Date: 1999-10-06
Speaker: EDDIE BERNICE JOHNSON (democrat)
Chamber: H
State: Texas

Mr. Chairman. this really is a historic day for this House. For the first time. Members will have an opportunity to fundamentally change how managed care operates in this Nation. For far too long. insurance companies have based their treatment decisions not on what is best for their patients but what is best for the companies stockholders. It is time to put health care providers and patients back into the business of patient care. We need the NorwoodDingell bill to ensure that patients have access to emergency care and to - specialists. HMOs need to be prohibited from gagging doctors and other providers so that they are prevented from telling their patients of all the treatment options available. What are the insurance companies afraid of? Are they afraid of their own policies? Patients also need the right to appeal when they disagree with HMO suggested treatment. The NorwoodDingell bill grants patients internal and external appeals. a process to ensure that the best possible treatments are made. The bill permits patients or their families who have been injured or die as a result of the HMOs denial of care to sue inState courts. What is wrong with that? If the insurance companies are confident of their policies. what is wrong with that? This is America. The NorwoodDingell bill. however. does not invite frivolous lawsuits. It imposes the number of limitations on lawsuits. These restrictions include those damages only allowable by State law. no punitive damages provided the HMO complied with an external reviewers decision and no plan would be requiredto cover services not provided in the contract. My State of Texas has a patients bill of rights. This legislation took effect 2 years ago. And while HMOs serve more than 4 million patients in Texas. there have been only five lawsuits resulting from the legislation. That is hardly a flood of lawsuits. To quote Senator David Sibley. one of my colleagues when I was in the Texas Senate. the bills Republican sponsor. "The sky didnt fall" with its passage. The number of lawsuits is low because our patients are fully using the external review process. and that is a component of the NorwoodDingell bill. More than 700 patients have used that external review process in the past 2 years to appeal decisions made by health plans. Critics of the NorwoodDingell bill have said it will increase health care costs. Since Texass bill of rights has been in effect. premiums in our State have been less than the national average. while health care costs rose 3.7 percent nationally in 1998. The Texas health care cost increased only by 1.1 percent. And these are figures done by the Texas Medical Association. As a former registered. degreed nurse. I strongly understand the relationship between a patients involvement in his or her treatment and quality health care. We cannot have one without the other. The NorwoodDingell bill will create a treatment environment where patients and doctors can work together with insurance companies to produce the best patient care and the best patient outcomes. I urge all Members to please support this bill. Let us put health care where the patients are.