[Congressional Record Volume 145, Number 99 (Wednesday, July 14, 1999)]
[Senate]
[Pages S8427-S8428]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        PATIENTS' BILL OF RIGHTS

  Mr. REED. Mr. President, I will discuss several issues that are 
central to the debate we are having on managed care in the Patients' 
Bill of Rights.
  First, I was very disappointed that the Senate rejected Senator 
Kennedy's amendment which would have extended the protections of the 
Patients' Bill of Rights to all privately insured Americans. Those in 
favor of much more limited coverage, very much restricted coverage, 
argue that the cost in the Democratic alternative would cause many 
Americans to lose their health insurance through increased premiums. 
They argue, as we have heard time and time again, that premiums would 
rise and that employers would drop coverage.
  When you actually talk to many employers, particularly those in small 
businesses who are represented by the American Small Business Alliance, 
for example, they tell quite a different story. They talk about a 
situation in which they have already seen premiums rise, but they get 
very little for what they pay for.
  For example, Mr. Brian McCarthy, President of McCarthy Flowers and 
Cabs, from Scranton, PA, had this to say. His words:

       Workers who spend time out sick or are consumed in battles 
     with their health plan wreak havoc on the bottom line. That 
     lost productivity costs my business a lot more than the 
     modest premium increases that may result from this 
     legislation.

  He went on to add:

       The Patients' Bill of Rights is about giving people the 
     care they need and deserve, and it clearly gives small 
     businesses a better deal for their health care dollar.

  That is not the voice of a Senator, but of a small businessperson who 
has seen the effects of managed care on his own bottom line.
  Another small business owner, Mr. Tom Reed, who owns Lake Motors in 
Eagle Lake, TX, said:

       My premiums go up now and I get nothing, or sometimes even 
     less coverage. The Patients' Bill of Rights at least will 
     give me something tangible, bringing me better value for the 
     health care money I spend.

  Those are the words of businesspeople who are struggling with the 
issues. They are in favor of this legislation because they want to get 
what they have been paying a lot for, and that is quality health care. 
They will only get that with the Democratic Patients' Bill of Rights.
  There have been studies that have supported these anecdotal comments. 
The Kaiser-Harvard Program on Health Policy surveyed small business 
executives from the small business sector, and they found that 88 
percent support independent appeals such as those that are in the 
Democratic alternative; 75 percent support the right to see a 
specialist without prior approval; 61 percent favor giving people the 
right to sue their health plan; and fewer than 1 percent suggested that 
they might drop coverage if rates increased.
  These are small business executives. This is compelling and 
persuasive evidence that, in order to be responsive to the needs of 
small businesses throughout the country, it is imperative that we pass 
the Democratic alternative.
  There is another aspect of this legislation which deserves 
discussion, and that is the fact that health care plans, HMOs, are 
immune from liability because of what is apparently a loophole in the 
ERISA law.
  A physician can be sued for malpractice, a physician can be sued for 
making misjudgments, but an insurance company, often working through 
nonphysicians, administrators, and reviewers, are immune from such 
suits.
  This aspect of accountability is critical to making sure that we have 
rights that are enforceable and that actually produce tangible results 
throughout the country.

  In another survey, the Kaiser Family Foundation found that 73 percent 
of those surveyed believe that patients should be able to hold their 
managed care plans accountable through the courts.
  This is not to suggest that anyone is encouraging a mass exodus to 
the courthouse. In fact, there is quite a bit of experience that 
suggests this probably will not happen.
  In Texas, in May of 1997, bipartisan legislation was passed making it 
the first State where managed care organizations can be sued for 
medical malpractice. Like the Democratic plan, the Texas liability law 
is closely tied to tough, independent external review processes. In 
fact, you cannot take advantage of the right to sue until you have been 
through this independent review process.
  Despite all the warnings about a flurry of lawsuits--the same thing 
we are hearing today--this has not been the experience in Texas. 
Neither has the State experienced increased premiums. What has happened 
is that both sides now are claiming success. HMOs are saying: Look, 
this is working. And consumers are saying: This is helping us out. In 
fact, according to Texas State Senator David Sibley----
  The PRESIDING OFFICER. The time has expired.
  Mr. REED. I ask unanimous consent for an additional minute
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. REED. I thank the Chair.
  According to one of the sponsors, Texas State Senator David Sibley, 
who is Republican, in his words, stated:

       [T]he Texas experience has been very positive. . . . Both 
     sides are claiming victory: the HMOs are saying ``see how 
     well it works; people aren't filing many reviews.'' The 
     consumer groups are saying that HMOs are being more 
     responsive and are looking more carefully at the needs of 
     patients before they deny claims.

  Mr. REID. Will the Senator yield?
  Mr. REED. Yes.
  Mr. REID. Is the Senator aware that George W. Bush, Governor of the 
State

[[Page S8428]]

of Texas, vetoed the initial HMO bill in the State of Texas?
  Mr. REED. I was not aware of that. But I think experience is showing 
that it would have been an error because the law is working very well. 
We have a rare historic opportunity to do something to help the 
American people. It has been done already by the great State of Texas 
in many respects, but we can do much more, and we shall do much better. 
I would like to see the same type of protections that are available to 
the good people of Texas afforded to everyone in this great country.
  I thank the Chair and yield the floor.
  The PRESIDING OFFICER. Under the previous order, the Senator from 
Wisconsin, Mr. Feingold, is recognized to speak up to 10 minutes.

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