[Congressional Record Volume 145, Number 158 (Wednesday, November 10, 1999)]
[Senate]
[Page S14584]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           UNITED HEALTHCARE

 Mr. GRAMS. Mr. President, I rise to express my support and 
appreciation regarding actions taken at United Healthcare that clearly 
demonstrate to me that proposed congressional action in the area 
referred to as ``patient's rights'' can be best handled by the 
marketplace.
  Yesterday, United Healthcare announced they will be changing the way 
they manage care in their health plans by giving physicians the final 
say in determining what course of treatment their patients will 
receive. In citing the reasons for the change of policy, United noted 
the savings resulting from their $100 million review process do not 
justify continuing it.
  United Healthcare is the second-largest health insurer in the nation 
and I believe their actions signal an industrywide realization that 
their review process may be saving them less than they thought.
  According to United Healthcare, 99 percent of their claims are 
approved despite an exhaustive review process. While this raises the 
question of exactly why the federal government needs to disrupt the 
entire health system by getting involved with one percent of health 
care claims, it also demonstrates our current private-sector health 
care providers must respond to consumer concerns or lose their 
customers to health providers that do.
  Of course, United Healthcare will still have some review process and 
require physicians to notify them when a patient needs an expensive 
procedure or requires hospitalization. This is clear in all of our 
interests to ensure the appropriate treatments are considered. We 
should trust our physicians, but with the rapid advancements made in 
health care every day it is reasonable for us to have a team of experts 
review all the latest treatments, devices and pharmaceuticals. Clearly, 
this is an area where health plans are, and should be assisting 
physicians and ensuring quality health services are offered 
appropriately in their facilities.
  By changing their review process, United Healthcare will reduce its 
medical monitoring staff by 20 percent and re-focus the remaining staff 
on Care Coordination efforts.
  This saves money for the plan which in turn saves money for consumers 
through lower premiums. I believe it is a significant step in the right 
direction, proving once again, that market forces and demands are 
productive and responsive. Government solutions usually distort market 
forces and end up with poorer services at higher costs.
  I should like to be clear about my support for the Patient's Bill of 
Rights Plus legislation I cosponsored and voted for--it is still needed 
because it addresses other important issues. What this change of 
practice announced by United Health does signal is the potential for us 
to reach a reasonable conclusion to negotiations underway between the 
House-passed Patient's Bill of Rights and the Senate-passed Patient's 
Bill of Rights Plus, particularly on the contentious issue of health 
plan liability.
  Mr. President, it is hard to overstate the importance of this 
announcement from United Healthcare and I felt it was imperative 
someone in Congress acknowledged private market forces for positive 
change far outweigh a government imposed remedy.

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