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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
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.