[Congressional Record Volume 145, Number 88 (Monday, June 21, 1999)]
[Senate]
[Pages S7373-S7377]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        PATIENTS' BILL OF RIGHTS

  Mr. DURBIN. Mr. President, thank you for the recognition, and I see 
the Senator from Rhode Island has joined me. I would like to address 
for a few moments an issue which, frankly, more than half of the people 
in America identify as something that worries them--a worry over your 
health insurance. How good is it?
  The rules being written by insurance companies now have you worried 
as to whether you can go to a doctor and get the kinds of treatment you 
really need for yourself, or your wife, your husband, or another member 
of your family. Can you go to the hospital of your choice if you have 
an emergency and need to go to the emergency room? Can you go to the 
hospital that is closest to where the accident occurred or to your 
home, or wherever? Does your insurance company say you have to go to 
another place? If you need a specialist--absolutely need one for your 
own medical care--can you expect, under your plan, to get that 
specialist, or do you expect to enter into a negotiation with your 
insurance company as to whether they will let you go to a certain 
specialist?
  When you doctor sits down with you in his office, when your heart is 
beating hard and you want to know what kind of treatment you need for 
that someone you love, are you sure that doctor is always telling you 
his best judgment based on years of medical training, or is he telling 
you what the insurance manual says he can tell you under the terms of 
his contract with the insurance company? If, God forbid, something goes 
wrong with a procedure, or something is done that ends up wrong, can 
you hold whoever is responsible accountable even if it was the 
insurance companies fault?
  These are basic questions that families across America are asking 
every day. In fact, a Rand study said that 115 million Americans either 
had a personal experience, or a member of their family or someone they 
knew had such an experience, with an insurance company that troubled 
them about whether or not they were being treated fairly.
  So the question before the Congress is: Can we try to bring some 
balance back to this situation so consumers and families across 
America, when they sign up for health insurance, have some assurance 
that they are going to get fair treatment, professional treatment, and 
quality care? It is pretty basic, isn't it?
  Can you think of another time in your life when you are more 
vulnerable than when you are sick, or when you have a baby you love in 
your arms and you say: Doctor, what does my baby need? Have you ever 
felt more helpless? I have been there! A lot of Americans have been 
there. You want to know, when that doctor looks in your eyes and says 
the best treatment for your little girl is the following surgery at the 
following hospital, that that is his best medical decision, not an 
insurance company decision.
  How can you hold people accountable in medical care when you have a 
situation under the law where you cannot take the insurance company 
into court to hold them responsible for their decisions? That, sadly, 
is the law today.
  So the law that we are hoping to debate on the floor of the Senate 
and the House called the Patients' Bill of Rights would try to rewrite 
this basic relationship, so that when you are dealing with your health 
insurance company, it is with more confidence that you are getting the 
best care, that you are getting honest answers from your doctor, that 
the recommendation coming to you for a member of your family or 
yourself is the best medical recommendation, not an insurance company 
recommendation.
  Now, this is an issue that is not new. We have had it around for a 
while. But for some reason, the leadership on the other side of the 
aisle does not want to debate this issue. They don't want us to talk 
about it. In fact, today there was an unrelated bill, the agriculture 
appropriations bill before the Senate. Byron Dorgan of North Dakota 
looked at the agriculture appropriations bill and offered the Patients' 
Bill of Rights as an amendment to it. What does that have to do with 
agriculture? Well, not much. People listening will say: Why did you do 
that? Well because he was, in desperation, trying to get this matter to 
the floor because, try as we might, leadership on the other side of the 
aisle does not want to debate this issue. They don't want Members of 
the Senate--Republicans or Democrats--to enter into a debate and have 
to face tough questions.

  How are you going to vote? If I am not mistaken, I accepted voting as 
part of my responsibilities as a Senator from Illinois. Isn't that why 
I am here--to debate issues and vote, to use my best judgment to try to 
improve the law so the people in my State and across the Nation are 
better off?
  One of the key questions here is: What do you do when an insurance 
company decides that they are not going to provide certain care to you? 
You have heard these cases. You have seen them in local hometown 
newspapers, on television, and on the radio where somebody says they 
need a certain treatment and the insurance company says no.
  What is next? Well, under the bill we have proposed on the Democratic 
side, we have a speedy independent appeals process. Well, it keeps you 
out of court and gets a decision made by somebody who may be objective. 
I think that is fair. That is what the Democratic bill proposes.
  The Republican bill, however, suggests that the insurance company 
should decide whether a denial is actually appealable and the insurer 
which has turned you down gets to pick somebody who will then decide 
whether the insurance company is right or wrong. And if you are 
injured, by their denial, you cannot sue. Sound fishy? It does to me. 
Basically, as far as I am concerned, the insurance company is 
insulating itself from ever making the right judgment.
  That is exactly the situation that we have today. It was recognized 
by one of the major newspapers in this country, USA Today. This article 
is from June 19 of last year. They called insurers the ``new 
untouchables''--people you can't sue--your HMO, managed care insurance 
policy.

       Bill Weaver, age 52, says his HMO misdiagnosed a brain 
     tumor for 2 years and told him his condition was inoperable 
     and hopeless.
       Jerry Cannon's wife Phyllis died from leukemia after her 
     HMO denied a bone marrow transplant her physician 
     recommended.
       Melody Louise Johnson died at the age of age 16 of cystic 
     fibrosis. Her mother says the HMO overruled the specialists.

  These are families from across America. Under the law as it is 
currently written, what recourse do these people have for the terrible 
outcomes dealing with insurance companies? Listen to this. They can go 
to Federal court and hire a lawyer and sue the insurance company. Do 
you know what they can recover? The cost of the procedure--the cost of 
the medical procedure. So if somebody dies, God forbid, you cannot 
recover for their death. If someone lingers and suffers literally for 
years because of a bad decision by the insurance company, they are not 
liable for that. If someone can't go back to work for 12, 24, or 36 
months, you cannot recover a penny for that. They are the

[[Page S7374]]

untouchables, the HMOs, the managed care insurance companies. They 
cannot be sued for anything other than the cost of the procedure.
  Well, I am sure, if you are listening to this, you think there must 
be a whole lot of companies in America which have similar treatment. 
No. This is the only group of companies in America that cannot be held 
accountable for their wrongdoing. How did it happen? Well, it happened 
right here. It happened right here many years ago when we passed 
something called ERISA, the Employee Retirement Insurance Security Act. 
This was a bill passed in 1974 that was supposed to protect workers. 
Instead, in recent years it has provided insurance companies with a 
legal shield. And 123 million Americans with their health insurance 
plans through their employer have nowhere to go when a bad result comes 
out of a bad insurance company decision. I think that is wrong.

  I don't think these insurance companies should be treated any 
differently from any other company, large or small, in America, or any 
other person, for that matter. If you are so reckless as to drink too 
much and get in your car and have an accident, can you be held 
accountable in America? You bet you can, and you should be. But if an 
insurer is reckless in making a decision about health insurance for 
somebody's daughter--if they make the wrong decision and they are 
maimed, crippled, or they die, can they be held accountable as an 
insurance company? Well, no, not really. That doesn't make sense, and 
it is not fair.
  Let me tell you about another case that really illustrates this very 
clearly. Carly Christy. These are the words of her father:

       Carly was nine years old when she was diagnosed with 
     malignant kidney cancer. When the HMO insisted that we trust 
     our daughter's delicate surgery to remove the cancerous tumor 
     from her kidney to a doctor with no experience in this area, 
     we were forced to find an expert and pay out of our pockets. 
     You only get one chance at removing a Wilm's tumor correctly 
     and successfully, to ensure the highest probability of 
     survival in children, and we weren't willing to take that 
     chance with our daughter's life because the HMO wanted to 
     save money.

  Her father Harry Christy says:

       Congress must close this loophole and hold health plans 
     accountable for cost-cutting decisions that result in patient 
     injury.

  Take a look at the two bills on the floor--the Patient's Bill of 
Rights, as they call them. How would they help Mr. Christy with his 
little daughter?
  Frankly, the Republican bill offers no recourse, no place to turn, 
because the HMO didn't deny treatment. In the Republican bill only 
outright denials are appealable, all quality issues are not appealable. 
In Carly's case the HMO just said you have to go to Dr. X who has never 
done this before. They were going to get treatment but not from the 
best doctor.
  If it is your daughter, don't you want the best and the brightest in 
America operating on her to try to save her life? If they said go to 
this other doctor who has never done this before on a surgery that is 
life and death, wouldn't that cause you some trouble?
  Harry Christy decided he and his wife were going to pay for this out 
of their pockets. I don't have to tell you what kind of money we are 
talking about. Average families literally put everything on the line--
their homes, savings, everything they can gather--for this care. That 
is how much they love this little girl and how much they think the 
insurance company made a big mistake.
  Under the Republican approach, that insurance company cannot be held 
accountable, because they said go ahead, go to a doctor who is 
inexperienced and if Carly had been injured by that insurance company's 
direction, the insurer would still have been immune from suit.
  The Democratic Patients' Bill of Rights says first you have a speedy 
external appeal, by someone not chosen by the insurance company, to 
decide whether the insurance company is right. If it turns out they are 
wrong, you can literally recover what it costs and the pain and 
suffering your family has gone through. If your daughter, for example, 
because of this mistake, has long-term problems, she can recover for 
that, too. I think that is sensible. I think it is reasonable.
  We have a chance with the Patients' Bill of Rights to do something 
for families across America--to finally bring this issue to the floor 
of the Senate. It is regretful that today when Senator Dorgan tried to 
bring this issue before the Senate, he was stopped. The Republican 
leadership was so determined not to debate this issue, they pulled this 
bill from the floor. They said we will not debate it.
  Of course, we are in evening business and Senator Reed of Rhode 
Island will follow me and discuss this as an issue whose time has come. 
This is an issue that affects literally all Americans. If we are going 
to make certain that we cover the millions of Americans who are 
concerned about their health care coverage, concerned about the quality 
of care, and concerned about their rights under the law, then we have 
to deal with reform that is meaningful.
  The Democratic Patients' Bill of Rights has the endorsement of 200 
professional organizations, including medical organizations, labor 
organizations, and consumer organizations. They have come forward and 
said this is the real deal here, the Democratic version is the real 
deal. The Republican bill has no support. Well actually they probably 
have the support of insurance companies, but it doesn't have the 
support of any health groups. I think this is about health and access 
to health care.
  We wrapped up last week a 5-day debate on protecting computer 
companies from being sued if they don't change their computers for this 
Y2K problem. The debate went on a long time. I think it was an 
important debate.
  If we can spend 5 days debating protecting computer companies, can't 
we spend 5 hours talking about protecting families across America, 
worried about health care coverage? Can't we bring for a vote on the 
Senate floor the very fundamental question as to whether or not the 
courthouse doors are closed when it comes to health insurance 
companies? Can't we suggest that in America--rich or poor, individual 
or business--we are all held accountable in court, all of us as 
American citizens, and that we shouldn't have the untouchables, the 
health insurance companies, who can't be brought into court?
  I hope this week we will take this issue up. I hope my colleagues on 
both sides of the aisle will understand the gravity of this issue and 
move forward.
  I yield the floor.
  Mr. REED. Mr. President, I rise today also to join my colleague from 
Illinois and to speak about an issue which is of great concern to the 
American people. That is the Patients' Bill of Rights.
  As is my colleague from Illinois, I am terribly frustrated. We are in 
the third week of June. Yet we have not been able to get this 
legislation to the floor for debate. Senator Dorgan today tried to do 
that, but he was frustrated.
  As Members go around this great country--and I will speak from my 
experience in Rhode Island--we talk to our constituents and there is a 
sense we have made progress on economic issues. The economy is doing 
better. People feel better about their jobs and about the future.
  If you speak with them for any length of time and ask them what 
really bothers them, they will quickly state they are afraid of getting 
sick. They are afraid, as a breadwinner, of becoming sick and not being 
able to get the care they need, even though they are in an insurance 
program. And they are particularly concerned about the health of their 
children.
  They have heard the stories and read the newspaper articles, as the 
Senator from Illinois pointed out, about the numerous people who have 
been paying for insurance or have been the beneficiaries of employer-
paid-for insurance. They have become ill, gone to their HMO thinking 
that at least they had insurance coverage, and they discovered they did 
not have it. They did not have it when it counted. They did not have it 
when they needed it, when they were ill or their children were ill.
  That is why we are advocating so strenuously bringing the Patients' 
Bill of Rights to the floor for debate.
  In March, I participated in the deliberations in the Senate Health 
Education Labor and Pensions Committee. We voted out a bill on partisan 
lines. It is not the bill I prefer. It is a bill that is deficient in 
many respects. However, it is the basis of debate, and it is the basis 
of the debate we should be having today on the floor of this Senate.

[[Page S7375]]

  There are two versions of this legislation. There is a Republican 
proposal and there is a Democratic proposal which my colleague from 
Illinois was talking about so eloquently. There are many differences. 
One of the most startling differences is that the Republican proposal 
covers a very small fraction of Americans. Not all Americans that have 
private health insurance are covered by HMOs. Under the Republican 
bill, a lucky 48 million Americans would have some protections.
  Ask yourself, if these protections are appropriate for 48 million 
Americans, why aren't they appropriate for every American who is part 
of the managed care health plan? I think the answer is quite clear: The 
Republican version is more sham than substance; more window dressing 
than a valiant, serious attempt to address the concerns of every 
American.
  That is unfortunate. Why should there be one person who is lucky 
enough to fall within a narrow category that is covered by the 
Republican plan--that person having access to quality care, that person 
having certain appeal rights--yet his neighbor, who is also covered by 
an HMO plan but one that is funded slightly differently is without 
these protections? There is absolutely no logic to this. The Democratic 
proposal would cover all Americans who are in these private HMO plans. 
It would do so in a way that ensures people are getting what they paid 
for.
  That is the other irony in this whole debate. We are not talking 
about a program which, through the generosity of the government or the 
generosity of someone else, people are getting some health care from 
insurance companies and they are deciding they shouldn't get X or they 
shouldn't get Y. These health insurance companies are being paid 
significant premiums by individuals and their employers for coverage. 
Yet the coverage is not being provided in so many cases.
  I am particularly concerned that this narrow scope is extremely 
detrimental to the children of this country.
  Only about a third of the children in these managed health care plans 
would be protected by the Republican program. I ask, very sincerely, 
why can't we at least cover every child in America? Is that too much to 
ask? I think not. I believe every American would recognize the need to 
do that.
  Now, managed care has provided benefits for children in this country. 
Their emphasis on preventive care, their emphasis on immunizations are 
all very good. But, frankly, I have a distinct impression a lot of what 
they are calling coverage for kids amounts to taking the premiums but 
not providing the service.
  I had the occasion to meet with a physician from California, from the 
University of California at Los Angeles, who has a very innovative 
program. In this program, he goes from school to school with a van to 
cover children who have asthma. It is very effective because not only 
does he diagnose the children and then treat them and then follow them 
up, which is critical, but he also looks at the statistics.
  He was able to essentially categorize all his patients into three 
groups: Those with private HMO insurance, those with California 
Medicaid insurance for low-income children, and those children without 
any coverage at all. What was startling to me was that when he looked 
at these different populations, he found essentially these kids got the 
same coverage, regardless of their category of insurance. All they 
really got was an emergency room visit, and when they saw the doctor 
because they had a terrible asthma episode, they were given, in the 
emergency room, a little paper bag with an inhaler and a few bits of 
medicine and then they were sent home--those without insurance, those 
with Medicaid insurance, and those in managed care plans for which an 
employer was paying a great deal of money.
  That just goes to show we really have to do a great deal more to 
ensure that children get the benefit of the health insurance plan they 
are supposed to be part of. Then we have to ensure that all of our 
citizens who participate in these plans get fair and adequate coverage. 
That is at the heart of the Democratic Patients' Bill of Rights, 
ensuring that all of our citizens who are in these managed care plans 
get access to quality coverage at affordable prices.
  I would like, for a moment, to concentrate on children in these 
plans, because, as I said before, this is a special concern of mine. I 
think, at a minimum, we can emerge from this Congress with legislation 
that guarantees every child in America access to quality health care, 
provisions in their managed care plans that make sure children are 
treated and treated well.
  Senator Durbin was talking about a parent whose child had a rare 
cancer. The HMO said: Yes, your daughter is quite ill, perhaps 
terminally ill. We will send her for treatments, not to a pediatric 
oncologist or a pediatric surgeon, someone who specializes not only in 
cancer but pediatric cancers, we are just going to send her to a 
surgeon. Those parents had to pay out of their own pocket, presumably, 
to get the right kind of care for their child.
  In the Democratic bill, there would be a guarantee that a child would 
have access to a pediatric specialist and pediatric services, because 
children are not just small adults. They have specialized health care 
needs that are very different from those of adults. But too often in 
managed care plans throughout this country they are simply treated as 
small adults, if they are treated in particular at all.
  There are some other things we have to have for children in these 
plans, particularly for children. We have to have expedited review, not 
only if their life is in jeopardy but also their development because 
this is another difference between an adult and a child. Adults are 
usually fully developed. Children are not. There are conditions which 
might not be life threatening but certainly threaten their development, 
both physical and intellectual. In those situations there have to be 
expedited appeals. Then we have to have the continuity of care for 
chronically ill or terminally ill children.
  We also have to recognize the information parents get when they make 
a choice about their health care plans should include specific 
information about how that plan treats children. Too often such 
information does not exist. Too often it is all done in terms of adult 
outcomes, adult studies. Unless parents have this information, 
sometimes the only time they realize how well their child is covered is 
when they discover their child is not covered well at all because he or 
she is deathly ill and is not getting the kind of care he or she needs 
or deserves.
  I am encouraged because Senator Bond has introduced a bill entitled 
``Healthy Kids 2000,'' which includes access to pediatric specialists 
similar to that in my legislation. Also, Senator Chafee has introduced 
a managed care bill, which also talks about access to pediatric 
specialists. So I hope there is an emerging consensus across the aisle 
that we have to do more for children in managed care.
  But let me say again, the Democratic bill strongly and emphatically 
defines the special rights of children in managed care. We have 
actually taken surveys and asked the American people, regarding access 
to care for children, what do they want; what do they demand. They want 
high-quality care. They want access to specialists. They want to be 
able to protect the development of children. They want to have 
expedited reviews when children's development or lives are threatened. 
And they are willing to pay for these provisions. What we found in too 
many managed care plans is that these types of protections just do not 
exist.
  In 1992, there was a study done of pediatricians. They found there 
were significant barriers to pediatric referrals in the managed care 
system, that pediatricians in the managed care system often encounter 
barriers to referring their patients to pediatric specialists. Of these 
pediatricians who were surveyed, 35 percent believed their patient's 
health was compromised because of the denial of access to pediatric 
specialists. This is a real problem, and it is a problem the Democratic 
proposal resolves.
  The PRESIDING OFFICER. The 10 minutes allotted for morning business 
for each Senator has expired.
  Mr. REED. Mr. President, I ask unanimous consent for an additional 2 
minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.

[[Page S7376]]


  Mr. REED. As I mentioned, these provisions that would help protect 
children are provisions which the American people want and the American 
people will pay for. They are provisions that are at the heart of the 
Democratic Patients' Bill of Rights. I think it is time to move. It is 
time to move forward on a debate about this critical issue, an issue 
that affects every family in this country. It is an issue that is 
critical to their well-being. It is an issue, frankly, that they sent 
us here to work on, to debate and to vote on. Difficult votes they may 
be, but they sent us here to take these votes.
  So I urge my colleagues to join together to begin the debate, to 
reach a conclusion, and to do something the American people want us to 
do--give them the opportunity to protect their health and the health of 
their families.
  I yield the remainder of my time.
  Mr. SCHUMER addressed the Chair.
  The PRESIDING OFFICER. The Senator from New York.
  Mr. SCHUMER. Mr. President, I ask unanimous consent to address the 
body for 10 minutes, under morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. SCHUMER. Mr. President, first, I compliment my colleague, the 
Senator from Rhode Island, for what he had to say today. He is exactly 
right about one of the problems we face these days with HMOs; that is, 
that many types of children's health are neglected.
  Just today I was in both Rochester and Syracuse, back in my State, 
New York, meeting with doctors and patients and health care providers 
about the problems they face in the health care area. What I found over 
and over was this problem that we are talking about that would be 
rectified by the Patients' Bill of Rights, as the Senator from Rhode 
Island correctly pointed out.

  I had a doctor in Syracuse, just this afternoon, maybe 3 hours ago, 
mention to me that one of her patients needed a pediatric oncologist, 
but the family's HMO would only allow an oncologist, not a pediatric 
oncologist.
  They had the procedure done--it was not done correctly--four times, 
and only on the fifth time did the HMO relent and allow the pediatric 
oncologist do the job. Then it was done and, thank God, successfully.
  The amazing thing about this is this would have saved money had they 
relied on the judgment of this doctor and used a pediatric oncologist 
right at the beginning. Then very simply the HMO would have saved 
money, the child would be healthier, and everyone would be happier.
  When many people ask, what is the problem with HMOs--and there are 
many and they have been documented by my friend from Illinois and my 
friend from Rhode Island--one of the things I am beginning to learn is 
that when HMOs come in, they try a cookie-cutter approach. They say one 
size fits all.
  In Rochester this morning, a young man told me this story: His wife 
needed a very special type of medicine because she was receiving 
treatment, I think it was for cancer. In any case, her immune system 
was down. She needed these drugs to help build up her immune system. 
These drugs are lifesaving. They are very precise. In other words, one 
has to measure the level in the blood before determining how much of 
another dose is needed. They are expensive--hundreds and hundreds of 
dollars a week--and they have to be taken at exactly the right time. If 
a dosage is missed, say, at 8 o'clock in the morning, you could acquire 
an illness that could kill you because your immune system is deficient.
  Everything was going fine. This young man said that he and his wife 
had no problems with their HMO through their travail of her illness, 
until the HMO decided that all prescriptions should come through a 
mail-order house in Texas. He has gone through an enormous amount of 
trouble.
  First of all, his wife has to have her blood taken and measured in 
Rochester and then communicate all the time with the facility in Texas. 
Second, sometimes the medicines do not arrive, and when they arrive 
late, if her blood level is different, they cannot be used.
  Every week this young man and his wife are shelling out hundreds of 
dollars because the HMO is insisting for this particular drug, a rare 
drug, a special drug and one that requires a great deal of care before 
it is administered, that they have to get it through this mail-order 
pharmacy.
  He said to me: If we had diabetes, and if the mail-order house was 
sending us the insulin, it would be just fine, because in those 
instances, it is a set dose of insulin and they could send a whole 
bunch.
  When they ran out, they could send a whole new bunch. They could send 
copayments. He said making them go through this mail-order house for 
the immune drug made no sense.
  Today, as I went through the day and listened to people, I found that 
happens all the time. Yes, in most cases, a pediatrician or a pediatric 
surgeon might do the job, but in certain cases an oncologist is needed. 
Who knows that? Certainly not the actuary sitting in the insurance 
company's home office who is now making the decision. The person who 
knows that, of course, is the physician or the nurse who has spent 
long, long years studying it and has had many years of experience in 
figuring this out.
  The problem we face and the problem we are trying to rectify with the 
Patients' Bill of Rights is to deal with many of these situations, to 
deal with the fact that medicine is not a cookie-cutter enterprise, 
that one size does not fit all, as much as a corporate mentality might 
like to see that happen in the name of saving dollars. In reality, in 
most cases, you lose dollars. Certainly the amount of dollars paid into 
the health care system is increased, not decreased by these mistakes, 
which are often very costly.
  The more I listen to my constituency throughout my State, from one 
end of the State to the other, the more I have come to the conclusion 
that we really do need this Patients' Bill of Rights. Today, we were 
debating State Department authorization which is obviously important. 
We have to deal with diplomacy. We have many other bills before us. But 
I cannot think of one that seems to have the urgency and importance to 
my constituents that this Patients' Bill of Rights does. I hope we can 
move quickly and bring the bill to the floor.
  There are two sides to this argument, as there are to most serious 
issues. I am hopeful the Patients' Bill of Rights that I have 
cosponsored and that Senator Kennedy has introduced will be the one 
that is passed. I join my colleagues, Senator Durbin from Illinois and 
Senator Reed from Rhode Island, in hoping that will happen. At the very 
least, we are entitled to debate the issue.
  This is such an important issue that we should debate it, and it is 
in the tradition of the Senate that when an important issue is facing 
us, we do not just say: Let's lickety dispose of it; you vote your 
bill, we will vote our bill, and that is that.

  We are trying to come to the best possible product and coming to the 
best possible product entails a significant amount of debate. Is it 
worth the time? Ask the pediatrician in Syracuse if it would have been 
worth the time. The amount of time and energy that she and the family 
she looked after far exceeded 4 or 5 days of debate. Ask the young man 
in Rochester who is having such trouble with his HMO using this 
pharmaceutical house. The amount of time and energy that that one 
family is going through will exceed the amount of time we spend on this 
debate. Of course, that is happening every day to tens of thousands, 
perhaps hundreds of thousands, maybe even millions, of American 
families. The argument that we do not have time to debate this issue, 
that we ought to just dispose of it and get rid of it, does not make 
much sense.
  In conclusion, I am joining my colleagues this evening and, I 
believe, many of my constituents in asking that once and for all we 
stop delay. It is already the end of June. We only have 6 or 7 weeks 
left on the legislative calendar, and we should debate the Patients' 
Bill of Rights. We must let people decide what should be the HMOs' 
responsibility in terms of specialists, in terms of appeal, in terms of 
emergency rooms, in terms of the ability to be sued, and then I believe 
we will come up with a pretty good product. This issue is of grave 
importance to many families. It will become of even greater importance 
to many others.
  I make a further plea to the majority leader in this body, someone 
for whom

[[Page S7377]]

I have a great deal of respect--and I know he has the best interests of 
the people at heart--and that is that we, as soon as we can, hopefully 
before the July 4 break, have a full-fledged, open debate on the 
Patients' Bill of Rights. It is my judgment, and I think the judgment 
of many, that there will be enough support in this body to pass a bill 
and end the pain and agony and suffering of so many American families.

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