[Congressional Record Volume 149, Number 40 (Wednesday, March 12, 2003)]
[Extensions of Remarks]
[Page E436]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   QUALITY HEALTH CARE COALITION ACT

                                 ______
                                 

                             HON. RON PAUL

                                of texas

                    in the house of representatives

                       Wednesday, March 12, 2003

  Mr. PAUL. Mr. Speaker, I am pleased to introduce the Quality Health 
Care Coalition Act, which takes a first step towards restoring a true 
free market in health care by restoring the rights of freedom of 
contract and association to health care professionals. Over the past 
few years, we have had much debate in Congress about the difficulties 
medical professionals and patients are having with Health Maintenance 
Organizations (HMOs). HMOs are devices used by insurance industries to 
ration health care. While it is politically popular for members of 
Congress to bash the HMOs and the insurance industry, the growth of the 
HMOs are rooted in past government interventions in the health care 
market though the tax code, the Employment Retirement Security Act 
(ERSIA), and the federal anti-trust laws. These interventions took 
control of the health care dollar away from individual patients and 
providers, thus making it inevitable that something like the HMOs would 
emerge as a means to control costs.
  Many of my well-meaning colleagues would deal with the problems 
created by the HMOs by expanding the federal government's control over 
the health care market. These interventions will inevitably drive up 
the cost of health and further erode the ability of patents and 
providers to determine the best health treatments free of government 
and third-party interference. In contrast, the Quality Health Care 
Coalition Act addresses the problems associated with HMOs by restoring 
medical professionals' freedom to form voluntary organizations for the 
purpose of negotiating contracts with an HMO or an insurance company.
  As an OB-GYN with over 30 years in practice, I am well aware of how 
young physicians coming out of medical school feel compelled to sign 
contracts with HMOs that may contain clauses that compromise their 
professional integrity. For example, many physicians are contractually 
forbidden from discussing all available treatment options with their 
patients because the HMO gatekeeper has deemed certain treatment 
options too expensive. In my own practice, I have tried hard not to 
sign contracts with any health insurance company that infringed on my 
ability to practice medicine in the best interests of my patients and I 
have always counseled my professional colleagues to do the same. 
Unfortunately, because of the dominance of the HMO in today's health 
care market, many health care professionals cannot sustain a medical 
practice unless they agree to conform their practice to the dictates of 
some HMO.
  One way health care professionals could counter the power of the HMOs 
would be to form a voluntary association for the purpose of negotiating 
with an HMO or an insurance company. However, health care professionals 
who attempt to form such a group run the risk of persecution under 
federal anti-trust laws. This not only reduces the ability of health 
care professionals to negotiate with HMOs on a level playing field, but 
also constitutes an unconstitutional violation of medical 
professionals' freedom of contract and association.
  Under the United States Constitution, the federal government has no 
authority to interfere with the private contracts of American citizens. 
Furthermore, the prohibitions on contracting contained in the Sherman 
antitrust laws are based on a flawed economic theory which holds that 
federal regulators can improve upon market outcomes by restricting the 
rights of certain market participants deemed too powerful by the 
government. In fact, anti-trust laws harm consumers by preventing the 
operation of the free-market, causing prices to rise, quality to 
suffer, and, as is certainly the case with the relationship between the 
HMOs and medical professionals, favoring certain industries over 
others.
  By restoring the freedom of medical professionals to voluntarily come 
together to negotiate as a group with HMOs and insurance companies, 
this bill removes a government-imposed barrier to a true free market in 
health care. Of course, this bill does not infringe on the rights of 
health care professionals by forcing them to join a bargaining 
organization against their will. While Congress should protect the 
rights of all Americans to join organizations for the purpose of 
bargaining collectively, Congress also has a moral responsibility to 
ensure that no worker is forced by law to join or financially support 
such an organization.
  Mr. Speaker, it is my hope that Congress will not only remove the 
restraints on medical professionals' freedom of contract, but will also 
empower patients to control their health care by passing my 
Comprehensive Health Care Reform Act. The Comprehensive Health Care 
Reform Act puts individuals back in charge of their own health care by 
expanding access to Medical Savings Accounts and providing Americans 
with large tax credits and tax deductions for their health care 
expenses. Putting individuals back in charge of their own health care 
decisions will enable patients to work with providers to ensure they 
receive the best possible health care at the lowest possible price. If 
providers and patients have the ability to form the contractual 
arrangements that they find most beneficial to them, the HMO monster 
will wither on the vine without the imposition of new federal 
regulations on the insurance industry.
  In conclusion, Mr. Chairman, I urge my colleagues to support the 
Quality Health Care Coalition Act and restore the freedom of contract 
and association to America's health care professionals. I also urge my 
colleagues to join me in working to promote a true free market in 
health care by putting patients back in charge of the health care 
dollar by supporting my Comprehensive Health Care Reform Act.

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