[Congressional Record Volume 147, Number 111 (Thursday, August 2, 2001)]
[House]
[Pages H5185-H5194]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
PROVIDING FOR CONSIDERATION OF H.R. 2563, BIPARTISAN PATIENT PROTECTION
ACT
Mr. GOSS. Mr. Speaker, by direction of the Committee on Rules, I call
up House Resolution 219 and ask for its immediate consideration.
The Clerk read the resolution, as follows:
H. Res. 219
Resolved, That at any time after the adoption of this
resolution the Speaker may, pursuant to clause 2(b) of rule
XVIII, declare the House resolved into the Committee of the
Whole House on the state of the Union for consideration of
the bill (H.R. 2563) to amend the Public Health Service Act,
the Employee Retirement Income Security Act of 1974, and the
Internal Revenue Code of 1986 to protect consumers in managed
care plans and other health coverage. The first reading of
the bill shall be dispensed with. All points of order against
consideration of the bill are waived. General debate shall be
confined to the bill and shall not exceed two hours equally
divided among and controlled by the chairmen and ranking
minority members of the Committees on Energy and Commerce,
Education and the Workforce, and Ways and Means. After
general debate the bill shall be considered for amendment
under the five-minute rule. The bill shall be considered as
read. No amendment to the bill shall be in order except those
printed in the report of the Committee on Rules accompanying
this resolution. Each such amendment may be offered only in
the order printed in the report, may be offered only by a
Member designated in the report, shall be considered as read,
shall be debatable for the time specified in the report
equally divided and controlled by the proponent and an
opponent, shall not be subject to amendment, and shall not be
subject to a demand for division of the question in the House
or in the Committee of the Whole. All points of order against
such amendments are waived. At the conclusion of
consideration of the bill for amendment the Committee shall
rise and report the bill to the House with such amendments as
may have been adopted. The previous question shall be
considered as ordered on the bill and amendments thereto to
final passage without intervening motion except one motion to
recommit with or without instructions.
The SPEAKER pro tempore (Mr. Fossella). The gentleman from Florida
(Mr. Goss) is recognized for 1 hour.
Mr. GOSS. Mr. Speaker, for the purpose of debate only, I yield the
customary 30 minutes to the gentlewoman from New York (Ms. Slaughter),
pending which I yield myself such time as I may consume. During
consideration of this resolution, all time yielded is for the purpose
of debate on this issue only.
Mr. Speaker, the legislation before us is a structured rule providing
for the consideration of H.R. 2563, at last. It provides 2 hours of
general debate equally divided and controlled by the chairmen and the
ranking minority members of the Committee on Energy and Commerce, the
Committee on Education and the Workforce, and the Committee on Ways and
Means, the three committees of jurisdiction.
The rule waives all points of order against consideration of the bill
and makes in order only the amendments printed in the Committee on
Rules report accompanying the resolution. It further provides that the
amendments printed in the report may be offered only by a Member
designated in the report, shall be considered as read, shall be
debateable for the time specified in the report equally divided and
controlled by the proponent and opponent, shall not be subject to an
amendment and shall not be subject to a demand for division of the
question in the House or the Committee of the Whole.
The rule waives all points of order against the amendments printed in
the report and provides one motion to recommit with or without
instructions.
In fact, it is pretty standard and fair in terms of rules on this
type of matter. What is unique is the long, long preparation, the
participation of so many Members to bring this legislation to the
floor. We believe on the Committee on Rules that we have crafted a good
rule to have full debate for the balance of the day and probably into
the early evening.
We have three major amendments with time specified of 40 minutes for
one, 40 minutes for another and 60 minutes for another. Members having
done
[[Page H5186]]
their homework will know what those are and we will get into them as we
go along. I think this should be comprehensive and give every Member
the opportunity to have their say.
{time} 1230
Mr. Speaker, this truly is a red letter day, not just for the
Congress but for the American people, because today, after 10 years of
debate and compromise, we are finally having the opportunity to put
forth patient protection legislation that will really change the way
our health care system operates for the better.
A true patients' bill of rights must make our health care system more
accessible. Health care insurance is no good if someone cannot get it.
So accessibility of health care and health care insurance is critical.
Obviously, it has to be affordable, more affordable. Affordable is an
area we have focused on. And most importantly, more accountable,
accountable to the Americans that health care serves.
This fair rule and the underlying legislation represents a reasoned,
commonsense approach that allows people that disagree with health care
providers an opportunity for just and impartial appeal. This is what
Americans have been asking for.
I have worked on health care legislation with so many colleagues ever
since coming to Congress, and I can tell my colleagues that this is
something that matters a lot back in my district and every other place
I go in the country when I talk about it. When I am back in my
district, not one town hall meeting goes by without constituents
registering concerns about their health care and questioning how things
will be fixed, how much it will cost, can I afford it, will I be able
to get it, and so forth.
It has always been a very delicate balance to come up with something
that will be supported by the House, of course our colleagues in the
other body, and the administration; and I commend the hard work of so
many, but especially the diligent efforts now on a timely basis of
people like the gentleman from Georgia (Mr. Norwood) and President
Bush, who understood compromise is still better for the American people
than nothing at all. Laws are better than unresolved issues.
Frankly, one of the reasons we can be here today is because of the
respect our colleague, the gentleman from Georgia, has in this body. In
the words of Senate Majority Leader Tom Daschle, and I quote him, ``If
Dr. Norwood, who I think knows the issue better than anyone else does,
feels that some of these proposals are acceptable, I would certainly
entertain them.'' Well, we are entertaining them today in an amendment
that every Member has had a chance to read, and we will have 60 minutes
set aside for debate on that.
What is important is that when our constituents ask, will I have
access to affordable health care, we can say forthrightly, look them
right in the eye, and say yes. When they ask, can I sue my HMO if there
is cause, the answer will again be yes.
With these positive reforms comes great responsibility, of course;
and I commend my colleagues for entertaining the compromise that will
not overburden the courts with frivolous lawsuits but will still allow
justice under the law. We must be sure that the courts are the last
resort and not the first. This bill provides for an independent review
process that is immediately responsive to patients' needs.
My constituents in southwest Florida are tired of standing in lines,
as I suspect Americans are elsewhere. The lines at the doctor's office
is bad enough, to say nothing of waiting times. They certainly should
not be waiting in additional queues at the courthouse. Instead of
driving people to court, a true patients' protection plan will enable
Americans to get the care they need and ensure the accountability of
medical providers. And I think that is what this legislation does.
Certainly the rule is designed to bring out the debate on these
points. Mr. Speaker, I urge my colleagues to continue the careful
manner in which this legislation was drafted, and I urge them to
support this rule.
Mr. Speaker, I reserve the balance of my time.
Ms. SLAUGHTER. Mr. Speaker, I thank the gentleman from Florida for
yielding me the customary 30 minutes, and I yield myself such time as I
may consume.
(Ms. SLAUGHTER asked and was given permission to revise and extend
her remarks.)
Ms. SLAUGHTER. Mr. Speaker, I rise in strong opposition to this rule.
I am opposed to the process the rule represents and the political
cynicism it embodies.
Make no mistake, this rule is designed to kill the bipartisan
patients' bill of rights. This is death by a thousand cuts. By slicing
away at the bipartisan-based bill, the leadership today once again will
bury one of the most important pieces of legislation to face this body
in a generation, all in an effort to appease the insurance companies
and the HMOs.
Mr. Speaker, there is no new agreement regarding the bipartisan
patients' bill of rights. Yesterday's hastily arranged news conference
by the administration was pure theater. Only one sponsor of the
bipartisan patients' bill of rights, the gentleman from Georgia (Mr.
Norwood), was included in the discussion with the administration. And
even the gentleman from Georgia admitted to the Committee on Rules last
night that he did not have a deal. And, indeed, until he saw what was
written in the Committee on Rules, he would not have one. And at that
moment last night he had no idea what would be written.
And now with ink barely dry, the Republican leadership is demanding a
vote. We wonder how many Members will see this so-called agreement
before they have to vote.
A dangerous pattern is developing in the Committee on Rules. Knowing
that they do not have the support to kill important measures, like
campaign finance reform or a balanced energy program that maintains the
environment, the leadership cloaks itself in the darkness of night.
When daylight breaks, they emerge with procedural hurdles designed to
obfuscate, confuse, and ultimately bury these measures that may mean
life and death for many of our constituents.
The leadership knows the Senate will not agree to this version of the
patients' bill of rights, and they know by passing the administration's
version they can force a conference with the Senate, thereby relegating
the patients' bill of rights to the legislative graveyard.
The rule today makes in order only those amendments designed to kill
the measure. There are poison pills. Each one weakens and dilutes
patients' protections. The amendments block legal remedies in State
courts under State laws, they hand over to HMOs the right to choose
which court to adjudicate in, and they stack the deck against anyone
who tries to enforce the patient protections we have worked for so long
to secure.
Moreover, the new Norwood bill fails to pay for any of the revenue
losses it causes. In case Members are unaware, the surplus we worked so
hard to secure the past 8 years is gone. In fact, the Treasury has had
to borrow $51 billion just to pay for the tax rebate mailed just last
week. Now, for the second time in 24 hours, we have blocked amendments
by Democrats who want to be responsible and pay for the cost of the
legislation we are considering.
The House is now preparing to blow an additional $25 billion hole in
the deficit. Democrats did offer responsible offsets but were voted
down unanimously in the Committee on Rules.
Where will this money come from? The only place left after the
massive tax cuts enacted by Congress are the Medicare and Social
Security Trust Funds.
I want to remind my colleagues this is about real people, about real
lives, and as I stated earlier, a matter of life and death for many.
H.R. 2563 would make a difference for the man who goes to the emergency
room suffering a heart attack and the woman who has to wait to get
permission to see her OB-GYN for a gynecological problem and the parent
whose child is being shunted from doctor to doctor by an insurer. It
would help patients obtain speedy reviews when potentially lifesaving
treatment is denied or when a financially crippling bill will not be
covered by the insurer.
The bipartisan bill would make a difference in the day-to-day lives
of the people we represent. And for this body to treat this measure so
cavalierly defies conscience and defies belief.
[[Page H5187]]
Make no mistake, this agreement is a win for the special interests
and especially the HMOs and insurance companies who support with their
contributions this new bill.
It is a loss for the American people on one of their biggest issues,
and a sad day for America, patients, doctors, and virtually every
family around the country.
One of the most egregious things is they have held HMOs to different
standards than they are holding doctors and hospitals. The HMOs alone
among the health care providers will be shielded from the consequences
of their own bad decisions, but the doctors and the hospitals are left
hanging out to dry. And I understood the AMA has just opposed this
bill.
HMOs will also have an extraordinary care standard, not a medical
standard, but what any ordinary insurance company would do. And in fact
what is being given to them goes to no other industry in the United
States. And by waiving away the State laws, many people in the United
States where they have good strong State laws will be worse off than
had this bill not passed.
Mr. Speaker, I reserve the balance of my time.
Mr. GOSS. Mr. Speaker, I yield such time as she may consume to the
gentlewoman from Ohio (Ms. Pryce), a distinguished member of the
committee and a member of our leadership.
Ms. PRYCE of Ohio. I thank my good friend from Florida and colleague
on the Committee on Rules for yielding me this time, and I rise in very
strong support of this rule.
Mr. Speaker, I came to the House of Representatives nearly 9 years
ago, and for the majority of my tenure here, Congress has been
struggling with the concept of a bill of rights for patients. There are
no policy arguments that have not been made, no statements left
unspoken, and no new points to interject.
Mr. Speaker, 95 percent of the patients' bill of rights is agreed to
by every one here. We all agree that patients should have access to
emergency room and specialty care and direct access to obstetricians,
gynecologists, and pediatricians. We agree that doctors should have
input in the development of formularies for prescription drugs and that
patients should have access to health plan information.
All the players agree that gag clauses that prevent doctors from
discussing certain health care options with their patients should be
prohibited and that patients should have a right to continuity of care.
In fact, I would like to remind my colleagues that the House has
previously passed a patients' bill of rights. We have, we have done it
here, and yet we still have no Federal protection to offer the 170
million Americans with private health insurance.
Well, help is on the way. We finally have a President committed to
making this happen and a Congress which has worked long and hard to
help him. Mr. Speaker, I understand this task has been a daunting and
difficult one, and that is why the agreement President Bush forged
yesterday is a giant step forward. An agreement that involved so many
hardworking, committed Members on both sides of the aisle needs a
chance to go forward today.
Mr. Speaker, we need a bill that will not penalize employers for
offering health care benefits; we need a bill that will not drive up
the cost of premiums; and we need a bill that will offer remedy to
patients who have been wronged; and, most of all, we need a bill that
can be signed into law.
There are many who would rather not see this happen today. They would
rather the American people not have this benefit. They would rather
have a political issue. And it is so easy to stand in the way. It is
much harder to forge consensus. This time the Committee on Rules, which
has met into the wee hours nearly every night this week, has forged a
fair and good rule that will do all of this.
We have already spent too much time on solutions that go nowhere.
This legislation, with the agreement offered by the gentleman from
Georgia (Mr. Norwood), has been agreed to by the President. It will
offer our best chance to provide real patient protection to those
Americans who desperately need it and have needed it for far too long.
I urge my colleagues to support this rule. It is fair, it is very
delicate, it is balanced, and it will bring a patients' bill of rights
to our President for his signature.
Ms. SLAUGHTER. Mr. Speaker, I yield 1 minute to the gentleman from
New Jersey (Mr. Menendez).
Mr. MENENDEZ. My colleagues, make no mistake, this bill is a special
deal for special interests. The patients' bill of rights went into the
White House emergency room with the gentleman from Georgia (Mr.
Norwood) and it came out as an ``HMO Bill of Rights,'' an ``Insurance
Bill of Rights,'' a special set of rights no other industry in America
has.
And speaking of rights, this bill kills State rights in protecting
patients. Just this week in New Jersey, a Republican governor signed a
bill passed by a Republican legislature which would provide for
enforcing our patients' bill of rights. This bill we are debating today
destroys New Jersey's patients' protections, and California and Texas
and every other State's right to protect patients, by superceding it.
This bill is a huge step backwards in patient protections. This bill
will not guarantee the care patients deserve and need but it will
guarantee HMOs' abuses.
Let us vote for patients, for people, for our constituents, and
against the special interests. Vote against the rule and the bill.
Mr. GOSS. Mr. Speaker, I yield such time as he may consume to the
gentleman from Missouri (Mr. Blunt), the distinguished member of our
leadership, the deputy whip.
Mr. BLUNT. Mr. Speaker, I thank my good friend for yielding me this
time, I want to use the last of the voice I have left this week to talk
for a few minutes about this bill and the rule that allows it to come
to the floor.
What we have a chance to do here today is to end 6 years of gridlock,
6 years of striving for a solution that has been outside of our reach.
Today we can achieve that solution.
Lots of Members have worked very hard to try to find that solution on
both sides of the aisle. My good friend, the gentleman from Iowa (Mr.
Ganske); the gentleman from Georgia (Mr. Norwood); the gentleman from
Michigan (Mr. Dingell); the gentlewoman from Connecticut (Mrs.
Johnson); and the gentleman from Kentucky (Mr. Fletcher) have all
worked hard to try to find that ground that gets us to a solution that
really does create parents' rights.
{time} 1245
I think what this bill does, and the amendments that go along with it
is, it puts patients first. It puts health care first. It puts the
health care decision first, and that is a critical difference in this
and some of the other concepts that we have talked about, such as the
health care professional review panel that has an immediate answer. In
fact, how they respond to that answer depends on the way that patients
are dealt with in the future of this process.
If in fact an individual is provided insurance, and responds to what
that doctor-driven health care professional panel says needs to be
done, they have done the right thing and the law recognizes that.
This law talks about greater access to the system. It talks about
liability, but it also talks about some ways to avoid that liability,
which continues to encourage employers to provide health care to their
workers.
For a generation now, one of the questions that workers first asked
when they filled out a job application was, Is health insurance
provided? What we do not want to see at the end of our debate here is
the answer to be, We used to have health care. We used to offer health
care, but now we just give employees money because we do not know what
our liability is. It was undefined.
Our bankers, if it is a small business, would not let us continue
down that path. Our shareholders, if it is a large business, because of
the responsibility we have to them, we decided not to have health care
insurance any longer because we did not understand our liability.
That is one reason many of us thought it was so important to
understand the limits of that liability. This bill sets a higher limit
than many of us would have ever thought we could accept; but employers
can work with it, the system can work it.
[[Page H5188]]
Most importantly, the results of the hard effort in the last 24
hours, the President's efforts, the efforts of the gentleman from
Georgia (Mr. Norwood), the gentleman from Arizona (Mr. Shadegg) stayed
up all night to make sure of the language, to come up with a bill that
this House can vote on this week that can be signed into law.
Mr. Speaker, 6 years of talking about this is too long. Now is the
moment when we can reach a final decision. We can send a bill to the
Senate that is a better bill than the Senate's bill. We can put a bill
on the President's desk. He wants to sign a bill; we ought to give him
the chance to do that.
This bill truly does protect patients' rights.
Ms. SLAUGHTER. Mr. Speaker, I yield 3 minutes to the gentleman from
Michigan (Mr. Dingell).
(Mr. DINGELL asked and was given permission to revise and extend his
remarks.)
Mr. DINGELL. Mr. Speaker, the Senate last week spent a whole week in
arriving at a decision on this legislation. It was a thoughtful debate,
compromises were worked out on a bipartisan basis, and a good bill was
sent here.
Let us look at where we are and why. A Member in this Chamber went to
the White House in a closed meeting and worked out a deal. That deal
was not reduced to writing until this morning. He did not know what was
in the deal at the time he appeared before the Committee on Rules.
Nobody else knew. I do not know now. None of you know. I seriously
doubt that the Member who cut the deal knows what he has done.
I do not think that any Member can understand the ramifications of
these curious transactions. In the Senate, the leaders were willing to
forgo the Independence Day recess in order to work this legislation up.
Here, without the vaguest understanding of what we are doing, we are
now rushing to send a bill to the President.
The doctors have a way of describing this thing. They say, First, do
no harm. There is a plethora of amendments which have been added to
this legislation under the rule. If Members vote for the rule, they are
going to vote for a bill that has not been tested and that the author
of the amendment cannot satisfactorily explain to himself or to us.
Mr. Speaker, this is a bad process. I would point out that it sets up
a whole new Federal standard for torts and for jurisprudence, something
which has not been done for 300 years in this country. I ask my
colleagues to note whether they can explain this or understand it, or
whether they or anyone, or the author of the amendment, can assure us
that this amendment does not foster mischief and misunderstanding and
the potential for real trouble for the American public.
I would note some other things for the benefit of this Chamber. This
is an HMO bill. It is a step backwards in that it preempts State laws.
It puts its finger on the scale of justice. Nay, it puts its whole fist
or forearm on the scales of justice because it lays in place
presumptions in favor of the HMOs.
The HMOs are smiling today. No one else is. Members who vote for this
amendment will not be smiling in a little while because the end result
of that is going to be that they are going to have hurt their
constituents, and have done the wrong thing.
I will tell Members some additional things. The States are making
fine progress in enacting patient protection laws. Those patient
protection laws are making real progress. This bill would essentially
preempt them and set aside all of that progress. States like Georgia,
States like New Jersey, States like Texas, are going to see their laws
superseded.
Mr. Speaker, the amendment to this bill is titled the Bipartisan
Patient Protection Act. It should be entitled, the Partisan HMO
Protection Act.
Mr. Speaker, I urge my colleagues to vote against the amendment.
Ms. SLAUGHTER. Mr. Speaker, I yield 1 minute to the gentleman from
Maryland (Mr. Wynn).
Mr. WYNN. Mr. Speaker, I rise in strong opposition to the rule and to
the underlying bill. The fact of the matter is that without a right to
redress, the so-called patients' rights are worthless. Today we will
hear the Republicans talk about the rights that they give patients, but
if patients cannot get into court in an easy, convenient manner, they
cannot redress their rights.
Remember, it is the patient's back, the patient's knee, the patient's
neck, the patient's facial scars that have to be corrected. If the HMOs
deny a patient relief, they should have the right to go to court, and
this bill does not do it. It guarantees every roadblock possible to
benefit the HMOs; every presumption possible to benefit the HMOs. It
wipes away State laws to benefit the HMOs. The protections are not in
this bill, the protections are for the HMOs. That is what is wrong with
this bill.
They will say if we let patients go to court, they will not be able
to get insurance. Studies have shown that the increase in costs are
minimal; people are willing to pay it. In Texas, which has the right to
go to court, they have not had a lot of lawsuits.
Reject this bill.
Mr. GOSS. Mr. Speaker, I yield 4 minutes to the gentleman from Iowa
(Mr. Ganske), a major player in this legislation.
Mr. GANSKE. Mr. Speaker, I thank the gentleman for yielding me this
time.
Yesterday was an amazing day in the Committee on Rules. I have been
to the Committee on Rules three times on the Patients' Bill of Rights;
and I must admit when we were talking about the Norwood amendment last
night and we did not have any language to talk about, and the gentleman
from Georgia (Mr. Norwood), was saying I reserve the right to not agree
with my own amendment, it was sort of bizarre. But I must say that I
have been treated with respect and kindness by the Committee on Rules.
Mr. Speaker, I wish very much that we had more time to see the
language of the Norwood amendment so people could fully understand it.
We are going to have a chance to talk about the Norwood amendment, and
I will go into it in more detail later. I intend to support the rule. I
understand fully how my colleagues on the other side of the aisle very
well are upset about this, but I feel it is time to move on with this
debate.
Mr. Speaker, I thank my colleagues from both sides of the aisle who
throughout the last 5 or 6 years have stood up as protectors of
patients and have been very interested in this. I cannot remember the
number of times I have given Special Orders late at night.
I have shown patients like this: HMOs Cruel Rules Leave Her Dying for
the Doc She Needs; What His Parents Did Not Know About; HMOs May Have
Killed This Baby. I have spoken about how, as a plastic surgeon, HMOs
using medical necessity, unfair definitions, which have denied children
care. I have spoken about this woman who lost her life because an HMO
did not provide her with the treatment she needed.
I have spoken about how an HMO would not pay this young woman's
emergency care and hospital bill because when she fell off a cliff, she
did not phone ahead for prior authorization.
A couple of years ago when we had this debate, this little boy came
to the floor. An HMO made a medically negligent decision which cost him
both hands and both feet. Under Federal law, if that is an employer
plan, the HMO is responsible only for the cost of his amputations.
I think we now have bipartisan support that is not fair or just, and
that we need to do something to prevent that from happening, and that
is why the underlying Ganske-Dingell bill sets up a strong external
appeals program, similar to what they have in Texas, to prevent this
from happening, to prevent cases from going to court.
Mr. Speaker, there will not be that much debate on the patient
protection part of the Ganske-Dingell bill because there are not any
amendments coming up, but they are solid. We are going to have three
amendments coming to the floor. One will be on access provisions, one
will be on medical malpractice liability, and the third is a very, very
important one, and that is, in fact, whether to provide additional
protections to HMOs.
We will go into some details, how the Norwood amendment would provide
affirmative defenses for HMOs that they do not have now, and how it
would actually preclude State law. I will at that time recite the lines
in the Norwood
[[Page H5189]]
amendment that do that, and provide Members with information on that.
Mr. Speaker, I just urge my colleagues to have a civil debate. Let us
get past the point of name-calling. Let us have a debate that is as
enlightened as they had in the Senate a couple of weeks ago, move
forward and defeat the Norwood amendment, and pass the Ganske-Dingell
bill.
Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from
Texas (Mr. Frost).
Mr. FROST. Mr. Speaker, let me start with the rule today. In a
continuing effort to block Democrats from imposing fiscal
responsibility on the House, Republican leaders have prevented us from
paying for this bill. That fiscal irresponsibility is why Republicans
are about to raid the Medicare and Social Security trust funds, as an
internal Republican memo made clear recently, and it is why just 6
months after Republicans inherited the biggest budget surplus in
history, the Federal Government is borrowing money again.
Now for the bill itself: For the past 5 years, Mr. Speaker, Democrats
and some courageous Republicans have worked hard to pass a real
bipartisan Patients' Bill of Rights, one that takes health care
decisions out of the hands of insurance companies and puts them back
into the hands of doctors and patients.
Mr. Speaker, the Ganske-Dingell bill does that. It protects patients'
rights without reducing health care coverage. During those same past 5
years, Mr. Speaker, Republican leaders have fought the bipartisan
Patients' Bill of Rights every step of the way. For the past 6 months,
the Bush administration has joined them in fighting tooth and nail to
protect insurance companies and HMOs.
It should be so no surprise that the Republican plan, proposed by
President Bush and the gentleman from Illinois (Mr. Hastert), that is,
the Norwood amendment we will debate later today, protects HMOs and
insurance companies at the expense of patients. Make no mistake,
Republican leaders are trying to turn the Patients' Bill of Rights into
an HMO Bill of Rights.
{time} 1300
The Republican plan creates special protection for HMOs and insurance
companies, one that no other industry enjoys, and would override State
HMO laws, including the patient protections that my constituents in
Texas enjoy today and that President Bush bragged about in last year's
campaign.
Mr. Speaker, the Republican plan would ensure that HMOs and insurance
companies, not doctors and patients, keep making vital medical
decisions.
Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from
Arkansas (Mr. Berry).
Mr. BERRY. I want to thank the gentlewoman from New York for yielding
time. I also want to thank the gentleman from Iowa (Mr. Ganske) for his
great leadership in this matter and, of course, the gentleman from
Michigan (Mr. Dingell) and all the others that have worked so hard for
this.
Mr. Speaker, the only way I can describe this rule and the bill that
is going to be offered as amended to this House today is ridiculous.
Just to begin with, the Committee on Rules was asked to take up a rule
for a bill they had not seen, that nobody had written yet. They had to
declare Wednesday was Thursday. If you have got something planned on
Thursday you very well may lose it, because we are going to skip
Thursday this week. Today is Wednesday. Tomorrow is going to be Friday.
That just shows you how ridiculous this whole thing has gotten. We have
got an old Southern saying about politics that those that get on early
get taken care of, everybody else gets good government. I think we have
clearly seen the evidence that the insurance companies got on early in
the last campaign. They have clearly been taken care of.
We have been presented with this so-called agreement between the
White House and someone on Capitol Hill where we have said that we are
just going to trample State law, do whatever you have to do to take the
State courts out of it; we are going to take away any rights from the
American people to deal with their insurance companies.
This whole bill should be called the HMO Protection Act, because they
have got more protection now than they had before this bill was
written. I do not think it will ever become law. I think it will die in
conference. But it is such a ridiculous idea that we would present this
to the American people and try to hoodwink them into thinking that they
are going to have a better deal.
Besides that, Mr. Speaker, it is not paid for. We are just going to
issue a magic lucky card to pay for it. I am surprised that the lucky
card is not described in the language.
Ms. SLAUGHTER. Mr. Speaker, I yield 3 minutes to the gentleman from
Texas (Mr. Stenholm).
(Mr. STENHOLM asked and was given permission to revise and extend his
remarks.)
Mr. STENHOLM. Mr. Speaker, I rise in opposition to the rule. It is
not a fair and it is not a good rule. I know that my friends on this
side of the aisle are getting a little tired of Members on this side
standing up and talking about that we are not paying for the
legislation that we proposed. I certainly recognize and support the
right of the majority to do as you wish regarding legislation, as you
are proving day after day. But for the last several years, I have
listened to my colleagues on both sides of the aisle speak with passion
and conviction about their commitment to putting an end to the practice
of raiding the Social Security and Medicare Trust Fund surpluses to
cover deficits in the rest of the budget. I believe that all Members of
this body who have voted time and time again to protect those trust
funds are sincere in their desire to honor that commitment.
Unfortunately, the manner in which we continue to consider legislation
is making it impossible to keep that commitment.
The $1.35 trillion tax cut recently signed into law, whether
acknowledged or not, has taken up the available surplus. It is becoming
increasingly clear that CBO and OMB when they offer their revised
budget forecasts next month will show the facts. No point in debating
whether it is or it is not; either it is or it is not. Those of us that
believe that it is, those that say it is not, we are going to know.
But let me point out a few facts. Last week, this House voted to
break the spending limits on the VA-HUD bill. There is a reasonably
good chance that this body is going to break those limits on defense
and on education. Last week, it was 8 billion additional dollars for
the faith-based initiative. This week it was $18 billion for the
railroad retirement fund. Yesterday it was $32 billion for the energy
bill. Today it is at least 20, probably as much as $30 billion for this
bill.
I heard my colleague from Arkansas say a moment ago, ``It's not paid
for.'' I respect the right of the majority to bring legislation to this
floor and not pay for it if that is what you wish. But why and how can
you continue to come to the floor and say it is a fair rule when you do
not allow the minority side the opportunity to pay for the bill in the
legislation that we are for? What is it that would let anyone stand on
the floor and say it is a fair rule when you deny the opportunity of
the other side of the aisle to work their will regarding the
legislation as they see it and let you work the will of the body as you
see it?
I really think we ought to defeat this rule, and we ought to send it
back to committee with at least allowing our side of the aisle the
opportunity to pay for that legislation that we propose. And if you
wish to raid the Social Security and Medicare Trust Funds, I respect
your right to do it.
Mr. GOSS. Mr. Speaker, I yield 4 minutes to the distinguished
gentleman from Florida (Mr. Foley), a Member of the Committee on Ways
and Means and a great contributor to this legislation.
Mr. FOLEY. Mr. Speaker, I appreciate the gentleman from Florida
yielding me this time. Listening to the debate this morning is causing
me some concern because I have heard phrases like ``we are rushing this
legislation to the floor.'' Yet it seemed to me weeks ago the other
side of the aisle demanded action on this bill before the summer
recess.
Let me just give you some quotes from National Journal's Congress
Daily today that appeared in print. The senior Senator from
Massachusetts
[[Page H5190]]
says about the gentleman from Georgia (Mr. Norwood): ``He has our
complete confidence and he's demonstrated time in and time out his
commitment to patients in our country.''
The gentleman from Arkansas who just spoke a moment ago: ``I don't
think anyone at any time has ever questioned Charlie Norwood's
sincerity or dedication to this mission. So the fact that he's out
there working doesn't give me any heartburn at all.''
That was yesterday, the wonderful gentleman from Georgia, and today
they will have you think he has become Dr. Kevorkian. The gentleman
from Georgia and I have worked on this bill since 1995. There is one
person in this Capitol more concerned with patients than any of us here
and that is the honorable gentleman from Georgia. But he recognizes one
very important and cogent point of this debate, that if somebody is
sick and somebody is ailing and somebody is hurt, they do not need to
wait in queue for 5 years to get a court of law to render a verdict on
their case, because regrettably if we wait for the court of law, likely
the patient will have died.
A good friend of mine, a trial lawyer who is a personal friend and a
supporter, called me yesterday. ``Please support the Dingell bill.
Support the right for patients to sue their HMOs.''
So I posed the question: ``You're a partner in a law firm. If you
provide health insurance, do you feel you should be sued for the
negligence of the managed care?''
He paused and said, ``Well, no, we merely provide the health care
policy.''
And I said, ``But you may in fact be drawn into liability because you
didn't give them an option of several policies, you gave them the
firm's policy. And should the firm be engaged in litigation with their
provider.''
Mr. Speaker, we can rant and rave about bipartisanship and I have
tried on several issues with the other side of the aisle, on several
key issues that my leadership gets madder at me by the day, whether it
is campaign finance reform or legislation that I think is important for
Florida and I get taken to the woodshed for being too bipartisan. But
on that side of the aisle, bipartisanship really truly means to me,
``It is our way or the highway. And God forbid you interfere with our
campaign plans for 2002 so we can deride the Republicans as a do-
nothing Congress.''
If we look in our hearts and search for the right answer and not try
and pillorize anybody who has been participating since 1995, we have
several good doctors working on this issue and I think they care
desperately about patients. And if we rise from the din of this kind of
conversation about simply the right to sue, which is really a nice club
over the heads of the insurers and I agree with most of that; but we
also recognize, too, that if anybody is being sincere, try filing an
action and see how long before your case is heard in court. Try going
down to a State or a local courthouse and find out not only what the
fees are involved but how soon they may get to your case. And ask the
person with breast cancer or lupus or some other disease that is
struggling trying to get recovery and coverage whether the wait was
worth it, whether hanging out at a courthouse with a bunch of lawyers
waiting 3 years for somebody to maybe render an opinion is better than
what is in the Norwood bill which is an expedited appeals process that
gets you into the facility that you most need to be in which is a
hospital rather than a jury box.
Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from
New Jersey (Mr. Andrews).
(Mr. ANDREWS asked and was given permission to revise and extend his
remarks.)
Mr. ANDREWS. Mr. Speaker, I thank my friend from New York for
yielding time.
Mr. Speaker, the House is about to embark on a travesty of procedure
if it adopts this rule. The last speaker said that we wanted to hurry
up and get the Ganske-Dingell bill to the floor, and he is correct. The
Ganske-Dingell bill was filed in February. February. For the last 4 or
5 months we have all had a chance to read it, question it, understand
it. The principal alternative to the patients' bill of rights that is
going to be offered by the gentleman from Georgia (Mr. Norwood) this
afternoon, the copy I read indicates it was printed at 7:18 a.m. today
for the first time. We were in the Committee on Rules last night, or
this morning, excuse me, after midnight, nearly at 12:30 in the
morning, I know it went on long after that, I commend the Rules members
for their diligence, and they had not started writing the bill yet. So
an immaculate conception occurred sometime during the night last night.
Sometime between 1 a.m. and 8 a.m., we gave birth to a product here
that purports to do in 6 hours what lawyers and scholars and judges
have taken 300 years to accomplish, and, that is, to write a complete
set of rules about proximate cause, affirmative defenses, contributory
negligence, rules of evidence, rules of discovery, all the things that
come into the process of adjudicating a legal dispute.
This is a travesty. Most of the Members who will consider this bill
today will not know what is in it. We have a few hours to try to find
out. Once this process goes forward, the American people will have a
few weeks and a few months to find out. And when they do, they will
recognize the deception that is about to be perpetrated upon the House
this afternoon.
Oppose this rule. Support the Ganske-Dingell bill.
Ms. SLAUGHTER. Mr. Speaker, I yield 1 minute to the gentlewoman from
North Carolina (Mrs. Clayton).
Mrs. CLAYTON. I thank the gentlewoman for yielding me this time. I
oppose this rule. I oppose this rule both on process and content. The
process indeed should have allowed us to at least know what the
amendments were. But even on content, all of us say that we want to
have a Patients' Bill of Rights. When there is an amendment to undercut
the very rights that you purport to have, I am not sure how you can say
that we all are supporting a Patients' Bill of Rights. The right of
enforcement of legislation is the integrity of your words when you say
you have a Patients' Bill of Rights.
Do we need a Patients' Bill of Rights? Yes. Why do we need it? We
need it because there are children who are sick who need to have the
opportunity to see a specialist. There are women who need to go to the
emergency room or to see their OB-GYN. There are sick older people who
need to be rushed for cardiac treatment. All of these are things we
know, that we experience from family members. This rule will not allow
that to happen. Indeed, this is a fraud. We should make sure that we
vote down this rule and allow us to have a more deliberative debate.
Mr. Speaker, this rule limits debate on one of the most important
pieces of legislation Congress will consider this year.
The authors of the Ganske- Dingell- Berry-Norwood bill worked hard to
craft a bi-Partisan Patient's Bill of Rights bill that would provide
meaningful patient protection to consumers. The authors also re-drafted
portions of their bill to include enhanced measures provided for in the
Senate Bi-Partisan Managed Care legislation by adding additional
protections for employers. Rather than moving towards a bi-partisan
bill that had a strong possibility of moving out of conference
committee quickly, we are on the verge of passing a bill that may be
stuck in a conference committee. The more we delay passing a bill that
makes HMO's more accountable and that extends access to care, the
longer the American people will have to wait before getting a full
range of the kind of patient care they deserve.
Although we are now debating this rule, we have not been provided an
adequate opportunity to fully examine the compromise legislation that
came about as a result of the agreement between the President and
Congressman Norwood. Legislation that affects so many Americans should
not be thrown on the Floor of the House in an effort to win a battle of
the words.
A Patient's Bill of Rights now means ready access to emergency
services. Health Plans would be required to cover emergency care in any
hospital emergency facility, without prior authorization, whether or
not the hospital is a participating health care provider in the plan.
A Patient's Bill of Rights now means ready access to services
provided by an OB-GYN. Women will have direct access to a physician
specializing in obstetrics or gynecology, without having
[[Page H5191]]
to obtain prior authorization or referral from their primary
physicians.
A Patient's Bill of Rights now means ready access to Pediatric Care.
Parents will be able to readily designate a pediatrician as their
child's primary care provider.
A Patient's Bill of Rights now means ready access to Specialty care.
Specialty care will be included as a benefit to ensure that patients
receive timely access to specialists. If no participating specialist is
available, the bill requires the plan to provide for coverage by a non-
participating specialist at no extra cost to the patient.
These and countless other measures in the Bi-Partisan Patient's bill
of Rights will be compromised because of the latest agreement with the
White House to limit the accountability of HMOs. The Ganske-Dingell-
Norwood-Berry Bi-Partisan Bill of Rights legislation is a meaningful
patient's bill of rights that has been open to scrutiny and debate.
This legislation should not be compromised because of late agreement
that did not include all of the authors of this bill.
Ms. SLAUGHTER. Mr. Speaker, I yield 1 minute to the gentleman from
New Jersey (Mr. Pallone).
{time} 1315
Mr. PALLONE. Mr. Speaker, I deeply resent the suggestions on the
other side that somehow what they are doing today is going to help a
person who is denied care get the care, get to the hospital, get the
operation. Just the opposite is going to happen here.
This rule allows for amendments to be brought up on things totally
unrelated to care, malpractice reform, medical savings accounts. These
are the kinds of provisions that, if they are included in this bill,
when we go to conference with the Senate, will kill the bill, just like
it did last time.
And then you have the other amendment that changes the liability and
makes it almost impossible for someone who has been denied care to even
have an independent review by an outside board. All sorts of roadblocks
are put in the way so that a person can never have an actual review.
Forget the court. They will never get to the court. They will never
have that kind of independent review by an external review board that
will let them have their care, let them go to the hospital.
Finally, most insidious of all, you change the State law so
progressive States like my own of New Jersey or Texas or others that
have put in place a real Patients' Bill of Rights, are now going to be
preempted. That person will never get to the hospital. You are making
the situation even worse for them than it is now.
Mr. GOSS. Mr. Speaker, I am very pleased to yield 2 minutes to the
distinguished gentleman from Kentucky (Mr. Fletcher), from the
Committee on Education and the Workforce, who has also been a major
player in this legislation.
Mr. FLETCHER. Mr. Speaker, I thank the gentleman for yielding me
time. We appreciate the work the gentleman has done, as well as the
Committee on Rules, on putting together a fair rule, and a rule that is
very timely.
As a family physician, one of the things that you learn to recognize
very early is that some things need to be done in a timely basis and
other things can wait. This needs to be done, I think, in a basis that
we can get this accomplished, because this has been debated for at
least 6 years, even longer. I think the first Patients' Bill of Rights
in this body was offered in 1991. Anyone, I say anyone and everyone who
has been engaged in this debate, is familiar with all the language in
all of these amendments.
I woke up this morning and got over here to read the bill very early,
it is 30 pages long, very easy to read, very understandable for those
folks who have dealt with this issue for a long time. It is something
not uncommon here. Five hours is plenty of time for folks to understand
what this bill does.
I commend the gentleman from Georgia (Mr. Norwood). He has been
willing, and maybe let me say very willing, to finally say let us put
patients above politics, let us break away, let us stop the logjam, let
us get a bill that the President will sign.
This rule allows the House to really express its will. We have an
excellent opportunity to start with the base bill, that the other side
prefers, and we allow for some amendments to that bill.
The bill certainly ensures us of quality. We are going to have some
access provisions, because I think there has been a flagrant disregard
for the uninsured from the other side. We address that.
But I think it is also important to realize that we do modify and
reach a compromise on liability, so that HMOs are held accountable, but
so that we do not allow frivolous lawsuits that drive up the cost and
take money out of patient care and put it into personal injury lawyers'
pockets.
I encourage Members to support this rule, and I thank the Committee
on Rules for an excellent job.
Ms. SLAUGHTER. Mr. Speaker, I yield 3 minutes to gentleman from New
York (Mr. Rangel).
(Mr. RANGEL asked and was given permission to revise and extend her
remarks.)
Mr. RANGEL. Mr. Speaker, it is amazing how the leadership here can
get hold of one or two Democrats and believe that everything they do is
bipartisan. It reminds me of the story that Jim Wright told about this
wonderful Texas stew that everyone loved, and they asked what kind of
stew it was?
He said it was horse and rabbit stew.
They said, it tastes delicious. What is the recipe?
He said, oh, it is one horse and one rabbit.
They said, it tastes delicious, but how do you do it?
He said one-half horse, one-half rabbit is how we make it.
Except it is one whole horse and one small rabbit. And that is how
the Republicans have moved forward in trying to get bipartisanship
here.
But I tell you, the tax bill, the $1.3 trillion tax bill, certainly
was not bipartisan. This bill is not bipartisan. And the rule which I
stand to oppose will not even allow us the opportunity to provide the
revenues to pay for this bill, if and when it becomes law.
There is a train wreck that is going to occur, and the train wreck is
that we have signed more checks, or promised to sign more checks, than
we have made deposits in the bank.
We have this $500 billion contingency fund over 10 years, but we said
we are going to have $300 billion of it for defense, $73 billion for
agriculture, $6 billion for veterans, $50 billion for health insurance,
$82 billion for education, $122 billion for expiring tax provisions,
$200 billion to $400 billion to change the alternative minimum tax. And
there is just not enough money in our account to pay for these things,
without invading the Medicare trust fund or the Social Security trust
fund.
Now, we know that there are some people on the other side of the
aisle that wish that we did not have these programs, and we also know
that they know that these programs are so popular that they cannot be
legislated out. But what you can do is to do what the President said in
his campaign, and that is get the money out of Washington, because they
will spend it.
I think the answer is, if we are spending it for Social Security
benefits, if we are spending it for health care and education, if we
are spending it for a stronger America, to invest in our young people,
then that is what we were sent here to do.
But if we are just getting the money out of Washington so that we can
create a deficit, so that we leave to our kids indebtedness, that we do
not repair the Social Security system, we do not repair the health
system, then I do not think that is what we were sent to Congress to
do.
In the middle of the night a deal was cut, after so many good Members
on both sides of the aisle tried to present a bill to the President
that was good for the men and women of the United States of America. It
is not a day to be proud of, but it is a day that we are going to vote
down the rule, I hope, and vote down this legislation.
Mr. GOSS. Mr. Speaker, I yield 2 minutes to the distinguished
gentleman from Texas (Mr. Paul).
(Mr. PAUL asked and was given permission to revise and extend his
remarks.)
Mr. PAUL. Mr. Speaker, I thank the gentleman for yielding me time.
Mr. Speaker, as you know, I am a physician. I practiced medicine for
more than 30 years, and I can certainly
[[Page H5192]]
vouch for the fact that medicine is a mess, managed care is not working
very well; and, hopefully, we do something good to improve it.
Unfortunately, I am not all that optimistic.
I support this rule because it is dealing with a very difficult
subject and it brings the Democratic base bill to the floor. I do not
see why we should not be able to amend that bill, so I do support the
rule.
But the IRS code has 17,000 pages of regulation. The regulations that
we as physicians have to put up with are 132,000 pages. Most everything
I see that is happening today is we are going to increase those pages
by many more thousands. So I am not optimistic that is going to do a
whole lot of good.
I think we went astray about 30-some years ago in the direction of
medical care when the government, the Federal Government, got involved.
The first thing is we changed our attitude and our definition of what
``rights'' are. We call this a Patients' Bill of Rights. It has very
little to do with rights, because most of what we do in medicine, we
undermine individual rights.
We have a right in society, in a free society, to our life and our
liberty, and we have a right to use that liberty to pursue our
happiness and provide for our own well-being. We do not have a right to
medical care. One has no more right to a service than one has a right
to go into someone else's garage and steal an automobile. So the
definition of ``rights'' has been abused for 30 years, but the current
understanding is that people have a right to services. So I think that
is a serious flaw and it has contributed to our problem today.
The other serious flaw that we have engaged in now for 30 years is
the dictation of contract. For 30 years now under ERISA and tax laws,
we have forced upon the American people a medical system where we
dictate all the rules and regulations on the contracts; and it causes
nothing but harm and confusion. Today's effort is trying to clear this
up; and, unfortunately, it is not going to do much good.
Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from
Michigan (Mr. Bonior).
Mr. BONIOR. Mr. Speaker, the gentleman from Texas (Mr. Paul) really
said it well, probably one of the understatements of the day, when he
said that the managed care system is not working very well.
In the last 2 weeks, 20,000 Michigan seniors have been told that they
will lose their health insurance. They are being dropped by their HMO
health insurers who are abandoning their commitments. Our seniors are
getting broken promises instead of the care that they expected and the
care that they deserve.
Now, on top of that, we get this double whammy that has come before
us, yesterday and today. For 6 years the American people have been
waiting for a Patients' Bill of Rights. For 6 years insurance companies
have done everything they can to block it. Access to the nearest
emergency room, insurance companies say no; give doctors the authority
to make the medical decisions that are right; insurance companies say
no; hold HMOs accountable for denying patients the care they need, the
HMOs and insurance companies say no.
The deal cut yesterday, the deal that is being rushed through this
House so we do not have to read the fine print, and, boy, if there was
ever one area you wanted to read fine print, it is this area, is not a
Patients' Bill of Rights, it is an insurance company bill of rights.
It is a radical betrayal of the public trust. Instead of protecting
patients, it protects HMOs. Instead of helping patients get the care
they need, it puts more roadblocks in that patient's way. Instead of
giving injured patients the right to seek justice, it gives HMOs
special immunity from the lawsuits and the standards and the laws that
every other American business must uphold.
Mr. Speaker, it is time we hold the insurance companies accountable.
Pass a true Patients' Bill of Rights. Defeat all these poison pill
amendments that this rule would make in order. Pass a good bill. Vote
no on the previous question, vote no on this rule.
Mr. GOSS. Mr. Speaker, I am privileged to yield 1 minute to the
distinguished gentleman from Indiana (Mr. Pence).
Mr. PENCE. Mr. Speaker, I thank the gentleman for yielding me time.
Mr. Speaker, even though I am a new conservative Member of this
institution, I came to Congress anxious to support a Patients' Bill of
Rights. I became involved in the front end of this debate to preserve
our free market health care system and to strengthen patient choice.
For too long, Mr. Speaker, I believe Congress has walked by on the
other side of the road, leaving patients, doctors and well-meaning
employers to fend for themselves in an increasingly complex health care
economy.
What we have before us today is truly a bipartisan Patient Protection
Act that will provide protections for all Americans, and trust doctors
with the power to make medical decisions, and so it will also encourage
employers to provide quality health insurance for their employees.
I urge all of my colleagues, regardless of your stripe or party, let
doctors provide timely care, give patients choice, and let this
Congress end the decade of walking by on the other side of the road,
and speed this timely aid to patients, doctors and well-meaning
employers.
Support the bipartisan Patient Protection Act.
Ms. SLAUGHTER. Mr. Speaker, I yield 1 minute to the gentleman from
Texas (Mr. Green).
(Mr. GREEN of Texas asked and was given permission to revise and
extend his remarks.)
Mr. GREEN of Texas. Mr. Speaker, I looked forward to this day when we
could have a Patients' Bill of Rights on the floor, but after seeing
what happened, I am so disappointed and so frustrated, and I think that
is what is going to happen with the American people.
Instead of a Patients' Bill of Rights, we have a patients' bill of
wrongs. We have a Patients' Bill of Rights that is masquerading, but it
is really the patients' bill of wrongs.
What it does is it transfers the decision-making from the State
courts, where in Texas we have it now, to under Federal rules in State
courts; and that is wrong, and nowhere in our jurisprudence history do
we have that. So it is going to make it harder.
It gives a presumption for the HMO so they are right and you have to
prove them wrong. We are actually going to increase litigation. My
colleagues do not want more litigation. When you give that right to the
insurance companies, you are going to make people hire an attorney just
to go through the appeals process, and that is wrong.
{time} 1330
In Texas, we had a Patients' Bill of Rights for 4 years, very few
lawsuits, 1,400 appeals, 52 percent in favor of the patient. So more
than half the time, the HMO was wrong; and they are wrong today.
Mr. GOSS. Mr. Speaker, I am pleased to yield 1 minute to the
gentleman from Ohio (Mr. Boehner), the chairman of the Committee on
Education and the Workforce.
Mr. BOEHNER. Mr. Speaker, I thank the gentleman from Florida for
yielding me this time, and I congratulate the Committee on Rules for
bringing to the floor the Patients' Bill of Rights.
Let us not make any mistake about what this bill is. It is the same
patient protections that we have talked about for years. It is the base
bill. There is only one real change in the bill that we are going to
bring to the floor today, and that is in the area of how much liability
we are going to impose on employers and insurers.
Many of us believe, under the base bill, that we will have unlimited
lawsuits that will tremendously increase costs for both employers and
their employees, and as a matter of fact, I believe will cause tens of
millions of Americans to lose their health insurance because of these
increased costs. That is unacceptable when we have 43 million Americans
with no health insurance at all.
Under the rule, the gentleman from Georgia (Mr. Norwood) will offer a
compromise that he struck with the President that does provide for
greater remedies and greater access to courts for those who have been
injured. But it will not unduly raise the cost of health insurance and
it will not force employers out of employer-provided coverage.
I think it strikes the right balance for the American people and we
ought
[[Page H5193]]
to stand up today and think of the patients, not the trial lawyers and
the politicians.
Ms. SLAUGHTER. Mr. Speaker, I would like to inform the gentleman from
Florida (Mr. Goss) that we have one speaker remaining, and I would ask
if he has more and does he plan to close.
Mr. GOSS. Mr. Speaker, I thank the gentlewoman for her inquiry. The
fact is, we have many speakers remaining, but we are only going to have
time for 1 more to be on the floor to close, and that will be the
gentleman from California (Mr. Dreier), the distinguished chairman of
the Committee on Rules.
Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from
Missouri (Mr. Gephardt).
(Mr. GEPHARDT asked and was given permission to revise and extend his
remarks.)
Mr. GEPHARDT. Mr. Speaker, I urge Members to vote against this rule.
I urge Members to vote against the Norwood amendment if the rule is
approved.
This is a bad rule, but more importantly, this is a bad bill. This is
not a Patients' Bill of Rights, this is an HMO and health insurance
company bill of rights. If the Norwood amendment passes, we are giving
HMOs and health insurance companies, who make many of the important
health care decisions in our lives today, a different standard of
accountability than doctors who make other decisions in our lives. We
are treating HMOs and health insurance companies in a preferential way,
as compared to doctors and nurses and hospitals that are held
responsible for their medical decisions.
If the Norwood amendment passes, what started out to be a Patients'
Bill of Rights becomes a dream bill for HMOs and health insurance
companies. They will have achieved what they often try to achieve in
making medical decisions, which is how to save money, how to make more
profit, not how to give people quality health care.
Let us look at just three things that Norwood changes in this bill
that are dramatic changes in our legal system as it applies to only
HMOs and health insurance companies. First, there is a presumption, a
presumption that if you lose at the arbitration level, at the board
level of appeals, against the patient, there is no presumption against
the HMO and the health insurance company; in no other area of our tort
law do we have that kind of presumption. Why would we want to give a
presumption against the patient, but not the HMO or the health
insurance company? It is a stunning abdication to the HMOs and health
insurance companies.
Secondly, and perhaps worse, this bill, if Norwood passes, will
preempt State tort laws. Our friends on the other side of the aisle are
fond of saying we need a Federal system; we need States to have
discretion. We have to look to States to put these laws in place, but
by the same token, when it suits them, because it suits the HMOs and
health insurance companies, then it is fine to preempt the State laws;
and for the first time in the history of this country, we will have a
Federal tort law that applies to malpractice and injury caused by HMOs
and health insurance companies. So States like Missouri or Texas or
California who have passed a good patients' bill of rights will have
all of that wiped out, and if a patient gets to court, can get through
the maze to get to court, they will be faced with a Federal tort law,
not the law of their State.
Thirdly, damages. We have $1.5 million cap on noneconomic, on
punitive, and that sounds like a lot of money. The problem with that is
that in many cases, that will be less than what one would get if one
was under State law. And even though it sounds like a lot of money, let
us stop for a minute and think about some of these cases.
Let me give my colleagues an analogy. There are a lot of cases now
about rollovers, Firestone cases. People have been gravely injured. I
heard of a woman who has two children; she rolled over and was badly
injured. She is now paralyzed; she is what you call a ``shut-in.'' She
can only move her eyes. She is on a ventilator.
What if she were a victim of malpractice by an HMO or a health
insurance decision? What if she were limited to $1.5 million with the
responsibility at her age to raise two kids? What if she were limited
to a new Federal tort law for the first time in our history, rather
than being able to use the law of her State to be justly compensated
for being injured in this way?
This is a stunning reversal for the patients and the people of this
country. This is special-interest legislation. This is doing the
bidding of health insurance companies and HMOs over the interests of
the people that we represent in our districts. This is a stunning
abdication of what we should be fighting to protect for the people that
we represent.
I defy any of us to go into a hospital room of someone who has been
done in by bad decisions made by HMOs and health insurance companies
and look them in the eye and say, I voted today to take away your
rights, to preempt your rights, to set up a new Federal tort law that
has never existed in this country.
In the name of God and common sense, I hope Members will vote against
this rule and vote against the Norwood amendment if it passes. Stand
for the people that you represent in this country. You have a solemn
obligation to fight for their interests and rights and not the profit
and the money for the health insurance companies and HMOs.
I beg you to vote against this rule, vote against the Norwood
amendment if it passes; and if the Norwood amendment goes in, vote
against this legislation.
Ms. SLAUGHTER. Mr. Speaker, I yield myself the remaining time.
I urge my colleagues to defeat the previous question, and if the
previous question is defeated, I will offer an amendment that makes in
order the Ganske-Dingell-Berry bipartisan Patient Protection Act
substitute amendment. This amendment pays for patient protections and
expanded MSA provisions provided in the bill by extending the regular
customs taxes and closing tax loopholes for businesses set up solely
for the purposes of tax relief.
Mr. Speaker, I yield back the balance of my time.
Mr. GOSS. Mr. Speaker, it is my privilege and honor to yield such
time as he may consume to the distinguished gentleman from California
(Mr. Dreier).
(Mr. DREIER asked and was given permission to revise and extend his
remarks.)
Mr. DREIER. Mr. Speaker, I thank the gentleman for yielding time, and
I want to congratulate him. He has worked for 12 years.
I would like to thank several other people, including the gentleman
from Iowa (Mr. Ganske) who is here; the gentleman from Georgia (Mr.
Norwood), the gentleman from Kentucky (Mr. Fletcher), and the gentleman
from Illinois (Mr. Hastert), the Speaker of the House of
Representatives, who has spent a decade working on this issue.
We are here with legislation which is designed to ensure that we have
a Patients' Bill of Rights. We want everyone to have recourse. But as I
listened to the arguments from the other side of the aisle, we are
hearing the same old, tired and failed class warfare, us versus them,
the haves and the have-nots. I have not heard much talk about the real
reason that we are here beyond ensuring that there is a recourse for
those who have been wronged.
There are a couple of important reasons. Frankly, they are going to
be addressed in the amendment process that we have here. We want to
make sure that we provide both availability, increase the availability
of health care and increase the affordability.
Now, we have heard from witnesses before the Committee on Rules, and
I would like to thank my colleagues of the Committee on Rules on both
sides of the aisle for working until the middle of the night and then
just a few hours later being here to report this rule out today. But we
heard in testimony before the Committee on Rules that we have a very
serious problem with the uninsured in this country. There are some who
have predicted that we can see an increase by 9 million in the number
of uninsured if we do not take action.
That is one of the reasons that the proposal of the gentleman from
Kentucky (Mr. Fletcher), which I believe is a very important one, along
with a number of our other colleagues, including the gentleman from
California (Mr.
[[Page H5194]]
Thomas) and others, dealing with medical savings accounts, is a very
important provision. Last night the gentleman from California (Mr.
Thomas) told us how the 18- to 29-year-olds are increasingly drawn to
the prospect of putting dollars aside to plan for their health care.
This is a very important step that we can take to deal with the issue
of the uninsured; and, of course, affordability. Affordability is
something that we are all very, very troubled about. And how is it that
we most effectively deal with it? Well, obviously, we have to have some
degree of competition, and I think that we have a chance to do that as
we move ahead with this legislation.
We have all worked hard. People keep talking about looking at the
fine print. As the gentleman from Illinois (Mr. Hastert) said on Meet
the Press last Sunday, 98 percent of this bill was agreed to in a
bipartisan way. We focused on a very small part of it that was an area
of disagreement, and we have seen the President of the United States
step forward with a wonderful array of proposals.
This morning he talked to us in the Republican Conference about the
wonderful successes that we have enjoyed over the last 6 months in the
area of education, tax relief, his faith-based initiatives, the energy
measure which we successfully passed here late last night, and now this
issue on a Patients' Bill of Rights. It was a key plan of his platform
when he ran for President. He said all along that he did not want to
veto legislation.
Mr. Speaker, we have here the chance to, from the House of
Representatives, pass legislation which the President of the United
States can sign so that we can enhance those issues of affordability
and availability that are so important and so badly needed, and so that
we can ensure that we have a meaningful and balanced Patients' Bill of
Rights.
Mr. Speaker, I urge my colleagues to support the rule, to support the
Norwood amendment, and to support the other two very important
amendments we have on medical malpractice and on the issue of
accessibility with medical savings accounts. Support the rule and
support those measures.
Mr. GOSS. Mr. Speaker, I yield back the balance of my time.
____________________