IA
103D CONGRESS
1ST SESSION
H. J. RES. 241
To ensure all residents equal access to quality health care services if a
managed competition health plan is enacted.
IN THE HOUSE OF REPRESENTATIVES
JULY 27, 1993
Mr. STARK introduced the following joint resolution; which was referred to the
Committee on Energy and Commerce
JOINT RESOLUTION
To ensure all residents equal access to quality health care
services if a managed competition health plan is enacted.
Whereas over thirty-seven million Americans have no health
insurance and therefore inadequate access to necessary
health care and tens of millions more residents have inad-
equate health insurance;
Whereas one solution to the health care crisis in the United
States of America currently being considered would en-
courage competition between large groups of providers
(Accountable Health Plans or AHP’s) to provide health
care to large groups of buyers (Health Insurance Pur-
chasing Cooperatives or HIPC’s);
HJ 241 IH
Whereas this proposed plan calls for the creation of a na-
tional health board which would define a standard pack-
age of health benefits and HIPC’s would negotiate prices
with competing AHP’s which would compete on the basis
of price, and quality of services;
Whereas tens of millions of Americans will be unable to af-
ford more than the lowest bidding AHP in a given geo-
graphic area and will, de facto, be locked into that plan
(for example, there will be no real freedom of choice for
these individuals);
Whereas the lowest bidding AHP in a given HIPC is less
likely to include adequate numbers of higher quality pro-
viders (such as tertiary hospital trauma centers, rehabili-
tation, and a full range of mental health facilities);
Whereas the proposed plan would allow each State significant
flexibility to organize and manage the HIPC’s and such
flexibility may result in quality differences between the
State;
Whereas the health industry has traditionally avoided the
Medicaid population, the poor, the unemployed, and the
chronically ill, assurances should be provided to guaran-
tee true equal access to quality health care to high-risk
populations;
Whereas one of the members of the Alliance of Managed
Competition has submitted testimony to the House Com-
mittee on the District of Columbia stating that it has
many providers who do not want poor people in their
waiting rooms and therefore would not participate in a
managed care operation that included large numbers of
Medicaid clients;
HJ 241 IH
Whereas concern has been expressed by representatives of the
disabled, chronically ill, and high-risk populations that
they will continue to have unequal access to quality
health care under managed competition proposals;
Whereas approximately 25 percent of the population of this
country still lives in rural areas which have small hos-
pitals or none at all and few, if any, physicians, and con-
cern has been expressed that rural residents will not have
universal access to quality health care;
Whereas most residents will feel secure and confident about
health care reform legislation when they have equal ac-
cess to quality health care regardless of income, place of
residence, status of health, or employment;
Whereas Members of Congress should not force millions of
their constituents into health care systems they them-
selves are unwilling to join; and
Whereas Members of Congress and their families who partici-
pate in the lowest bidding AHP in their congressional
district will provide an immediate warning of quality
problems, deficiencies, and underservice, and thus will en-
sure that everyone, regardless of income, place of resi-
dence, status of health, or employment will have access
to quality health care: Now, therefore, be it
Resolved by the Senate and House of Representatives
of the United States of America in Congress assembled,
That all Members of Congress and their families enroll
in the lowest bidding AHP in their home of record.
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