[Congressional Record Volume 145, Number 88 (Monday, June 21, 1999)]
[Senate]
[Pages S7290-S7292]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        PATIENTS' BILL OF RIGHTS

  Mr. KENNEDY. Mr. President, I will address the Senate this morning on 
a subject which I believe needs attention in the Senate and also needs 
action by this body, and that issue is the legislation called the 
Patients' Bill of Rights.
  The Patients' Bill of Rights is legislation which has been before the 
Senate for some 2 years. It is a rather simple bill. It is 
understandable. It is a rather commonsense bill. That is, we are, with 
this legislation, going to give assurances to the American people when 
they purchase insurance, that the medical profession, the doctors and 
the patients themselves, are going to make decisions related to the 
health care which affects them, rather than the accountants or 
insurance agents.
  Basically, that is what this legislation is about. There are a number 
of guarantees and protections included in the Patients' Bill of Rights, 
which I have addressed on other occasions and which I, again, will 
mention this morning.
  Every day we fail to take action on this legislation, we see what has 
happened in this country over the last 2 years; the patients suffer, 
while our Republican leadership refuses to schedule this particular 
legislation.

  During the 2 years that we have been blocked, effectively, from a 
Patients' Bill of Rights, HMO abuses have caused some 33 million 
patients difficulty in getting specialty referrals, delayed needed 
medical care for some 33 million patients, forced some 23 million 
patients to change their doctors, forced 14 million patients to change 
medications, denied payments for emergency services to 11 million 
patients--those are patients who use the emergency room, who felt they 
had a medical emergency but were denied the coverage from their HMO and 
had to pay for it out of their own pocket--and caused unnecessary 
suffering and financial loss and frustration for millions more.

[[Page S7291]]

  Over these last days, as we did last year, we have pointed out not 
only numbers but also in real terms what is happening to families all 
across this country. For those supporting a Patients' Bill of Rights, 
which is the legislation introduced by Senator Daschle, he has stated--
and others who support it have stated--that we are ready, willing and 
able to enter into time agreements, but we want to have this measure 
scheduled. We ought to be able to permit the Senate to vote on these 
measures. They are enormously important, as we have been reminded in 
the past days by my colleagues and others.
  We spent 5 days on legislation protecting various computer companies 
in this country from the potential of a Y2K glitch. We believe that we 
would not even need that amount of time to debate legislation that will 
provide protections for families, for parents, for loved ones, for 
husbands and wives, and particularly for children. We make the case--I 
do today--that it is time for the Congress to act to protect the 
patients against the abuses of managed care.
  Patients and doctors should make the medical decisions, not the 
insurance company accountants. Too often, managed care is mismanaged 
care. Members of the Senate know it. Doctors, nurses and other health 
care professionals know it. The American people know it. It is time for 
the Republican leadership to stop protecting the insurance company 
profits and start protecting patients.
  I point out that we have more than 200 organizations that support our 
legislation. It isn't that we just want to advance some proposal that 
has been assembled by the members of our party; there are those in the 
other party, including Dr. Ganske, a doctor who is a Republican, and 
others who support our proposal. But more than 200 organizations 
representing the medical profession--the nurses, the doctors, the 
consumers, those who have studied this program--favor our proposal. 
There isn't one--not one--we are still waiting to hear just one medical 
professional group that supports the Republican proposal.
  We are prepared to debate. But the American people, and those who are 
involved in the health care delivery system, those who are involved in 
research, those who are involved in protecting children, those who are 
involved in protecting women, those who are involved in protecting the 
disabled, those who are at the cutting edge in advancing research, 
understand the importance of this debate, this discussion, and votes 
here in the Senate.
  We think it is time that we get to the business of the families of 
this country by moving ahead and starting to have this measure before 
us. We have reviewed the proposal made by the Republican leadership. We 
are now 2 weeks before the July break. We believe we can handle this 
legislation prior to that period of time. We want this matter 
scheduled. We want to be able to move toward this debate.
  I remember the comments that have been made in recent times by the 
Republican leadership: Well, we need to have a certain number of 
amendments. We can have two amendments, three amendments, four 
amendments, but we are not going to permit this matter to be brought 
before the Senate unless we have a prior agreement for three or four 
amendments.

  That was last year, and we are again being denied the opportunity to 
debate this legislation even though we had before the Senate, just a 
very few weeks ago, the juvenile justice bill. There was no limitation 
on the number of amendments at that time. We had many contested 
amendments during that debate on the issue of gun control. We had a 
series of amendments, but nonetheless we had action on that 
legislation. We debated it, and then we brought that measure to a 
close. We did it in the longstanding, 200-year tradition of the Senate. 
We believe that on a matter which is of fundamental importance and 
significance to families that we ought to follow that procedure and 
that we ought to move ahead on this legislation at this time.
  During the past year and a half, the Republican leadership has 
effectively used every trick in the book to delay or deny action on 
this issue. It is no secret what is going on. Stonewalling tactics have 
stalled consideration of this legislation for more than a year.
  It was just over a year ago, on June 18, 1998 that Senator Lott 
proposed to bring up the bill on terms that made a mockery of the 
legislative process. That proposal would have allowed the Senate to 
proceed to HMO reform but permitted the majority leader to pull the 
bill down at any time. The agreement also barred the Senate from 
considering any other health care legislation for the rest of the year.
  Do we understand--do the American people understand what was being 
proposed for debate in the consideration of a Patients' Bill of Rights? 
The majority leader said: Well, I'll bring it up, but I'll be able to 
pull it down if I want. And if we bring it up, we have to have the 
assurance that no other legislation dealing with health care would be 
permitted on the floor of the Senate. That was the proposal a year ago. 
Obviously, we were not willing to agree to that proposal because that 
was completely in conflict with the public's interest for debate and 
discussion about these matters.
  On June 23 of last year, 43 Democratic Members wrote to Senator Lott 
to urge that he allow a debate and votes on the merits of the Patients' 
Bill of Rights. We requested that the Senate address the issue before 
the August recess. The response, on June 24 of last year, almost a year 
ago, was that Senator Lott simply repeated his earlier unacceptable 
offer.
  Then on June 25 a year ago, Senator Daschle proposed an agreement in 
which Senator Lott would bring up the Republican bill by July 6 so that 
Senate Daschle could offer the Democratic Patients' Bill of Rights, and 
the Senate could offer relevant amendments to HMO reform.
  The Democratic leader had indicated that every amendment would be 
relevant to the proposal, that there would be only relevant amendments 
to the Patients' Bill of Rights. Yes, that was rejected as well.
  The next day, on June 26, the majority leader offered a proposal, 
once again, that allowed him to withdraw the legislation at any time 
and bar consideration of any other health care legislation. That was on 
June 26. That is twice they did it almost a year ago, and we are no to 
a debate.
  It goes on.
  On July 15, 1998, he made another offer. This time he proposed an 
agreement that allowed for no amendments. He would bring up his bill, 
we could bring up ours, and that is it--all or nothing. The American 
people would be denied votes on key issues, denied key protections, 
too.
  On July 29 and on September 1, the Republican leader offered 
variations of the proposal.
  I could go on--and will--but it is just an indication of how long and 
how hard we have been trying to get this matter before the Senate in 
order to be able to try and vote on this.

  Many Members of this body say: Well, we know it is not being called 
up because of various interests and interest groups. But let me just 
remind the Senate what has happened. See if they are somewhat troubled 
by it when we talk about interest and interest groups.
  Not long ago, Mr. Gradison, who is the former head of the Health 
Insurance Association of America, was asked in an interview published 
in the Rocky Mountain News, to sum up the strategy of the special 
interests that are committed to blocking meaningful reform on the 
Patients' Bill of Rights. Acording to the article, Mr. Gradison 
replied, ``There's a lot to be said for `just say no.' ''
  The author of the article goes on to report: At a strategy session 
called by a top aide to Senator Don Nickles, Gradison advised 
Republicans to avoid taking public positions that could draw fire 
during the election campaign. Instead of participating in a productive 
debate on how best to assure that all patients have the protections 
currently afforded only to those fortunate enough to be in the best 
plans, such as Members of the United States Congress and the Senate, 
insurance companies and their allies in the business community have 
heeded the call of the Republican leadership. The leadership aide, 
acting on the behalf of Senator Lott, urged the industry in 1997 to get 
off their butts and get off their wallets and block reform. The 
Republican leadership directed these special interest friends to write 
the definitive paper

[[Page S7292]]

trashing all these bills, and they have responded accordingly, pouring 
tens of millions of dollars into paid advertising, ginned-up studies, 
and lobbying campaign coffers of those who are willing to stand in the 
way of the much-needed change. Over $100 million has been spent in 
distortion and misrepresentation on this legislation, Mr. President. 
The interesting thing is, even with $100 million spent, if you take the 
various studies and reviews out there, not just the case studies which 
come to our offices every day, but any of the measurements that are 
being taken out there about people's concerns, you find that it really 
hasn't impacted families in this country. They know what is happening 
every single day, and they know the kinds of protections they need. 
They know the importance of this legislation.

  What are we basically talking about in terms of these commonsense 
rights?
  How much time do I have remaining?
  The ACTING PRESIDENT pro tempore. The Senator has 1 minute 12 seconds 
remaining.
  Mr. KENNEDY. These are the commonsense rights: The right to a 
specialist, if you have a condition serious enough to require specialty 
care--no parent should be told that his child, with a rare cancer, will 
be treated by an HMO adult oncologist when the physician lacks the 
expertise needed to save the child--the right to prescription medicines 
that your doctor knows best that you need; the right to go to the 
nearest emergency room without financial penalty; the right to 
participate in clinical trials--that is so important with the whole 
range of new breakthrough drugs--the right to continue care if you are 
in the middle of a course of treatment and your doctor is dropped from 
a network or your employer changes insurance plans; the right to a 
speedy and fair, truly independent appeal; and the right to hold your 
plan accountable in court. These protections and the others are simply 
common sense. We believe we ought to have an opportunity to debate 
those and to offer those measures in the Senate.
  I am very hopeful that we are going to be able to get this matter 
scheduled. It is a matter of enormous importance. We have seen reported 
out of our Health, Education, Labor and Pensions Committee legislation 
that has been favored by our Republican friends. Let's have that 
legislation before the Senate, with the time and opportunity to cover 
those matters, and let the Senate express its will. I am convinced that 
we will act to protect the families of America.
  The ACTING PRESIDENT pro tempore. The time of the Senator has 
expired.
  The distinguished Senator from Minnesota is recognized.
  (The remarks of Senator Grams pertaining to the introduction of S. 
1247 and S. 1245 are located in today's Record under ``Statements on 
Introduced Bills and Joint Resolutions.'')
  Mr. LEVIN addressed the Chair.
  The PRESIDING OFFICER. The distinguished Senator from Michigan.
  Mr. LEVIN. Mr. President, I yield to the Senator from Massachusetts.
  The PRESIDING OFFICER. The Senator is Massachusetts is recognized.
  Mr. KENNEDY. Mr. President, three years ago, the entire Nation 
watched in horror and disbelief as an epidemic of church arsons gripped 
the South. The wave of arsons was primarily directed at African-
American churches and it was a reminder of some of the darkest periods 
in our history--when African-Americans were the constant targets of 
violence by cowardly racists. In response to this epidemic, Congress, 
with overwhelming bipartisan support, passed the Church Arson 
Prevention Act. We recognized that all Americans--Democrats and 
Republicans, men and women, whites and nonwhites, Jews, Catholics, 
Protestants, and Muslims--deserve to be free from these vicious hate 
crimes.
  Unfortunately, this kind of bigotry has raised its ugly head again, 
in the form of the despicable arson attacks on the synagogues in 
Sacramento, California last Friday. Houses of worship have a special 
place in our society, and when they are attacked, the devastation is 
far-reaching. The B'nai Israel synagogue is the oldest synagogue west 
of the Mississippi River. In the charred remains of its library were 
over 5,000 books, some hundreds of years old and many out of print.
  Since passage of the Church Arson Prevention Act in 1996, the FBI and 
ATF have documented over 600 cases of church arson. With the passage of 
that legislation, the Justice Department was given the tools it needs 
to apprehend and prosecute the individuals responsible for these 
deplorable acts, and to deal with such hate crimes more effectively.
  All of us look forward to swift action to bring those responsible for 
these shameful attacks to justice. Although the parishioners at B'nai 
Israel, Congregation Beth Shalom, and Knesset Israel Torah Center may 
have lost the use of their synagogues for a time, their spirit and 
strength in the face of their loss are an inspiration to the entire 
country.
  Congress needs to bring the same vigorous bipartisan attention to 
other kinds of hate crimes.
  Few crimes tear more deeply at the fabric of our society than hate 
crimes. These despicable acts injure the victim, the community, and the 
nation itself.
  We have acted to deal with arson attacks on places of worships, and 
we need to take similar action to deal with other hate crimes.
  We need to give the federal government more effective tools to 
investigate and prosecute these contemptible acts. In March, many of us 
joined in introducing S. 622, the Hate Crimes Prevention Act of 1999. 
This bill has the support of the Department of Justice, constitutional 
scholars, law enforcement officials, and many organizations with a long 
and distinguished history of involvement in combating hate crimes. The 
goal of the Hate Crimes Prevention Act is to provide federal 
investigators and prosecutors the tools they need to fight these 
senseless and violent acts.
  Congress' silence on this basic issue has been deafening, and it is 
unacceptable. We must stop acting like we don't care--that somehow this 
fundamental issue is just a state and local problem. It isn't. It's a 
national problem, and for too long, Congress has been AWOL. We must 
act, and we must act now, to make the federal government a full partner 
in the ongoing battle against hate crimes in all their ugly forms.
  Mr. LEVIN addressed the Chair.
  The PRESIDING OFFICER. The distinguished Senator from Michigan is 
recognized.

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