[Congressional Record (Bound Edition), Volume 146 (2000), Part 10]
[Extensions of Remarks]
[Page 13640]
[From the U.S. Government Publishing Office, www.gpo.gov]



               QUALITY HEALTH CARE COALITION ACT OF 2000

                                 ______
                                 

                               speech of

                            HON. MATT SALMON

                               of arizona

                    in the house of representatives

                        Thursday, June 29, 2000

       The House in Committee of the Whole House on the State of 
     the Union had under consideration the bill (H.R. 1304) to 
     ensure and foster continued patient safety and quality of 
     care by making the antitrust laws apply to negotiations 
     between groups of health care professionals and health plans 
     and health insurance issuers in the same manner as such laws 
     apply to collective bargaining by labor organizations under 
     the National Labor Relations Act:

  Mr. SALMON. Mr. Chairman, I rise to comment on H.R. 1304, the Quality 
Health Care Coalition Act--Representative Campbell's bill which the 
House passed on June 29. While I had some reservations about this bill, 
I supported the legislation because I believe that it ultimately will 
level the playing field for health care providers when they negotiate 
patient-care agreements with managed care companies. I believe that we 
should do all we can to restore the relationship between patient and 
physician. Too often, managed care companies negotiate with providers 
on a ``take it or leave it'' basis. And because many independent 
physicians have little leverage over third party payers, they must take 
what is offered for their services or lose patients. We improve the 
quality of patient care when we give physicians a greater role in 
determining care.
  Mr. Chairman, as you know, the bill would give physicians and other 
health care providers the same collective bargaining options (under the 
Clayton and Sherman Acts) accorded to labor organizations under the 
National Labor Relations Act. Smartly, the negotiating authority 
granted by H.R. 1304 sunsets in three years. At that point, the General 
Accounting Office will study the impact of the legislation and make 
recommendations on how to improve it.
  Opponents of the bill argue that it will allow physicians to form 
monopolies. Nothing in this legislation preempts the FTC or anti-trust 
department at DOJ from overseeing the business practices of groups 
formed by doctors. And the bill specifically states that physicians 
must negotiate in ``good faith'' with managed care companies. I 
encourage the FTC and the DOJ to continue to pay close attention to any 
activity that would adversely affect patients. Ironically, it is the 
HMOs which seem to exhibit monopolistic behavior. Over the last decade, 
third party payers have increasingly exercised their market power over 
both patients and doctors.
  As I mentioned before, I have some reservations about the bill. For 
example, I am concerned that the legislation might create agreements 
where HMOs will pass any increase in health care costs to patients. I 
am also concerned that any shift in cost to patients will increase the 
number of uninsured. But, that argument is used every time Congress 
tries to reform the current health care system and it is the reason we 
cannot break the stranglehold that HMOs have on our health care 
decisions. At some point, we must return the health care market back to 
patients and doctors. I believe that this bill is a small step toward 
restoring the patient-physician relationship.




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