[Congressional Record (Bound Edition), Volume 145 (1999), Part 17]
[House]
[Pages 24650-24651]
[From the U.S. Government Publishing Office, www.gpo.gov]



     THE PROBLEMS WITH THE DINGELL-NORWOOD HEALTH CARE REFORM BILL

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Washington (Mr. Nethercutt) is recognized for 5 minutes.
  Mr. NETHERCUTT. Mr. Speaker, yesterday the House of Representatives 
voted on different versions of health care reform. I believe that every 
one of our colleagues who spoke on this issue and voted on this issue 
had the best interests of patients in mind as they cast their votes.
  There were two issues that were discussed this week in connection 
with health care reform and patient care. First, we passed legislation 
this week to increase the access of patients to health care insurance 
coverage. That was a very important effort that was

[[Page 24651]]

undertaken by the House of Representatives.
  Second and most recently, yesterday we considered changes in the law 
to deal with the problems that patients have had with their health 
maintenance organizations, a problem that was illustrated time and time 
again by Members who stood here on the floor of the House.
  For me, I believe insurers should be held accountable for their 
actions if they cause actions that hurt a patient or inactions that 
hurt a patient that is covered by a plan. I happen to support the 
coalition substitute amendment introduced by the gentleman from Florida 
(Mr. Goss) and the gentleman from California (Mr. Thomas), the 
gentleman from Oklahoma (Mr. Coburn) and the gentleman from Arizona 
(Mr. Shadegg), among others.
  This legislation provided the protection I felt patients needed, and 
encourages care rather than lawsuits. It contained an internal and 
external appeals process that requires a faster response than required 
by the bill which ultimately passed the House yesterday afternoon, as 
sponsored by the gentleman from Georgia (Mr. Norwood) and the gentleman 
from Michigan (Mr. Dingell).
  The coalition bill, the bill that I supported, requires expedited 
appeals to be resolved in 48 hours, as opposed to the 72 hours that are 
set forth in the Norwood bill. I want my colleagues and others, Mr. 
Speaker, to understand that there were many similarities in the Norwood 
bill and the coalition bill, which I will call it.
  Both guarantee patients the right to choose a doctor outside their 
network. Both guarantee women direct access to obstetrical-
gynecological care. Both guarantee access to specialists. Both 
guarantee children direct access to pediatric care. Both guarantee 
coverage for emergency medical services without prior authorization, 
which is an important issue. Both guarantee coverage of a terminated 
provider for patients undergoing a course of treatment. Both prohibit 
so-called gag clauses. Both forbid insurers from offering providers 
incentives for denying coverage. Both provided a grievance process for 
beneficiaries to file complaints.
  Both allow patients to appeal denial of benefits, but the coalition 
bill actually requires a faster response than mandated by the Norwood 
bill, the difference between the 48-hour expedited appeals process and 
the 72-hour process in the Norwood bill.
  Both allow patients to sue their health maintenance organizations if 
they are hurt by them. The coalition bill allows patients to sue their 
HMOs in Federal court once they have exhausted the internal and 
external appeals process. The Norwood bill allows patients to bring 
lawsuits in State courts, which have 50 different States with 50 
different sets of rules. To me, that was a cumbersome process, and very 
difficult for employers to try to deal in 50 different States with 50 
different laws relative to liability.
  The Norwood bill puts employers at risk for lawsuits. I know there 
was a great deal of debate on that issue, and interpretation of 
language and counter-interpretation of language. But the facts are that 
the Norwood bill puts employers at risk for lawsuits, greater risk, 
without having a more extensive, exhaustive process before we ever get 
to a lawsuit.
  Employers offer health insurance benefits voluntarily. I fear that if 
the stability of their business is at risk due to a threat of a 
lawsuit, under the measure that was passed yesterday, employers would 
just say, no, we are not going to offer health insurance any longer.
  Washington State, my State, is currently facing a crisis in its 
individual insurance market. Excessive regulations have driven insurers 
out of our State. Those who have remained are no longer taking new 
enrollees. That is a problem for people in my State who seek insurance 
coverage. Individuals can no longer buy insurance in most of our State, 
even if they have the money.
  So excessive regulation, frivolous lawsuits, and risk to employers 
created by the Norwood bill will create the same problem in the group 
insurance market across the country. I think that would be an 
unintended consequence of our debate that occurred here yesterday and 
earlier this week.
  The last thing we need, Mr. Speaker, is a government-run, massively 
complicated health care program. I fear we are heading toward that if 
the Norwood bill becomes law.
  So my hope would be that those who are conferees on this issue and 
others who have an interest in this debate would work hard to get the 
facts out about the potential consequences or unintended consequences 
of an extensive, mandated legislation for health care that will drive 
people off the insurance rolls and then lead to, ultimately, the 
unintended consequence of a massive health care plan run by the Federal 
Government that was rejected so forcefully in 1993 and 1994.

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