we will keep going.
  Mr. Speaker, I yield to the gentleman from Texas (Mr. Green) my 
colleague on the Committee on Commerce who has been so much involved 
with the health care initiatives that we have made over the last few 
years, Kids Health Care, Kennedy-Kassebaum and the others.
  Mr. GREEN of Texas. Mr. Speaker, I thank my New Jersey colleague for 
being chair of our Health Care Task Force of the Democratic Caucus, and 
I think after what happened this last week and the American people have 
made very clear about what issues they want this Congress to work on. 
At the top of that list is managed care reform.
  Of course, I think we have heard not only that voice but that echo 
now for a number of years. And last year the Republican leadership 
failed to make the good-faith effort to pass meaningful HMO reform. In 
fact, the bill that we passed is what I called a sham bill that did 
nothing to protect patients.
  While it had a good name, the Patient Protection Act really did more 
to protect the insurance companies than anyone else. And I say that 
because actually it rolled back the State law in the State of Texas 
that the State of Texas had passed in 1997. And almost every one of the 
so-called patient protections had loopholes big enough to drive a car 
through.
  Fortunately, the Senate had enough sense not to force through that 
partisan bill that did not adequately protect patients, and this year 
it seems the roles are reversed. This year the Senate ``HELP'' 
Committee passed a managed care bill along party lines and rejected 20 
out of 22 Democratic amendments. The only amendments they accepted were 
technical in nature. The 20 amendments designed to protect patients in 
managed care were voted down one by one.
  Now, they did not all deal with allowing patients to sue their health 
care provider. So 20 of those amendments, Mr. Speaker, were rejected. 
Republicans rejected amendments that would have protected women who 
undergo mastectomy for breast cancer and rejected expanding access to 
emergency room care and access to clinical trials so that patients in 
the managed care system can have the cutting-edge health care 
available.
  Hopefully, the House will act more responsibly this year and reject 
the Senate proposal. Our House Committee on Commerce began hearings 
already, we had one hearing on a promised bipartisan hearing schedule 
for managed care reform. Certainly, the press releases and the public 
statements by the House and committee leadership has been encouraging. 
Let us just hope that they follow through with their commitment to 
bipartisanship and agree to support real managed care reform like the 
Patients' Bill of Rights.
  That means not just a flashy title or a few catch phrases, but 
elimination of gag clauses for all physicians and providers and 
patients; provide timely and binding external appeals; guarantee access 
to specialists and emergency room care and, again, access to clinical 
trials so patients can have cutting-edge technology, allow doctors to 
determine what is medically necessary, and also protect the privacy of 
medical records.
  Most importantly, managed care reform holds the medical decision-
maker accountable. Now, the medical decision-maker sometimes may not be 
that provider. What some people either do not understand or care about 
is that there is no accountability without liability. There is no 
accountability without liability. We can pass all the patient 
protections we want with the best appeals and full access to 
specialists, but if a health plan cannot be punished for ignoring these 
medical decisions, they will continue to ignore doctors' treatment 
decisions and patients will continue to suffer.
  Managed care was begun in our country and I understand. Before I was 
elected to Congress, my job at my company was dealing with insurance 
companies and negotiating for health care for our employees. And having 
dealt with them, I know the cost that individual businesses were 
seeing, and so managed care was created to control those costs.
  Again, they have done that. But let us bring that pendulum back and 
say, we want to control those costs, but we do not want to see the loss 
of quality for those employees that I used to have to find their 
insurance for or the people out there who today are trying to find that 
insurance.
  Mr. Speaker, I again thank my colleague from New Jersey for his 
leadership and also this special order this evening allowing those of 
us, who all have different ways we talk, to talk about from all across 
this country how important real managed care reform is for this session 
of Congress.
  Mr. PALLONE. Mr. Speaker, I thank both my colleagues from Texas. As 
they say, Texas is one of the first States to actually implement these 
patient protections that we are talking about. But we still need the 
Federal legislation, because so many people are not covered by State 
legislation.
  Mr. Speaker, I yield to the gentlewoman from Texas (Ms. Jackson-Lee).
  Ms. JACKSON-LEE. Mr. Speaker, I agree with the gentleman from Texas 
(Mr. Green), and there was one point that I wanted to add, because I 
know that he has worked very hard on this issue of children's health.
  I think we should really make very plain and clear that the Patients' 
Bill of Rights is going to enhance the care of children. One of the 
things negatively that comes out of being denied is the denial of a 
specialist for a child. Many parents have made mention of the fact that 
this insurance covers them, it is managed care insurance, their child 
needs this kind of procedure and this kind of specialist. Yet, when the 
parent goes to their insurance company to seek it, they are denied.
  Mr. Speaker, there is nothing more hurting than a parent who cannot 
help to provide good health care for their children. So I think that we 
should not leave tonight without noting how important this is to the 
children of America, and particularly those children needing mental 
health services who for so long have been denied access.
  Two-thirds of America's children do not have access to mental health 
services. So I would simply say that we are talking of adults, adults 
probably signed on the Internet. But this has an enormous reach to the 
children of America to make sure that they have good health care.
  I just wanted to add to the gentleman's comments as well to make sure

[[Page H1855]]

we did not forget the children in all of this.
  Mr. PALLONE. The gentlewoman is absolutely correct. One of the 
criticisms that we have had of the Republican bill, the leadership 
bill, is that although sometimes it provides for pediatric care or a 
pediatric specialist, it does not in any way provide for the subgroups. 
As we know, today oftentimes children need to go to a specialist other 
than just the pediatrician, who has almost become a general 
practitioner. That kind of specialty care is not provided for in the 
Republican bill.
  Mr. Speaker, I yield to the gentleman from Texas (Mr. Green).
  Mr. GREEN of Texas. Mr. Speaker, in the closing minutes of the 
special order, I would like to mention what the gentleman from New 
Jersey said about changing Federal law, because again the gentlewoman 
from Texas (Ms. Jackson-Lee) and I are both from Texas, and Texas 
changed the law in 1997 for those insurance policies that are licensed 
under State law. I know it is being considered by dozens and dozens of 
States.
  But in Texas I have seen the percentage, that over 60 percent of the 
health insurance policies in our State are issued under ERISA, under 
Federal law. So we can have the best laws we want to coming out of our 
State capitols all across the country, and I think the one in Texas is 
really revolutionary, so to speak, and I hope other States will follow 
this on those policies that are licensed by State law; but we have to 
pass something in Congress to affect Federal law, to affect those 
multi-State companies that have plans in the gentleman's district, in 
my district, and yet they come under Federal law.
  So we need to deal with the majority of the people. That is why 
Congress has to take up this standard and follow the lead of States 
like Texas. I know New Jersey is considering it also. I would hope that 
we would have that.
  That point needs to be made. It is not Congress meddling in States' 
rights, it is Congress learning from the success that we have had, at 
least in the State of Texas, and following through. Okay, it has worked 
in Texas. We have not seen breaking down the courthouse doors with all 
these lawsuits that have been threatened or at least threatened by the 
insurance companies.
  All it is is trying to manage the field, to make that pendulum come 
back a little bit so we talk about quality. We have to pass a Federal 
law to give our constituents, no matter who they work for, whether it 
is an in-State insurance policy or a multi-State, that same protection. 
Again, I thank the gentleman for bringing that up.
  Mrs. NAPOLITANO. Mr. Speaker, last Friday, Labor Secretary Alexis 
Herman and my colleague Xavier Becerra joined me for a rally and press 
conference at Los Angeles County+USC Medical Center to unveil the 
nationwide internet petition calling for a Patients' Bill of Rights.
  Based on the enthusiasm of the large crowd that morning, my guess is 
that this is going to be a popular petition across my State and our 
Nation.
  And there is good reason for it to be popular. The petition, at 
www.familiesusa.org calls for a meaningful Patients' Bill of Rights--A 
Patients' Bill of Rights that guarantees:
  access to specialists,
  choice of health coverage, by offering an alternative to HMO's of 
that is all an employer can provide.
  access to emergency care whenever and wherever it is needed,
  the right of patients to hold their HMO accountable,
  protection for providers who advocate for patients,
  and, access to approved clinical trials when no other treatment is 
available.
  The importance of guaranteeing these rights cannot be overstated. 
Passage of a meaningful Patients' Bill of Rights will save lives.
  Last Friday we heard the stories of two victims of HMO practices, 
Nick Enriquez and Serenity Silen. Both were children who deserved much 
better care than they received.
  The story of Serenity's father's battle with his HMO to save his 
daughter's life epitomizes why we need a meaningful Patients' Bill of 
Rights.
  Serenity was diagnosed with leukemia, but only after having been 
misdiagnosed four times because HMO's were not willing to pay for the 
cost of full medical diagnostic tests, such as a complete blood count.
  After about 2 months, Serenity's father had to take her out of his 
HMO's network to finally get a proper diagnosis.
  But it did not end there, when Serenity returned to the HMO for 
treatment, she received substandard care. At one point, when Serenity 
went into remission, she could have been given a bone-marrow transplant 
that would have increased her chances of survival. Instead, the HMO 
said a transplant procedure was ``expensive'' and only reserved as a 
last-ditch effort. But this delay jeopardized any future transplant, 
and fatally endangered Serenity's life.
  After an exhausting struggle with the HMO, Serenity's father found a 
hospital outside of the HMO network that could provide proper care for 
her. But it was too late. Because of their focus on cost instead of 
care, the HMO created a time delay that resulted in irreversible damage 
to Serenity's health and caused her premature death.
  We cannot let this type of practice continue. Health care decisions 
belong back in the hands of patients and doctors, not insurance company 
administrators who are only watching the bottom line.
  Serenity's father said it best. ``Children deserve to live.'' No 
child should ever have to go through what Serenity experienced.
  Let us, together, do something about this.
  Let us bring compassion back to health care.
  Let us put patients first.
  Let us pass a meaningful Patients' Bill of Rights.
  Mr. PALLONE. Mr. Speaker, the gentleman is absolutely right. What we 
need is comprehensive Federal reform, and the Patients' Bill of Rights 
is the best and the most comprehensive managed care bill before the 
Congress.
  I am just hopeful that with this electronic petition drive, that we 
will convince the Republican leadership and make them understand that 
they should not waste time, and they have to bring the Patients' Bill 
of Rights to the floor so we can pass it here, pass it in the Senate, 
and then send it on to the President, who indicated very strongly on 
Friday at our rally that he would sign this bill when it gets to his 
desk.

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