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Copyright 2000 / Los Angeles Times
Los Angeles Times
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June 30, 2000, Friday,
Home Edition
SECTION: Part A; Part 1; Page 24; National Desk
LENGTH: 695 words
HEADLINE: COLLECTIVE BARGAINING FOR DOCTORS GAINS;
INSURANCE: THE HOUSE APPROVES A MEASURE ALLOWING MEDICAL PROFESSIONALS TO
NEGOTIATE CONTRACTS, DESPITE FEARS THAT IT MIGHT RAISE COSTS.
BYLINE: NICK ANDERSON, TIMES STAFF WRITER
DATELINE: WASHINGTON
BODY:
The House early today approved legislation to grant
doctors, dentists and other medical professionals the right to
bargain collectively with insurers and
HMOs, a measure that proponents claimed would help improve quality of care for
patients but critics said would do little more than raise their premiums.
The 276-136 bipartisan vote represented a significant victory for the
legislation's chief sponsor, Rep. Tom Campbell of San Jose, the Republican
nominee for Senate in California. It was the last House action before
representatives began their Fourth of July recess.
Hours earlier, the Republican-controlled Senate on Thursday evening voted, 51
to 47, to endorse a limited set of new patient protections, including a
restricted right for patients to sue their health maintenance organizations.
On his measure, HR 1304, Campbell faced significant challenges from key players
within his own party's leadership, who pushed the vote off until the wee
post-midnight hours.
One proposed amendment to Campbell's bill that the leadership allowed into the
debate was denounced by abortion-rights supporters as a restriction on the
ability of doctors to discuss abortion in negotiations with health plans. It
was narrowly approved.
Campbell's legislation would alter antitrust law to boost the negotiating
position of medical professionals--and thereby, he hopes, give greater voice to
patient advocates--at a time when companies that deliver managed care are
consolidating and wielding great clout in the health care marketplace. If
enacted, the measure would sunset after three years. Congress would then have
to decide whether to renew the measure.
Under current law, doctors who are employed by a hospital or
municipality may unionize. But most doctors may not join a union because
antitrust laws ban collective bargaining when they are self-employed
contractors. Campbell said his bill was not meant to unionize doctors and noted
that it included a provision prohibiting strikes by covered medical
professionals.
The American Medical Assn., representing doctors, strongly backed Campbell's
bill. The American Assn. of Health Plans and some key business groups just as
strongly opposed it.
While the debate drew heated rhetoric from members of both parties, Campbell
himself was restrained in his comments as he steered the measure through a
series of procedural land mines.
A typical exchange with one critic who charged that doctors were only out to
jack up their fees--and thereby pass on costs to consumers--ended with Campbell
saying calmly,
"If you
want better quality of medicine, it might be that you have to pay for it."
Proponents argued that giant health-care plans have too much power to dictate
to doctors the terms under which they discuss and deliver care to patients.
"The health-care system has become David and Goliath, and we've got to give
David something to fight with," said Rep. Sheila Jackson-Lee (D-Texas).
But opponents said doctors were seeking to tilt the playing field in their own
favor. Rep. John A. Boehner (R-Ohio) said doctors would
"form a cartel to prey on American consumers."
Before the debate began Thursday evening, Campbell, an antitrust expert and
Stanford University law professor, had gained the backing of 220 House members
as co-sponsors--a majority of the 435 representatives. Among the co-sponsors
were 90 Republicans.
But the
legislation now faces iffy prospects in the Senate, where major bills on other
issues are backlogged in this election year.
In the end, the most significant result of the House vote could be the
potential boost it would give to Campbell's underdog campaign to unseat Sen.
Dianne Feinstein (D-Calif.) in November.
For her part, Feinstein issued a sharply worded critique of the Campbell bill
even though she has not taken a formal position on it.
"I believe that we will only see true health-care reform with passage of a
meaningful 'Patients' Bill of Rights,"' Feinstein said, referring to House-approved legislation that would regulate
HMOs and give consumers broad rights to sue to enforce standards of care.
Campbell voted against that legislation.
LOAD-DATE: June 30, 2000