Date: 1999-10-05
Speaker: EDDIE BERNICE JOHNSON (democrat)
Chamber: H
State: Texas

Mr. Speaker. Will enactment of the NorwoodDingell Bill lead to skyrocketing health care costs? Since Texas began to implement a series of managed care reforms in 1995. our HMO premium increases have mirrored or trailed those premium hikes in other states that dont have managed care reform bills in place. Nationally. health care costs have increased by 3.7 percent in 1998 while in Texas. the costs increased by only 1.10 percent for the same period.. Will enactment of the NorwoodDingell Bill lead to frivolous law suits? Since Texas enacted its Patients Bill of Rights in 1997. there have been only five lawsuits in a managed care system that serves four million patients. This number of lawsuits is low because our patients are fully using the external review process that is a component of the NorwoodDingell bill. More than 700 patients have used the external review process in the past two years to appeal the decisions made by health plans. Of those. about half of the decisions have gone in favor of the HMOs. Will the NorwoodDingell Bill result in employers dropping their employees from health care coverage and thus drive up the number of uninsured families? It may be too early to tell using our states example. But the fact remains that as HMOs have increased penetration in recent years. so has the nubmer of uninsured. That is the case in Texas and around the nation. Since the Texas Legislature made managedcare plans liable for malpractice. there have been five known lawsuits from among the 4 million Texans who belong to HMOs. "The sky didnt fall." said Sen. David Sibley. the Republican who championed the Texas version of the Patients Bill of Rights. "Those horror stories." envisioned by the health insurance industry "just did not transpire." While it is too early to see the full effect on my state it is evident that the implementation of this legislation has had a dramatic effect on resolving complaints between patients and their health plansbefore they get to the courthouse. Clearly this legislation has acted as a prime motivator for HMOs to settle their disputes with their patients. Regrettably. the vast majority of Americans do not have this option. Thats why it is vital that we have national Patients Bill of Rights that has some teeth in itthat permits patients to suit their HMOs when treatment decisions result in injury or death as well as granting patients access to emergency care and specialty care that is not currently allowed. I strongly believe that the Texas experience strongly speaks to the benefits of empowering patients and doctors so that they can work with the insurance companies in ensuring that our health care system provides the best care for all Americans. Republican .Health Care Bill: The -Republicans introduced the Quality Care for the Uninsured Act. This legislation does move the health care debate forward. But not very far. It is not a bipartisan bill and it does not- address that.entire scope of health care delivery or whats wrong with managed care. At best the Republican bill nibbles around the corners of health care debate. It provides for Medical Savings Plans and 100 percent deductibility of individual insurance premiums for the selfinsured and uninsured. This legislation does nothing to increase access to emergency services or obgyn. It does nothing to address the lopsided nature of the managed care equation in which insurance companies make- most of the patient deci.sions. while doctors and the patients themselves are left in the waiting room.