[Congressional Record (Bound Edition), Volume 147 (2001), Part 11]
[Extensions of Remarks]
[Page 16462]
[From the U.S. Government Publishing Office, www.gpo.gov]



                   BIPARTISAN PATIENT PROTECTION ACT

                                 ______
                                 

                               speech of

                        HON. SHEILA JACKSON-LEE

                                of texas

                    in the house of representatives

                        Thursday, August 2, 2001

       The House in Committee of the Whole House on the State of 
     the Union had under consideration the bill (H.R. 2563) to 
     amend the Public Health Service Act, the Employee Retirement 
     Income Act of 1974, and the Internal Revenue Code of 1986 to 
     protect consumers in managed care plans and other health 
     coverage:

  Ms. JACKSON-LEE of Texas. Mr. Chairman, we were given an opportunity 
today to come to this House Floor and enact a bipartisan, widely 
supported version of the Patients' Bill of Rights. I urge all members 
to support this fine bill and oppose the industry backed Norwood 
Amendment, which will only eviscerate the patient protection America 
needs. H.R. 2563, in its original form, will provide the health care 
reform the Nation needs by:
  1. Giving every American the right to choose his/her own doctor.
  2. Covering all Americans with employer based health insurance.
  3. Ensuring that independent physicians conduct all external reviews 
of medical decisions.
  4. Holding HMOs accountable when they make faulty decisions.
  H.R. 2563 requires health plans to establish both internal and 
external appeals processes for decisions that affect health care 
benefits. The process requires that all internal reviews be exhausted 
in a timely manner before an independent medical expert would be 
allowed to review the decisions made by the health plan.
  Under H.R. 2563, patients will be permitted to protect their rights 
by allowing a cause of action in state court for medical decisions, and 
in federal court for administrative decisions that prevent patients 
from receiving care. H.R. 2563 respects federalism by allowing state 
law to control when suits are brought in state court. The legislation 
punishes bad faith on the part of providers, also, by allowing for non-
economic damages of up to $5 million as a civil monetary penalty.
  H.R. 2563 represents the concerns of both patient and providers by 
providing a comprehensive and balanced system that provides fair access 
to health care and fair resolution of disputes. It does this by 
protecting employers from excessive liability. H.R. 2563 protects small 
businesses and others who delegate their healthcare decisions to 
experts. Employers are protected from legal liability unless they 
participate in a decision on a claim that results in harm to the 
patient.
  Mr. Chairman, the benefit to patients this legislation will bring is 
important. This bill restores the patient's confidence in healthcare by 
guaranteeing emergency room coverage and ensuring timely access to 
healthcare. Also, Mr. Chairman, this legislation will protect the 
rights of women and children to access the specialized care they need. 
The bill provides direct access to OB/GYN care, as well as allowing 
parents to chose a pediatrician as their child's primary care provider.
  I strongly urge all members to resist the Norwood amendment and any 
other attempt to alter what is already a compromise bill. The Norwood 
amendment would tilt the playing field in favor of institutional 
decision-makers. The proposed $1.5 million cap on non economic and 
punitive damages does not accurately reflect the devastating impact of 
medical decisions that result in lifelong injuries. By requiring 
federal rules to apply in both state and federal court cases, the 
amendment also trounces the ideals of federalism.
  This, however, is made almost irrelevant by the worst aspect of the 
Norwood amendment. If passed, this amendment would create a rebuttable 
presumption in favor of the decision of the independent reviewer, while 
at the same time giving the decision maker authority over who will do 
the independent review. Then the patient must produce clear and 
convincing evidence to overcome that presumption, a standard of proof 
just below that required for a criminal conviction. Thus, the standard 
required to review decisions actually limits the rights citizens would 
have in court. Also, the reviewer has no real incentive to be 
independent at all. This is not reform.
  Mr. Chairman, the American people look to us to follow their wishes 
and enact real reform that puts the health of patients first. In order 
to do this, we must pass H.R. 2563. If we choose to follow the path the 
leadership desires by passing these misguided amendments, only special 
interests will be satisfied.

                          ____________________