[Congressional Record Volume 145, Number 135 (Thursday, October 7, 1999)]
[House]
[Pages H9520-H9521]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




      LOOK TO TEXAS FOR EXAMPLE OF MEANINGFUL MANAGED CARE REFORM

  (Mr. GREEN of Texas asked and was given permission to address the 
House for 1 minute and to revise and extend his remarks.)
  Mr. GREEN of Texas. Madam Speaker, my colleague from Arizona needs to 
come to Texas, and we will show him what has happened in the real world 
when we have really had a Patients' Bill of Rights and real effective 
reform.
  We do not have a lot of lawsuits. In 2 years, in fact we have had 
three, maybe four.

[[Page H9521]]

                              {time}  1030

  What we have seen, though, is the external appeals process backed up 
with the right to go to the courthouse means that they settle those 
appeals.
  In Texas, we are finding that over 50 percent of the appeals are 
being found in the patient's favor. In other words, the decision-maker, 
the insurance company, whoever made that decision was wrong over 50 
percent of the time. And that is what is wrong with the current system.
  I do not want lawyers to get rich. They want health care. The people 
want health care. That is what they are doing. And in Texas, with 2 
years' experience, that is what is happening, strong external appeals 
backed up with a judicial review that they do not want to go to neither 
the insurance companies nor the patients.
  We have that in the Norwood/Dingell bill, and that is why it is so 
important. Medical necessity, external appeals, access to specialists, 
emergency care, but also backed up with an accountability system.
  If Wal-Mart can be sued for a slip-and-fall in State courts, why 
should their employees not be able to go to State courts?

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