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June 30, 2000, Friday, Late Edition - Final

SECTION: Section A; Page 22; Column 1; National Desk

LENGTH: 537 words

HEADLINE: House Votes Doctors' Collective Bargaining

BYLINE: By ROBERT PEAR

DATELINE: WASHINGTON, Friday, June 30

BODY:
The House early this morning passed a bill that would give doctors an exemption from antitrust laws so they could bargain collectively with insurance companies over fees and other issues.

The vote was 276 to 136. The American Medical Association lobbied for the bill, saying doctors needed protection so they could serve as advocates for their patients in dealing with huge insurance companies and health maintenance organizations.

But Federal anti-trust officials strenuously opposed the bill, saying it would allow doctors to fix prices and increase their charges. The Congressional Budget Office, the Justice Department and the Federal Trade Commission all predicted that the bill would lead to higher health care costs for patients and for employers who provide health benefits to employees.

Representative Tom Campbell, Republican of California, the chief sponsor of the bill, said it would restore "a fair balance between doctors and insurance companies," so doctors could provide more adequate care for their patients.

The outlook for the bill in the Senate is uncertain. Several senators have expressed support for it, but doctors have not found a Senate champion for the measure.

The bill would exempt health care professionals from major provisions of the antitrust laws when they negotiate with H.M.O.'s and insurers over fees and contract terms.

Doctors who are employees -- at hospitals, for example -- can already join labor unions and collectively negotiate with their employers under existing law. The House bill would grant similar immunity from the antitrust laws to independent doctors who are supposedly competing with one another.

Representative John Conyers Jr., Democrat of Michigan, a co-author of the bill, said it provided "an important antitrust exemption for doctors," and he added: "Doctors are being restricted in their ability to make decisions for patients. We've seen a massive consolidation of the health insurance market. We need to give relief to doctors. They're feeling the pinch. Some doctors are in dire circumstances."

Mr. Campbell's bill became entangled in a furious debate over abortion rights. Conservatives led by Representative Tom Coburn, Republican of Oklahoma, proposed an amendment to make clear that the right to bargain collectively did not apply to negotiations to force a health plan to perform or pay for abortions. The House approved this amendment by a vote of 213 to 202.

Mr. Coburn said the amendment was needed to prevent doctors from trying to force Catholic hospitals to provide abortions. But supporters of abortion rights said the amendment was irrelevant to the purpose of the bill.

Supporters of the legislation expressed the same frustrations that have inspired a nationwide campaign to define patients' rights and to regulate H.M.O.'s and insurers. Mr. Campbell said some health plans required doctors to see 10 patients an hour.

Doctors are well paid by comparison with most workers but say they have been squeezed financially by insurance companies trying to earn profits for investors at the expense of patients.

Insurers, H.M.O.'s, employers and many nurses opposed the Campbell bill, saying it would legalize "doctor cartels." http://www.nytimes.com

LOAD-DATE: June 30, 2000