[Congressional Record Volume 147, Number 85 (Tuesday, June 19, 2001)]
[Senate]
[Pages S6402-S6403]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                     CONCLUSION OF MORNING BUSINESS

  Mr. REID. My understanding is that the hour of morning business is 
now terminated; is that right?
  The PRESIDING OFFICER. The Senator is correct.
  Mr. REID. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. DASCHLE. Mr. President, I ask unanimous consent the order for the 
quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DASCHLE. Mr. President, this is an important day--and one that 
has been a long, long time coming.
  It has been nearly 5 years since President Clinton, at the time, 
appointed an independent panel of health care experts and asked them to 
come up with a Patients' Bill of Rights.
  It has been more than 4 years since President Clinton urged Congress 
to pass a Patients' Bill of Rights reflecting the panel's 
recommendations.
  It has been more than 3 years since the first bipartisan Patients' 
Bill of Rights was introduced in the House.
  And, it has been nearly 2 years since the last time we debated a real 
Patients' Bill of Rights here in the Senate.
  We have talked long enough. There is only one thing left to do. We 
need to pass a real, enforceable Patients' Bill of Rights now.
  The reason we are debating this bill is because so many people--
inside and outside of Congress--refused to give up. I especially want 
to thank the Senate sponsors: my colleague, Senator Kennedy, who has 
spent his entire adult life--nearly 40 years--working to improve health 
care for all Americans; my colleague, Senator John Edwards, who has 
played an indispensable role in finding an honest, honorable middle 
ground on the difficult question of liability; and my colleague, 
Senator John McCain, for having the courage--once again--to disregard 
party labels and challenge the special interests in order to change 
what needs to be changed.
  This bill matters--deeply matters--to America's families. More than 
70 percent of all Americans with insurance and 80 percent of all 
Americans who get their insurance on the job--are now in some kind of 
managed care program. To them, this isn't a political issue; it can be 
a life-or-death issue.
  This bill ensures that doctors, not insurance companies, make medical 
decisions. It guarantees patients the right

[[Page S6403]]

to hear all of their treatment options--not just the cheapest ones. It 
says you have the right to go to the nearest emergency room when you 
need emergency care. It guarantees you the right to see a specialist if 
you need one. It gives women the right to see an OB-GYN without having 
to see another doctor first to get permission. And it guarantees that 
parents can choose a pediatrician as their child's primary care 
provider, if they need one.
  But rights without remedies are no rights at all. That is why our 
bill guarantees people the right to appeal decisions by their HMO to an 
independent review board, and to get a timely response. Finally, if the 
HMO ignores the review board, our bill allows people to hold HMOs 
accountable--the same way doctors and employers, and everyone else in 
America is held accountable for their actions. The 85 million Americans 
enrolled in Medicare, Medicaid and other Federal health programs 
already have each of the protections in our bill. So does every Member 
of this Senate.
  Our bill extends them to all privately insured Americans--no matter 
what State they live in, or what insurance plan their employers choose.
  Opponents claim that guaranteeing these rights will cost too 
much. They say people will lose their insurance because insurance 
premiums will go through the roof. But the facts show otherwise. 
According to the nonpartisan Congressional Budget Office, our bill 
would increase employee premiums an average of about $1.20 a month for 
real rights that can be enforced--$1.20 a month.

  Many things have changed since the first time this Senate passed a 
Patients' Bill of Rights. The bill itself has changed. We started with 
a bipartisan compromise: the Norwood-Dingell Patients' Bill of Rights. 
This bill is a bipartisan compromise on a bipartisan compromise.
  One of the most important compromises concerns liability. This bill 
says very clearly that employers cannot be held liable unless they 
participate directly in a decision to deny health care. The only 
employers who can be held liable are the small fraction of companies 
that are large enough to run their own health care plans--less than 5 
percent of all American businesses. Small businesses never make 
treatment decisions, so they would never be sued.
  We have also compromised on where people can seek justice. Instead of 
allowing all disputes to be heard in State courts, this bill says 
disputes about administrative questions should be heard in Federal 
courts. Only cases involving medical decisions should go to State 
courts--just like doctors who make medical decisions.
  Support for a Patients' Bill of Rights has grown--inside and outside 
of Congress. In the Senate, we have Senators McCain, Edwards, and 
Kennedy. In the House, we have Congressman John Dingell and two 
conservative Republicans, Charlie Norwood and Greg Ganske. Outside of 
Congress, 85 percent of all people surveyed--and 79 percent of 
Republicans--support the protections in this plan, and so do more than 
500 major health care, consumer and patient-advocate groups all across 
the country.
  There has been one other significant change since the first time we 
debated a Patients' Bill of Rights. Before, we could only guess what 
would happen if people were able to hold HMOs accountable. Now we know. 
Texas and California have both passed Patients' Bills of Rights.
  Texas passed its law in 1997. In nearly 4 years, 17 lawsuits have 
been filed--about five a year. In the last 6 months since California 
passed its law, 200 disputes have gone through the independent appeals 
process. None--not one--has gone to court. And two-thirds of the 
disputes were resolved in favor of the HMO. Experience from the two 
largest States--the two best laboratories--show that the scare tactics 
used by opponents of this bill are simply that: scare tactics.
  There are some important things that have not changed in the years 
since we started this debate. Americans are still being hurt by our 
inaction. Every day that we delay passing a real Patients' Bill of 
Rights, 35,000 Americans are denied access to specialty care--and 
10,000 doctors; see patients who have been harmed because an insurer 
refused to pay for a diagnostic test.
  Despite the growing support inside and outside of Congress, we still 
face formidable opposition from the special interests.
  HMOs and their allies reportedly are spending $15 million on ads to 
try to kill this bill this week. We welcome an honest and open debate 
on the issues. We hope opponents will resist the temptation to kill 
this bill by loading it up with amendments that make passage difficult.
  Our hope is that this debate will be like the one we had not long ago 
on another important reform--campaign finance reform. In fact, I have 
personally suggested to Senator Lott that we take up this bill under 
the exact same understanding that we took up campaign finance reform; 
that we have a good debate on amendments; that we offer the motion to 
table, if that would be offered; if it is not tabled, that it be 
subject to second degrees. I think it worked as well on the campaign 
finance reform as any bill I have recently had the opportunity to 
consider, and I hope we can do the same thing for the Patients' Bill of 
Rights. I am hopeful our Republican colleagues will agree to that this 
afternoon.
  There is one more important change that has occurred since the first 
time we debated a Patients' Bill of Rights. We now have a new 
President. Members of his staff have said President Bush will veto our 
bill if this bill makes it to his desk. We remain hopeful that the 
President will decide to join us once he hears the debate and sees what 
our bill actually does.
  In the second Presidential debate, then-Governor Bush said:

       It's time for our nation to come together and do what's 
     right for people. . . . It's time to pass a national 
     Patients' Bill of Rights.

  We agree. The American people have been waiting too long. Working 
together in good faith we can end this wait and pass a real Patients' 
Bill of Rights.
  I announce to all of my colleagues that it is my intention to stay on 
this bill for whatever length of time it takes. Obviously, we have this 
week and next week that are full weeks for consideration of the bill. 
My expectation is that if we finish the bill a week from this Thursday 
night, there would not be a session on Friday preceding the recess.
  If we are not finished Thursday night, we will then debate the bill 
and continue to work on it Friday, Saturday, Sunday. We will not have a 
session on the Fourth of July, but we will pick up again on July 5 and 
go on as long as it takes. We will finish this bill. It is also my 
expectation that if we finish this bill in time, I would be inclined to 
bring up the supplemental appropriations bill following the completion 
of the Patients' Bill of Rights.
  Those two pieces of legislation are bills I have already indicated to 
the Republican leader would be my hope that we could complete before 
the July 4th recess. In fact, it is my expectation and absolute 
determination to finish at least in regard to the Patients' Bill of 
Rights. We will see what happens with regard to the supplemental in the 
House and here in the committee.

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