FOR IMMEDIATE RELEASE
U.S. Chamber of Commerce Letter on S. 326 The "Patients' Bill of
Rights Act"
March 17, 1999
The Honorable Jim Jeffords Chairman Health, Education, Labor and
Pensions United States Senate Washington, DC 20510
Dear Mr. Chairman:
As the Senate Committee on Health, Education, Labor and Pensions
prepares to take up S. 326, the "Patients’ Bill of Rights Act," the U.S.
Chamber of Commerce urges you to oppose benefit and plan design mandates
that will further increase the cost of health insurance. The U.S. Chamber
of Commerce is the world’s largest business federation representing more
than three million businesses and organizations of every size, sector and
region.
The benefit mandates and plan design requirements included in S. 326
will most certainly increase the cost of health insurance and will
disproportionately impact the smallest business owners who lack the
ability to manage escalating health care costs. A recent survey of Chamber
small business owners found that four out of five of our members
experienced premium increases averaging 19 percent this year. Many of
these businesses were forced to alter their benefits, often by switching
to a lower cost plan or increasing premiums and cost-sharing for
employees. Ten percent of small business owners who made changes in
response to the premium increases discontinued coverage for their
employees. Not surprisingly, a majority of respondents who do not
offer health coverage said they would do so if it were more affordable.
The U.S. Chamber opposes government mandates that lock into statute
current medical practice and plan design features. Best practices and
market innovation in the health care setting evolve continually as
practitioners, purchasers, consumers and payers seek higher standards for
quality. That many employers and health plans may have voluntarily already
adopted a number of the mandates now under consideration should not
warrant federal legislation requiring such provisions. The marketplace
often moves more quickly in response to consumer demand than can
governmental bodies. The mandates under consideration today may well
be outmoded in a short matter of time as processes that better serve
patients are developed. Unfortunately, these future plan improvements will
be hampered in achieving their potential because they must work around the
strictures imposed today.
We urge you to reject amendments to S. 326 that would require direct
access to specialists and other proposals that loosen the managed care
framework. There are many models for providing health benefits that embody
managed care principles, with proportionate cost increases as the plans
and networks become looser and more open. Yet only 14 percent of the
Chamber’s survey respondents with less than 10 employees are able to offer
more than one health plan option; just two out of three businesses with
more than 100 employees were able to offer a choice of health plans. For
many employees of a small business, the difference between having a closed
network from which to choose providers and a plan offering more freedom is
the likelihood of no coverage at all.
The Chamber also strongly urges you to reject amendments to the
legislation that would expand the definition of medically necessary care
or expand employer and plan liability in benefit claims disputes. A
reasonable system of external reviews by independent specialists would be
preferable to drawn out litigation and jury awards for punitive damages
that do little to enhance the quality of care provided the patient, but
which amply reward trial lawyers. A number of health plans have already
voluntarily embraced such a system to ensure that patients benefit from
the most current knowledge available with regard to their diagnoses,
rather than relying on local custom or common practice that may no longer
meet an evolving standard of care. We encourage the committee to leave
open the possibility of future improved processes to determine necessary
and appropriate coverage and consider appeals.
Many of the amendments that will be offered to S. 326 are intended to
resolve perceived inequities in the array of health benefits voluntarily
offered today by employers. The U.S. Chamber of Commerce believes strongly
in market, not government, solutions to these issues. We ask you to be
mindful of the adverse impact good intentions can have in approving
measures that will raise costs and threaten continued health coverage in
the name of protecting patient rights.
Sincerely,
R. Bruce Josten Executive Vice President Government
Affairs U.S. Chamber of Commerce
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