Health - Patients' Bill of Rights

Patients´ Bill of Rights

Statements

Excerpts from Statement to the American Association of Health Plans
"The State of American Public Health"
February 24, 1998

By Henry A. Waxman

Introduction

Good morning. It's a pleasure to be here with you today to talk a little about what is on the Congressional horizon in the health care arena.

I'm always pleased to talk with the AAHP because I think your membership is critical in the efficient and effective delivery of health care in this country. We have seen tremendous growth in the managed care area over the last decade, and there can be no doubt that you have contributed mightily to efforts to moderate out-of-control growth in health care costs, and in providing organized and coordinated care to millions of Americans.

It's also a particular pleasure to be here in a year when we don't have to talk about massive budget cuts in our Federal health programs, or reconciliation legislation that puts budget cuts ahead of good health policy. The last few times we have talked we've had to worry about Republican proposals to turn Medicaid into a block grant, and undo the protections of Medicare.

While I am not entirely happy with all that the Congress did do in the massive budget bill we passed last year, at least our worst fears did not come to pass.

So it is encouraging to have the opportunity to talk about upcoming health policy in the context of some very positive things:

a budget that is virtually in balance, so that we can finally return to discussing what positive changes we should be making in our health care system;
the establishment last year of a large program to provide health care coverage for some 5 million kids who have been without health insurance;
the continuing, promising development of the protease inhibitor drugs that have revolutionized the outlook for persons with HIV;
and the rapidly growing public support for tobacco control, particularly for taking aggressive action to stop kids from ever starting smoking.
Quality

I know that legislation in the area of health care quality and consumer rights is of great concern to this group. And I certainly know that many of you do not support all of the efforts to legislate in this area that are underway on Capital Hill.

I'm not going to talk about this area in any detail, because I know you have already heard a lot on this topic from John Dingell, as well as others. John and I and many others in the Democratic caucus are working together on the bill he discussed, which will be unveiled shortly. So I won't go over the ground he has already covered so thoroughly and so well. But I do want to make just a few points.

First, I want to make it very clear that I both strongly support this legislative effort and I am a long-time supporter of good, well-run managed care plans. From the early days of HMO legislation when we had to provide some help to get managed care plans started, through many efforts to assure inclusion as an option in Medicare and Medicaid, I have recognized that managed care has an extremely important contribution to make to the health care system.

In my own State of California, we have a long history of HMO coverage, and continue to have greater penetration of the health care market by managed care plans than anywhere else in the country. This is an industry that is clearly here to stay, and one that can and does exert some very positive influences on the health care system.

But we would all be kidding ourselves if we denied that along with the broad expansion of managed care we have also seen increasing consumer concerns about some aspects of these systems. People are unhappy when they need a specialist and can't get to one. They are unhappy if they suspect that cost concerns have become more important than providing high quality, necessary care--when they think the bottom line of profits is governing what care is covered. They are frustrated if they have nowhere to go with their complaints.

We cannot let this dissatisfaction fester. We simply have to take action to restore trust.

Now I know, and you know, that all these complaints aren't only limited to managed care plans--they have long been a part of traditional fee-for-service insurance coverage as well. But the restriction of choice of provider, and the more visible control exercised through managed care plans, have given focus to public discontent. And I strongly believe in the end you all have as great a stake as anyone in finding ways to restore consumer confidence and protections.

Second, I would stress to you that concerns about this issue are truly bipartisan in the Congress. We will have a Democratic bill for consideration, alongside the bill of Congressman Norwood, and others. Speaking for myself, I want to make sure the bill that moves forward is balanced to preserve managed care as well as protect consumers.

And I think the majority of my colleagues view the issue in the same way. But we will take action, I am convinced of it.