Extension of Remarks
Introductory Statement
of the Honorable Pete Stark
PATIENTS' BILL OF RIGHTS FIRST CONFERENCE COMMITTEE MEETING
March 2, 2000
The American public is frustrated with the status quo on managed care. Poll
after poll shows that the public strongly supports passage of a federal
patients’ bill of rights. In fact, a recent Kaiser Family Foundation and Harvard
School of Public Health survey finds that after more than two years of debate on
patients’ rights, most Americans believe that problems with managed care have
not gotten better and that the need for legislative action is more, or as
urgent, as it was when this debate began.
With the voice of the American
public firmly behind us, it is clear that the starting point for this important
conference should be the House-passed Bipartisan Consensus Managed Care Reform
Act. The House passed that bill last October by a stunning bipartisan margin of
275-151 – with 68 Republicans joining with us. The American public supports this
legislation and it deserves to become law.
We worked with our Republican
colleagues in the House who share a commitment to protecting patients in managed
care plans across the country and the result is already a work of compromise. We
agreed to changes from the original Dingell legislation that included: a
limitation on liability so that if the plan follows the decision of the external
appeals entity, then the patient has no right to punitive damages; deletion of a
significant portion of the original legislation that required plans to turn over
data to the federal government for quality purposes; and, changes in the
external appeals structure and medical necessity definitions. All of these
modifications were in order to make the bill a truly bipartisan product that
could pass the House and be signed by the President. The House succeeded in our
job.
That should be the starting point for this conference. Unlike the
work of the House, the Senate legislation did not achieve bipartisan support,
does not apply to everyone (it is limited to the 48 million Americans in
self-insured plans), and it does not include a right for patients to sue their
health plans when their medical decision-making causes harm.
Both the
House and Senate bills also include a section dedicated to so-called "access"
provisions. These include tax provisions to provide for the deductibility of
health insurance premiums for people who pay more than 50% of their premiums,
expansion of the failed MSA demonstration, tax deductibility for long-term care
insurance, and the creation of new association health plans and so-called
HealthMarts which would bypass state insurance regulation.
Providing
access to health insurance for America’s 44 million uninsured citizens is a
vitally important issue. Unfortunately, these provisions which total some $48
billion in taxpayer expenditures do virtually nothing to help decrease the
number of uninsured. Instead, they provide new tax breaks for people who already
have health insurance. And, according to new analysis by the Congressional
Budget Office, the association health plans and HealthMarts would actually have
the negative impact of causing some 20 million Americans to pay more for their
health insurance, while only expanding coverage to some 330,000 people. Based on
these facts, none of these provisions deserves the title "access."
Again,
expanding health insurance coverage is one of my highest priorities. But, it
would be wrong to hold this long-sought and much-needed patients’ bill of rights
hostage over provisions that fail to effectively address the problem of the
uninsured.
It is far too soon to tell what this conference committee will
be willing or able to achieve. I recall numerous pronouncements of dates by
which we would be done with the Patients’ Bill of Rights over the past several
years. None of those have come true and I am not sure this one will either. But,
I am ready and willing to get to work to with my colleagues to create a strong,
federal managed care reform bill that applies to all health plans and holds
health plans accountable for their actions. Let’s get to work.
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