Richard F. Corlin, MD
President-Elect
American Medical Association

Patients’ Bill of Rights

Let me bring you up to date on the progress of the patients’ bill of rights.

Twice this year, a narrow majority in Senate voted to block passage of a patients’ bill of rights that would protect our patients from HMO and managed care abuses.

Instead, Senate, with one-vote margin, passed legislation that claims to protect patients – but seems to be more of an HMO Protection Act.

Still time, for this Senate to give patients the protections they deserve.

All we need is a single Republican senator to provide one vote necessary to enact a real patients’ bill of rights.

House of Representatives has passed a real patients bill of rights by an overwhelming – bipartisan – majority.

But House-Senate conference committee charged with reconciling differences between the two bills experienced the partisan gridlock we’ve come to expect from Washington.

Meanwhile, the public wonders why the Senate has failed to pass the same patient protections that are supported by 81 percent of registered voters – Democrats, Republicans and Independents alike.

The real answer: Big insurance and its deep pockets.

Big insurance spent more than $100 million to kill patients’ rights legislation.

Our patients today are not getting their money’s worth from their health insurance premiums.

Wall Street rewarding those highly paid insurance executives for withholding medical services.

Senate just one vote away from a meaningful patients’ bill of rights.

A bill that will:

• Allow physicians – not insurance company bean counters – to make medical decisions.

• Give patients an independent, timely appeals process if care is delayed or denied.

• And hold health plans accountable when they make decisions that harm patients.

Passage of a patients’ bill of rights will help restore public confidence in our health care system.

Will demonstrate that Congress can actually legislate -- and not just debate -- health care issues.

Bill would also free up policy-makers in the next Administration and the 107th Congress to devote greater attention to such issues as covering the uninsured, Medicare reform and prescription drug coverage.

All that will take is for one senator to step forward and make history.

In the last few weeks the AMA’s National House Call in Tennessee, Oklahoma, Pennsylvania and Michigan -- putting pressure on senators in those states to help pass a meaningful Patients’ Bill of Rights.

A bill to both protect patients – and hold insurance firms accountable.

In the remaining days of the 106th Congress – no matter what happens --the AMA will remain focused – disciplined – and aggressive.

Hope you will stay the course with us.

As your Senators Mikulski and Sarabanes well know – not a Republican issue or a Democratic issue – but a patient issue with enormous bipartisan support in the House.

Still time for this Senate – for this Congress – to give patients the protections they deserve.

Bliley Bill / NPDB

Speaking of patient protections, it’s outrageous that Rep. Thomas J. Bliley (R, Va.) has co-opted that term to name his legislation to open the confidential National Practitioner Data Bank to the public.

By introducing the so-called Patient Protection Act of 2000, Rep. Bliley is trying to distract physicians’ attention from the Patients’ Bill of Rights effort at this critical time.

We need to send a clear message to Rep. Bliley: We will not be distracted from our all-out efforts to pass a patients’ bill of rights and put an end to managed care abuses.

Safeguarding the millions of patients in our health care system is one of the AMA’s highest priorities.

The best approach to meet patients’ needs for physician information is to perfect state-based systems already in place. There’s no reason to re-invent the wheel.

States are at the forefront of providing patients with relevant information on health care providers – and the state medical boards have full access to the information in the national data bank.

Experts -- including the Institute of Medicine -- that have studied ways to improve the quality and safety of health care have concluded that simply opening the National Practitioner Data Bank and disseminating this legal data would not help patients.

Congress didn’t design the National Practitioner Data Bank to provide patient information.

The NPDB doesn’t contain information about the overall qualifications of physicians and other health care providers.

The well-balanced and complete information that states are working to give patients stands in stark contrast to the federal data bank – which contains mostly reports of legal settlements that are not an indicator of physician quality or competence.

Most physicians have malpractice claims on their records – this doesn’t mean they are bad physicians.

In fact, a New England Journal of Medicine study indicates that only about 1 in 5 settlements results from negligent medical care.

The AMA is urging Congress to assist with efforts being made by state licensing boards – where real progress is being made toward getting patients the information they need.

Campbell Bill

We found broad bipartisan support in Washington for the Campbell bill, H.R. 1304, the Quality Health-Care Coalition Act of 2000.

The House of Representatives approved the Campbell bill by a wide margin – voting to allow collective bargaining by self-employed physicians.

Since 1994, there have been 275 mergers and acquisitions of health plans. Now, just seven powerful plans – and the Blues – control the cost, access and quality of care for more insured Americans.

We all know that these powerful health plans intimidate and threaten physicians with antitrust violations in order to bar them from talking to one another – and to insurers – about patient care.

We need legislation at the federal level to offset the enormous advantage insurance companies have in dictating terms – dictating what the underwriters think is appropriate patient care – and appropriate levels of quality.

Utah physician leaders recently met with Senator Orrin Hatch, chairman of the Senate Judiciary Committee. Senator Hatch acknowledged that there is a problem, but believes the Campbell Bill goes too far.

While there may not be enough time left in this session for the Senate Judiciary Committee to hold hearings, Senator Hatch has agreed to work with us on addressing the antitrust issue in the next Congress.

This Congress will end in October, when our legislators return home for the November elections.

So, act now in urging Senators Mikulski and Sarabanes to support a Senate version of H.R. 1304 in order to level the playing field for physicians against the giant insurance plans.

Patient Prescriptions

Concerning the drive to have Medicare fund patient prescriptions – we physicians understand how important it is for our patients to have their medications.

But we think this must be brought about in a fiscally responsible way.

Any proposed Medicare outpatient prescription drug benefit should be funded separately from Parts A and B of Medicare.

Requiring a new infusion of dollars into the Medicare program -- something that is certainly possible in this era of economic plenty.

But this benefit should be targeted to reduce hardship for those who need it – those whose incomes aren’t adequate to cover it and those with catastrophic drug costs.

We will be following the political debates that take place on the issue of Medicare prescription benefits.

And carving out a position based on for what’s best for our patients – and for the profession.

Closing

Health care high on the public’s political agenda – and we’re seeing the candidates respond.

Critical election ahead – control not only of the White House, but House of Representatives and several competitive Senate races as well -- that could influence the future of American medicine’s legislative agenda.

Organized medicine has the right – and the responsibility – to advocate for our patients – and our profession.

The AMA is there for you in Washington – and working with our partners in the Federation in the states.

To ensure that American medicine remains the greatest in the world.

We appreciate your help and partnership – and so do the patients of America.

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