Statement of Dr. Mary Herald on the Norwood-Dingell Patient's Bill of Rights

March 2, 2000

Good morning, Mr. President, Members of Congress, Secretaries Shalala and Herman, and other distinguished guests.

Everyone is here today to make a stand for the rights of managed care patients. To make sure they receive the high quality health care that they deserve. As a member of the American College of Physicians-American Society of Internal Medicine and a practicing physician, I feel especially strong about this subject.

Mr. President, I care for patients every day who desperately need the protection that a strong, enforceable Patients' Bill of Rights would provide them when they are at their most vulnerable—when they are ill, and worried about their families, and frightened themselves. The last thing they need is to have to worry about whether their managed care plan will be willing to provide them with the care they need when they need it. But too many people that pass through my hospital and office are forced to battle with their health plans at the same time they are fighting to recover from an illness.

Mr. President, everyone seems to be in favor of passing a Patients' Bill of Rights. Please let it be meaningful. We need to make sure that the patient protections we provide people are real.

I am an endocrinologist, and most of my patients have diabetes, a potentially devastating disorder affecting 16 million Americans. Appropriate early diagnosis, treatment and consistent aggressive management of diabetes has been proven to markedly reduce complications such as heart attacks, stroke, kidney failure and blindness. In my experience there is nothing more critical than maintaining a constant level of care for these patients by physicians appropriately trained to care for them. Some of my patients are blocked from getting that type of care because their plan limits consultation visits to 2 or 3 a year or the new primary care doctor insists on going it alone, reluctant to seem "too easy" on referrals to the health plan. This creates a barrier to state of the art care and leads to delayed and inadequate treatment, exacerbating complications and, of course, increased costs. The Norwood-Dingell bill would change that.

Some of my patients need pituitary gland surgery—a particularly complicated type of neurosurgery. But many times, the surgeons participating in the patient's health plan don't have the appropriate expertise to perform the surgery safely. This leaves my patients with the choice of paying out-of-pocket for the procedure when health plan providers can't meet their needs or risk their health by going to a surgeon that may be overextending his or her skills. No one should have to make that decision—and the Norwood-Dingell bill would ensure that patients wouldn't have to. The Senate bill would force them to choose.

Providers everywhere can tell you that there is nothing more devastating to a patient dealing with the emotional and physical strains of chronic disease than having to sever your relationship with a physician you have been seeing for months if not years. When a physician is dropped by a health plan or when a health plan is dropped by an employer. Patients need to know that their care won't be dropped in midstream. It only adds another burden to a patient who should be focusing solely on their condition and their recovery, and not have to evaluate by who and how their next treatment is going to be delivered.

I've seen too many cases such as this in our current health care delivery system, and I can't bear the thought of seeing any more. We need to act now.

Lastly, I want to address responsibility to our patients. If I or my colleagues make a mistake, we can and should be held accountable. In our current system, health plans aren't subject to that accountability. That is wrong. We need strong patient protections and a fair independent appeals process in order to reduce litigation, but in those rare cases where a health plan error causes a patient harm, they should be held accountable.

Mr. President, I am not a politician, and I don't know much about politics. I don't know anyone who doesn't support passing a Patients' Bill of Rights. But I know—and so do the Members of Congress here with you today—the differences between a real Patients' Bill of Rights and one that is a Bill of Rights in name only. We elected our representatives to respond to problems—not just talk about them. I hope that the Congress as a whole can do what the House did last year and join together in passing a long overdue Patients' Bill of Rights.

It is now my pleasure to introduce the man who has fought harder for the rights of patients than anyone else, the President of the United States—William Jefferson Clinton.