[Congressional Record Volume 155, Number 44 (Thursday, March 12, 2009)]
[Extensions of Remarks]
[Pages E655-E656]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




           INTRODUCING THE QUALITY HEALTH CARE COALITION ACT

                                 ______
                                 

                             HON. RON PAUL

                                of texas

                    in the house of representatives

                        Thursday, March 12, 2009

  Mr. PAUL. Madam 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. For over a 
decade, 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 care 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 who spent over 30 years practicing medicine, 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 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 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-

[[Page E656]]

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.
  Madam 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 
providing Americans with large tax credits and tax deductions for their 
health care expenses, including a deduction for premiums for a high-
deductible insurance policy purchased in combination with a Health 
Savings Account. 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, 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.

                          ____________________