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The House in Committee of the Whole House on the State of the Union had under consideration the bill (H.R. 1304) to ensure and foster continued patient safety and quality of care by making the antitrust laws apply to negotiations between groups of health care professionals and health plans and health insurance issuers in the same manner as such laws apply to collective bargaining by labor organizations under the National Labor Relations Act:

• Mr. SALMON. Mr. Chairman, I rise to comment on H.R. 1304, the Quality Health Care Coalition Act--Representative CAMPBELL's bill which the House passed on June 29. While I had some reservations about this bill, I supported the legislation because I believe that it ultimately will level the playing field for health care providers when they negotiate patient-care agreements with managed care companies. I believe that we should do all we can to restore the relationship between patient and physician. Too often, managed care companies negotiate with providers on a ``take it or leave it'' basis. And because many independent physicians have little leverage over third party payers, they must take what is offered for their services or lose patients. We improve the quality of patient care when we give physicians a greater role in determining care.

• Mr. Chairman, as you know, the bill would give physicians and other health care providers the same collective bargaining options (under the Clayton and Sherman Acts) accorded to labor organizations under the National Labor Relations Act. Smartly, the negotiating authority granted by H.R. 1304 sunsets in three years. At that point, the General Accounting Office will study the impact of the legislation and make recommendations on how to improve it.

• Opponents of the bill argue that it will allow physicians to form monopolies. Nothing in this legislation preempts the FTC or anti-trust department at DOJ from overseeing the business practices of groups formed by doctors. And the bill specifically states that physicians must negotiate in ``good faith'' with managed care companies. I encourage the FTC and the DOJ to continue to pay close attention to any activity that would adversely affect patients. Ironically, it is the HMOs which seem to exhibit monopolistic behavior. Over the last decade, third party payers have increasingly exercised their market power over both patients and doctors.

• As I mentioned before, I have some reservations about the bill. For example, I am concerned that the legislation might create agreements where HMOs will pass any increase in health care costs to patients. I am also concerned that any shift in cost to patients will increase the number of uninsured. But, that argument is used every time Congress tries to reform the current health care system and it is the reason we cannot break the stranglehold that HMOs have on our health care decisions. At some point, we must return the health care market back to patients and doctors. I believe that this bill is a small step toward restoring the patient-physician relationship.

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