[Congressional Record (Bound Edition), Volume 145 (1999), Part 10]
[Senate]
[Pages 14539-14540]
[From the U.S. Government Publishing Office, www.gpo.gov]



                        PATIENTS' BILL OF RIGHTS

  Mr. LEAHY. Mr. President, it is interesting when you think of the 
debate we are in. Here we are as Americans in the richest and most 
powerful country the world has ever known. There is really no 
comparison to it. We have the most highly trained and capable health 
professionals of any nation. Our technology leads the way on the 
frontiers of medical science. People come from all over the world to 
train and to be educated in medical science. But at that same time, 
millions of American families in our Nation with its first-class 
medical expertise are subject to second-class treatment because of the 
policies and practices of our health insurance system.
  I have to ask, is it really beyond the ability of this great Nation 
to ensure access and accountability to help these families? Of course 
it is not. Is this an important enough problem that solving it should 
be a high priority for this body, the Senate? Of course it is.
  Although the President and many of the Senators have done their 
utmost for years to encourage the Congress to act, I am afraid that the 
Republican leadership long ago decided that protection for those 
Americans insured through private managed care plans was just not a 
priority for us--this despite the fact that we have had calls from 
nonpartisan groups from every corner of the Nation. The Republican 
leadership has refused to schedule a full and reasonable debate to 
consider the vote on the Patients' Bill of Rights.
  Certainly from my experience in the Senate it is clear that the only 
step left is, of course, to bring the Patients' Bill of Rights directly 
to the floor. I believe we should keep it there until the Republicans, 
who are in the majority, agree that it merits the priority 
consideration that we--and I believe most of the American people, 
Republican and Democrat--strongly believe it does.
  I applaud Senator Kennedy, Senator Durbin, and many others for 
leading this vigilance to save the Patients' Bill of Rights. I commend 
the distinguished Senate Democratic leader, Mr. Daschle, for continuing 
to insist on a reasonable time agreement as he attempts to negotiate 
with our friends on the other side of the aisle.
  I urge our friends in the Republican Party to make the Patients' Bill 
of Rights a high priority. Let's get on with the debate, vote it up or 
vote it down, and then go on to the other matters, things such as the 
agriculture appropriations bill and other business before us.
  The Patients' Bill of Rights that we Democrats have presented 
reflects a fundamental expectation that Americans have about their 
health care. That expectation is that doctors--not insurance 
companies--should practice medicine.
  To really sum up our Patients' Bill of Rights, we are saying that 
doctors--not insurance companies--should be the first decisionmakers in 
your health care. The rights that we believe Americans should have in 
dealing with health insurers are not vague theories; they are 
practical, sensible safeguards. You can hear it if you talk to anybody 
who has sought health care. You can hear it if you talk to anybody who 
provides health care. I hear it from my wife, who is a registered 
nurse. I hear it from her experiences on the medical-surgical floors in 
the hospitals she has worked in. If you want to see how some of them 
would work in practice, come with me to Vermont. My state has already 
implemented a number of these protections for the Vermonters who are 
insured by managed care plans. I am proud Vermont has been recognized 
nationally for its innovation and achievements in protecting patients' 
rights.
  I consistently hear from Vermonters who are thankful for the actions 
that the Vermont legislature has taken to ensure patients are 
protected. But I also hear from those who do not yet fall under these 
protections.
  This Congress should waste not more time and instead make a 
commitment to the American people that we will fully debate the 
Patients' Bill of Rights. We must protect those Vermonters who are not 
covered under current state law. And we must act now to cover every 
other American who expects fair treatment from their managed care plan.
  I am one of many in this body who firmly believe in the importance of 
this bill. I hope the leadership is listening and I hope they hear what 
we are saying. It is what Americans are saying.
  As I stated at the beginning of this message, millions of American 
families in this Nation of first-class medical expertise are subject to 
second-class treatment because of the policies and practices of our 
health insurance system.
  We have heard a lot of ``our bill has this,'' and ``their bill 
doesn't have that.'' Here are some of the facts. Our Patients' Bill of 
Rights will protect every patient covered by private managed care 
plans. And it offers protections that make sense, such as ensuring a 
patient has access to emergency room services in any situation that a 
``prudent layperson'' would regard as an emergency, guaranteeing access 
to specialists for patients with special conditions, and making sure 
that children's special needs are met, including access to pediatric 
specialists when they need it.
  Our Patients' Bill of Rights provides strong protections for women. 
It will provide women with direct access to their ob/gyn for preventive 
care. Through successful research, we have learned that regular 
screening can prevent breast cancer and cervical cancer in women of all 
ages.
  We stress the importance of regular visits to ob/gyns to the women in 
our lives: our mothers, our wives, our daughters, and our sisters. But 
we make it difficult for these women to receive care by requiring 
referrals and putting other obstacles in the way of their care. Let us 
make sure women have the direct access they need and deserve.

[[Page 14540]]

  Our bill also will give women time to recover when they have 
undergone surgery. We should let doctors and patients determine if a 
lengthier hospital stay is necessary, and our bill would let them 
decide.
  Health plans must be held accountable for their actions, just as 
doctors and hospitals are today. Out Patients Bill of Rights provides a 
variety of ways to achieve this goal.
  First, patients must be able to appeal decisions made by their health 
plans. In our bill, any decision to deny, delay or otherwise overrule 
doctor-prescribed treatments could be appealed. And our bill says these 
appeals must be addressed in a timely manner, especially when the life 
of a patient is threatened. Patients must have the opportunity to 
question managed care decisions and insurance companies must be held 
accountable, especially when they decide to overrule the decisions of a 
trained health care providers.
  Our bill would require an external appeals process through an 
independent body with the ability and the authority to resolve disputes 
in a variety of instances. We know this is often a successful way of 
mediating labor disputes. Why can't it work for our patients, too?
  Finally, the Patients' Bill of Rights would allow patients to hold 
health plans liable for their decisions. This is essential. How can we 
justify holding our physicians responsible for decisions that they are 
not really making? Doctors must account for the decisions they make. 
Why shouldn't health insurers be responsible for theirs?
  Differences between patients and their managed care plans can readily 
be resolved without going to court. But that will not and should not 
always be the case. We must extend this consumer protection to 
patients.
  Mr. President, let us make the Patients' Bill of Rights the high 
priority that our families want it to be on our agenda.

                          ____________________