Date: 1999-09-28
Speaker: EDDIE BERNICE JOHNSON (democrat)
Chamber: H
State: Texas

Madam Speaker. I have not yet understood why there is such concern from the HMOs that people. not have the right to complain when they feel that they have been harmed by the rules of an HMO. They must not have any confidence in the quality of care which they are making sure that are offered to patients. In todays Washington Post there is a story on the Texas bill. and we are still waiting for the sky to fall. and it has not fallen. but the insurance people continue to say: But it will fall. Out of 4 million members of an HMO in Texas. I think they have had 4. maybe 5 lawsuits. and one was very recent. and it all has to do with the care. Now when HMOs offer quality care. there should not be any fear. This bill in Texas was not carried by a partisan Democrat. It was a conservative Republican member that I served with in the Texas Senate who carried this bill. and. as far as I can tell. they are very pleased with having access because it does challenge HMOs to give more attention to the quality of care. I still have a hard time understanding what the fear is. All the horror stories that were envisioned by the health insurance industry just has not happened. and 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 the patients and their health plans before they go to the courthouse. which is where it should be. But I have a real problem with us saying in a democracy that people. patients. do not have a right to challenge any institution that is in charge of their health care. It is ironic that the HMOs will tell physicians exactly what they can do and what they cannot do. and -physicians are held accountable. but they refuse to hold themselves accountable when many of them really are not physicians but simply some bureaucrats that areinterested in their bottom line. The legislation enacted in Texas acted as a prime motivator for HMOs to settle their disputes with their patients. and regrettably. the vast majority of Americans do not have this option which I think is unconscionable in a country that practices the greatest democracy in the world. I have a feeling that what we are facing even next week might not be the kind of approach to the whole problem that we have worked so hard for. We do have bipartisan support for a very good Patients Bill of Rights.. I would like very much to see that bill to come to the floor and let us debate it and let us vote and let the votes fall where they may. as we do in many other situations. I am a little suspect though. I do not believe that it will happen quite as easily. But I do strongly believe that the Texas experience has offered a real -example of what will happen or what can happen. I believe that if the sky was going to fall. it has had time to fall. I believe that if patients were just looking for someplace to file a suit. they can certainly find it without subjecting themselves to poor health care. I just do not believe that we are going. to find the kind of uprising that we hear in a scare tactic. Anything that we do short of making sure patients have an adequate and fair chance of good health care is not fair to the American people. At best. this bill that they are talking about bringing to the floor. simply nibbles around the corners of the health care debate. It provides for health care savings plans and a 100 percent deductibility for individual insurance premiums for the selfinsured and uninsured. But as my colleagues know. we have so many people that do not have access to insurance. and that will not mean anything to them. And as my colleagues know. the insurance that we are talking about here will not touch most of the lowincome people because they simply cannot afford to have that type of money set aside for a savings account for their health care insurance. I think that option is one that perhaps ought to be there for those who can afford it. but what we are looking for is insurance that all Americans would have access to and can expect in return a decent practice of medicine by their own standards of medical practice that physicians are educated and trained to render and do not really need an insurance plan to tie their hands when they are the ones who have gotten this education. One size really does not fit all. People really are different. When you are 7 years old and you have the same diagnosis. it can act up on the body quite differently than if you are 70 with the same kind of diagnosis. Just to be discussing this in America at this time is something that puzzles me. I just simply cannot -understand why we are going through this kind of debate of denial of people of their right to decent healthcare. It is clear that managed care has brought about some lowering of costs. so I do not think we should throw the whole plan out. but I do feel strongly that patients have a set of basic rights they should be able to depend upon. They should have access to some specialist to see what that condition really is. second opinions. emergency room care. and. certainly. of all things. a physician who is taking orders from this plan should not be subjected any more to the risk of a lawsuit than the plan that is dictating what he does. because very frequently if a physician is placed in that position. he often has to do things that are against really his better judgment. That is really not fair to the physicians. If these plans feel so comfortable and so confident with what they are offering. there should not be any fear of lawsuits. People are not seeking lawsuits when they go to the doctor or go to a hospital. They are seeking care. I will tell you from personal experience. if everyone who went to a hospital would file a suit. it would be a very different pattern than what we are seeing in this country and a very different picture. Even hospital administrators and persons who work at hospitals will tell you that people do not really come looking for a way to file a lawsuit. They can find that more often than what they give attention to. But the culture of denial that is going around in some of these plans is so very disappointing. to the point where it brings about a great deal more suspicion and a great deal more anger among people that know the difference in having access to some reasonable. decent healthcare.. versus having a touch and a wipe across the top. sotospeak. of a wound. It makes all the difference in the world of how a patient will get along. how long their convalescence will be. how long their illness might be. All of us know that most of the time if a patient can get access to care quickly. with adequate and proper medication. that the illness can be shorter. and especially if they have confidence in the plan. But if they have got to go through a great deal of hassle. a great of emotional upheaval. and still not know for sure whether they are getting the best care. that within itself interferes with the healing process. -It seems to me that we have allowed ourselves to get so divided on this issue that the insurance companies have lost sight of what we are trying to do. They have lost sight of the fact that we are talking about human beings. They are only really seemingly interested in protecting their pockets and trying to be sure that people do not have the right to complain and get redress when they feel they have been harmed. That is so very unfortunate. But. under the circumstances. we all must stand up as tall as we can and stand with the American people to be sure that. to the best of our ability. they have access to the care that they paid for. and that they get the quality care that we certainly can offer in this country. I thank the gentleman for continuing to bring this issue to the forefront. It is one that will not go away. Every person in this country is interested in having access to quality care. and it is possible. without the world falling. I think my state of Texas has proven that.