LEXIS-NEXIS® Academic Universe-Document

LEXIS-NEXIS® Academic

March 16, 2000 Thursday, STATEWIDE

SECTION: MAIN; Pg. A10

LENGTH: 772 words

HEADLINE: CAPITOL FOCUSES ON COLLECTIVE BARGAINING BY DOCTORS

BYLINE: JOHN A. MACDONALD; Courant Staff Writer

DATELINE: WASHINGTON --

BODY:
They're at it again.

Doctors and insurers, increasingly at odds over the last decade, are about to renew their dispute in Congress. The two powerful groups will be on opposite sides today when the House Judiciary Committee is scheduled to debate whether self- employed doctors should be exempt from federal antitrust legislation if they band together to negotiate contracts with health insurers.

If it became law, the exemption would mean a major shift in power in favor of doctors, who saw their authority and fees erode during the 1990s with the rise of managed care.

"It's the only way I see for releasing some of the crushing power over the spirit and souls of physicians that managed care currently exerts," said Dr. Donald D. Timmerman, president-elect of the Connecticut State Medical Society.

The exemption would affect about two-thirds of the nation's 620,000 doctors -- those who are self-employed and have contractual agreements with health plans. Current federal law prohibits them from joining forces to bargain for fees. The American Medical Association announced last summer it will help doctors directly employed by health plans form unions that would bargain for their salaries.

Worried about increasing costs, insurers are fighting the exemption, but concede they are likely to lose when the issue comes to a committee vote, probably today.

"I wouldn't be surprised as things currently stand," said Jack Ericksen, director of congressional relations for the Blue Cross and Blue Shield Association.

Still, Ericksen and other analysts doubt an antitrust exemption will clear Congress this year because the measure has no lead Senate backer and lawmakers plan an abbreviated session so they can get home to campaign for the fall elections.

Beyond that, officials at the Justice Department and the Federal Trade Commission have announced their opposition.

"This bill would allow . . . health care professionals collectively to raise their fees to health insurers without fear of antitrust liability and without regard to competitive market forces fostered by the antitrust laws," Joel I. Klein, assistant attorney in charge of the Justice Department's antitrust division, has told the committee.

There is "no justification" for the increased costs the measure would cause, Klein added.

Doctors see the measure as a chance to restore equilibrium between themselves and insurers. "Clearly, the role of physician has never been more important than it is now, as many managed care companies continue to put profits before patients," said Thomas R. Reardon, president of the American Medical Association.

"The Campbell bill would level the playing field between physicians and insurers and allow physicians to fulfill their role as patient advocates," Reardon said.

Dr. Kristen Zarfos, an assistant professor at the University of Connecticut Health Center who also has a private surgical practice, likened managed care to a middle-man standing between patients and doctors. "I think the American people want their health care to get back to being between them and their physicians," she said.

Rep. Tom Campbell, R-Calif., is the measure's chief sponsor. A believer in free markets with a doctorate in economics, Campbell said: "This legislation is the best way to let the market deal with the complaints so many health care professionals have raised with HMOs. . . . This will ensure that all health care professionals will be able to secure contracts of a fair and equitable nature, and the patients will be better served."

Insurers vigorously dispute Campbell. "Existing rules already allow physicians to get together to discuss quality-of-care issues," said Charles N. Kahn, president of the Health Insurance Association of America. "Giving them a waiver [from antitrust rules] will only lead to higher costs for consumers and employers."

An association study asserts the measure could raise health insurance premiums by as much as $95 billion a year, or about 13 percent. Insurers often produce reports showing the high cost of legislation they oppose.

Despite insurers' opposition, Campbell has rounded up 197 sponsors for his measure, leaving him only 21 votes short of House passage. Missing from the list, though, are any members of the House Republican leadership and influential Judiciary Chairman Henry J. Hyde, R-Ill.

"The doctor-patient relationship must be preserved, and I am concerned that it may be diminishing," said Hyde, who has not taken a position. "On the other hand, almost everyone's life would be easier if they were exempt from the antitrust laws."

LOAD-DATE: March 16, 2000