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Antitrust Relief Letter of support for H.R. 1304, the "Quality Health Care Coalition Act of 1999." The AMA, numerous medical specialties and state medical societies salute Rep. Tom Campbell's (R-CA) legislation--March 25, 1999 March 25, 1999 The Honorable Tom Campbell U.S. House of Representatives 2442 Rayburn House Office Building Washington, DC 20515 Dear Representative Campbell: The undersigned medical organizations are pleased to support, the "Quality Health Care Coalition Act of 1999." This legislation would allow health care professionals to negotiate collectively with health plans regarding terms that affect patient care, thus restoring physicians' ability to advocate for quality care for their patients and strengthening the physician/provider-patient relationship. The health care industry has seen a significant concentration of health plans: over 162 mergers in the last ten years. The New York Times recently reported that in the past four years the 18 leading health insurers have combined into six. Consequently, physicians increasingly find themselves at the negotiating table with enormous health plan bureaucracies whose main interest is in the financial bottom line. Physicians' ability to effectively advocate for quality care has been whittled away to the detriment of patients and efficient, effective health care delivery. The result is increasing control over health care by insurers that place cost and profitability before quality and individual patient care. We see example after example of how physicians are presented with "take-it-or-leave-it" negotiations by health plans that cover a very large portion of their patients. Unfair and heavy-handed negotiating tactics often result in contracts with terms that harm patients, especially when it comes to terms that arbitrarily define which treatments are "medically necessary" and how to protect the privacy of medical records. For instance: Requiring physicians to use the least costly of alternative treatments which can be provided to patients; Preventing physicians from openly discussing alternative treatments that the plan does not consider to be "medically necessary;" Requiring physicians to agree to defend, indemnify and hold harmless the plan and its agents, for any claims, lawsuits or damages as a result of any disclosure of patient information made by the plan that results in a violation of a patient's privacy rights; and Requiring physicians to participate in all of the plan's products and to accept arbitrary compensation rates subject to change at short notice despite its effects on physicians' ability to deliver quality care. Previous efforts to modify antitrust enforcement policy have failed to "level the playing field." Insurers operate under an antitrust exemption. Enormous health plan bureaucracies put health plan profits above patient care. Consumers are paying more but getting less. The "Quality Health Care Coalition Act" would level the playing field by providing individual health professionals the leverage they need to negotiate effectively with health plans. We thank you for introducing this bill that would improve patient care by restoring balance to negotiations between health plans and health care professionals. We share your belief that high quality health care can be driven by a truly competitive marketplace, not by the ability of health plans to dictate contract terms as a result of market power acquired by purchasing market share. Sincerely, American Academy of Facial Plastic & Reconstructive Surgery American Academy of Ophthalmology American Academy of Otolaryngology Head & Neck Surgery American Association for Thoracic Surgery American Association of Clinical Endocrinologists American Association of Neurological Surgeons American Association of Orthopaedic Surgeons American College of Cardiology American College of Chest Physicians American College of Rheumatology American College of Surgeons American Gastroenterological Association American Lung Association American Medical Association American Osteopathic Association American Psychiatric Association American Society for Gastrointestinal Endoscopy American Society for Reproductive Medicine American Society of Anesthesiologists American Society of Cataract and Refractive Surgery American Society of General Surgeons American Society of Plastic & Reconstructive Surgeons American Thoracic Society American Urological Association Congress of Neurological Surgeons National Medical Association Renal Physicians Association Society of Thoracic Surgeons Medical Association of the State of Alabama Alaska State Medical Association Arkansas Medical Society California Medical Association Colorado Medical Society Connecticut State Medical Society Medical Society of Delaware Medical Society of District of Columbia Florida Medical Association Medical Association of Georgia Hawaii Medical Association Idaho Medical Association Illinois State Medical Society Indiana State Medical Association Iowa Medical Society Kansas Medical Society Kentucky Medical Association Louisiana State Medical Society Maine Medical Association Michigan State Medical Society Minnesota Medical Association Missouri State Medical Association Montana Medical Association Nebraska Medical Association Nevada State Medical Association New Hampshire Medical Society Medical Society of New Jersey New Mexico Medical Society Medical Society of the State of New York North Carolina Medical Society North Dakota Medical Association Ohio State Medical Association Oklahoma State Medical Association Oregon Medical Association Pennsylvania Medical Society Rhode Island Medical Society South Carolina Medical Association South Dakota State Medical Association Tennessee Medical Association Texas Medical Association Utah Medical Association Vermont State Medical Society Medical Society of Virginia Washington State Medical Association West Virginia State Medical Association State Medical Society Wisconsin Wyoming Medical Society Printer-friendly version Published Mar 25 1999 Updated Apr 20 1999 1:51PM Return to Antitrust Relief