•The panel included Art Lerner, former head of the Federal Trade Commission's health care bureau, Ed Wristen, executive vice president and COO of First Health Group, Marion McCartney, director of professional services at the American College of Nurse Midwives, and Ann Cato, senior corporate counsel of Wal-Mart Stores.

The health cost increase caused by H.R. 1304 would most hurt those working Americans who today have health coverage but couldn't afford higher premiums.

•Many employers such as Wal-Mart try hard to offer employee health benefits.  Of Wal-Mart's insured employees and their families, thanks to Wal-Mart, 40 percent have health benefits for the first time in their lives.

•Wal-Mart employees, including part-time associates, are offered health coverage.  About 92 percent of Wal-Mart's workforce earns hourly wages.  These are the people most vulnerable to rising health care costs.

•Wal-Mart's Ann Cato pointed to the Charles River Associates estimate of the cost rise that H.R. 1304 would cause:  "[T]otal annual personal health care spending would rise between 3.1 and 7.1 percent, or by $34.5 to $80.0 billion annually.  Private health insurance premiums would increase annually by 5.8 to 11.0 percent ($21.7 to $41.1 billion).  Annual impacts toward the lower end of the [cost increase] range can be anticipated to result fairly quickly . . . ."  Translation: Wal-Mart's and other low-wage employees stand to lose coverage first.

 Allowing independent health providers to get together and bargain collectively would limit consumers' choice of some health services.

•Marion McCartney, a certified nurse midwife, gave an example of the kinds of anticompetitive behavior H.R. 1304 would allow; today, such behavior may well violate the antitrust laws.

•An Arkansas OB/GYN nurse practitioner who already had hospital privileges returned to school and became a nurse midwife.  Upon completion, she applied to the same hospital for expanded privileges.  The medical staff protested the executive committee's initial approval, and one physician who supported the nurse midwife caught a lot of flack from opposing physicians.  The executive committee thus reversed its decision and denied expanded privileges, denying the community the choice of nurse midwifery services.  She requested a hearing to appeal the denial, but received instead an offer of relocation assistance.  The doctors who supported her appeal received threats from other doctors that no more patient referrals would come to them and that they would be excluded from the primary care network.

The members of the coalition, representing a range of diverse groups, may not agree on many other health policy issues.  But they fully agree that the proposed antitrust exemption would only hurt, not help, the health care system.