SHADEGG CALLS ACTION ON H.R. 1304 PREMATURE
Bill would undermine a strong Patients' Bill of Rights

WASHINGTON -- U.S. Congressman John Shadegg (R-AZ) today distributed a "Dear Colleague" letter to all House members expressing deep concerns about H.R. 1304, the Quality Health Care Coalition Act, which is scheduled for debate later this week. Below is the text of Shadegg's letter:

Dear Colleague,

As a conferee on the Patients' Bill of Rights, I am keenly aware that the playing field in health care, an industry increasingly dominated by managed care companies, is not level. Many health care providers feel that they must accept the rules dictated by HMOs, suffer financially, or leave the practice of medicine altogether.

But even as I work for enactment of a strong Patients' Bill of Rights that will address this physician frustration, I remain opposed to H.R. 1304, the Health Care Quality Coalition Act, and believe strongly that the House should not take action on this measure until Congress has sent the President a strong and effective Patients' Bill of Rights.

I agree with advocates of H.R. 1304 that doctors need more leverage in their negotiations with health plans. They point to contractual provisions that they say show that health plans enjoy an unfair advantage over physicians in contract negotiations -- "gag" clauses that prevent doctors from informing patients of all their medical options, provisions that limit access to emergency room care, and clauses that impose unfair barriers to patients who need to see medical specialists. If such provisions sound strikingly familiar, they should. EACH ONE OF THESE PROVISIONS -- AND MANY MORE LIKE THEM -- ARE ADDRESSED BY BOTH THE HOUSE AND SENATE VERSIONS OF THE PATIENTS' BILL OF RIGHTS! Passage of a strong Patients' Bill of Rights will go a very long way in addressing the problems physicians face in dealing with managed care companies.

In contrast to the Patients' Bill of Rights, which contains many ideas that states already have implemented, H.R. 1304 takes a radical and untested approach to the relationship between doctors and managed care organizations. In fact, this year alone, according to an article in this week's AMNews, a publication of the American Medical Association, all 17 states that considered versions of H.R. 1304 have rejected such legislation. To date, bills have advanced only in Texas and the District of Columbia, and both jurisdictions place tight legal constraints on physician groups formed to negotiate with insurers. These constraints, which would protect patients against anticompetitive behavior, are missing entirely from H.R. 1304, which would permit collusion, price-fixing, boycotts, and other anticonsumer activities.

The House should not proceed with an antitrust exemption when final action on the Patients' Bill of Rights is imminent. Conferees have worked long and hard on a difficult and sometimes contentious subject. Not only would it be a shame to see our efforts undermined, indeed it is premature for the House to move forward on H.R. 1304 without having the opportunity to assess carefully the effect that a strong Patients' Bill of Rights will have.

I strongly urge that we defer action on H.R. 1304 until the House and Senate have adopted the Patients' Bill of Rights.

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