"Patient Protection Bill of 1999" Will Make Matters Worse for Patients

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Medical Gridlock Ahead if We Continue Marching Towards Socialized Medicine

The House of Representatives today begins debate on H.R. 2723, the Bipartisan Consensus Patient Protection Bill of 1999 which was introduced by Rep. Charles Norwood (R-Ga). The purpose of Dr. Norwood's bill, which has been co-sponsored by 147 members of the House, is to reform Managed Health Care.

Now, if you remember, Managed Health Care was the issue that the Clintons said would SOLVE all of America's health care problems. In 1993 an estimated 35 million Americans did not have health insurance. Clinton wanted to create what amounted to a government managed health care system. While he didn't get all that he wanted, in the last seven years many of his programs have been adopted in one form or another and, after almost 7 years of Clinton's Health Care reforms, the number of Americans without health care has risen to 44.3 million, according to the Census Bureau.

Behind HR 2723 are many in the Health Care profession-doctors, nurses, and many concerned Americans. Those opposing HR 2723 include the HMOs and the insurance companies, who say that passage of HR 2723 will cause hundreds of thousands, perhaps millions of people to LOSE their existing health insurance. My goal for my research was to determine which approach in Congress-the Republican or the Democrat approach-was the best. Ordinarily, the fact that the doctors support HR 2723 and the HMOs and Insurance companies oppose it would be enough for me to support HR 2723.

However, that was before I spent most of the month of August researching the health care for the September issue of the monthly newsletter. We've been through all this before and, somehow, the results are always different than what we are assured they will be. Remember back in 1993 and 1994 when the Clintons were telling us that their Health Care scheme would solve all our problems? In a radio address in August 1993 Clinton said:

"Next month I'll outline a health care plan to Congress that offers hope for all Americans who want to work and take responsibility, and create opportunities for themselves and their children. The plan will be built on three guiding principles: Security, savings and simplicity. First, it will guarantee all Americans the security of knowing they won't lose their health coverage even if they switch jobs, lose a job, get sick, have a family member who gets sick, move to a new city or start a small business. Second, the plan will generate savings by introducing real competition into the health care market. We'll limit the growth of expensive premiums and costs that can't be justified-such as drugs made in America costing three times more here in the United States than they do overseas. We'll root out fraud and abuse which now eat up to 10 percent of every health care dollar. And we'll reform a malpractice system that drives up prices for doctors and patients. And we'll make it more rewarding for doctors to practice preventive medicine than to perform expensive tests and procedures that aren't necessary. Third, the plan will be simpler for consumers and health care providers."

The Health Care plan he introduced was designed to force everyone in the country into a government controlled HMO. and, while he didn't succeed in getting that to happen, little by little during the intervening years the public, especially those trapped in government financed programs such as Medicare or Medicaid, have been strongly pressured to join an HMO. Legislation has been passed, often with the help of Republicans, which was supposed to address problems, bingeing the medical profession deeper and deeper into the medical crisis that is beginning to overwhelm the system, cause small hospitals (Bob's note: Stanford University Hospital just filed for bankruptcy a couple months ago-October 1999) to go bankrupt and prompt doctors to leave their profession.

An example was HR 3103, the so-called "Kennedy-Kassebaum-Health Care Access, Portability and renewability" bill which was supposed to solve all the problems faced by people with pre-existing conditions. Clinton said as he signed the bill on August 21, 1996:

"Never has such a measure been more needed for our people. Our new economy presents Americans with opportunities like never before to work their way into better paying jobs. And yet our health care system has worked to paralyze many workers who fear losing their health care coverage if they take those better jobs and change their employers. At the same time, millions of Americans find themselves labeled as people with pre-existing conditions, from cancer to AIDS, which disqualifies them and their families for coverage-including the husband, the pregnant wife-who lose their insurance; the young woman who can't change jobs because her new insurance doesn't cover diabetes; the small business owner who faithfully pays group health insurance premiums for years and then finds that his coverage won't be renewed because one of his employees has developed a heart condition. No more. This bill changes all that. Today we declare a victory for millions of Americans and their families. No longer will you live in fear of losing your health insurance because of the state of your health. (Applause.) No longer need you hesitate about taking a better job because you're afraid to lose your coverage. And no longer will small businesses be denied access to insurance for their employees. The Health Insurance Reform Bill I sign today will protect the health care of millions of working Americans and give them and their families something that cannot be measured-peace of mind. The bill also addresses other problems in getting more affordable insurance to our workers. It makes it easier and less expensive for the self-employed to purchase their insurance."

That also was the bill which was supposed to prevent:

"...fraud and abuse. It toughens penalties and helps us to go after bad apple health care providers who bilk the system of billions of dollars from Medicare, from Medicaid and from private insurance companies. I especially want to thank Secretary Shalala for her work on these fraud and abuse provisions. Third, it makes the health care system more simple. It will modernize, streamline and cut the cost of insurance paperwork by devising a uniform electronic system for paying health care claims. It will provide steps to protect the privacy of people in the system as it does so. Fourth, it allows the establishment of a limited number of medical savings accounts to allow us to study this approach and see how it works, to determine whether this new approach can make a positive contribution to health care coverage and to affordability. And, fifth, it helps with long-term care. It provides consumer protections and makes long-term care insurance more affordable. This bill, in short, does a very great deal."

What a joke! What it actually did, and I saw this in my own family, was to make it impossible or almost impossible to even GET insurance. In one case a slightly elevated cholesterol count made it impossible for a son to buy ANY health insurance for his entire family. When the insurance company could not limit coverage for any possible problem that might result from an elevated cholesterol count, they wouldn't write the insurance at all. That was two years ago when my son changed jobs. He became one of the hundreds of thousands of Americans who find, each year, that a change in their job situation has caused them to lose their health insurance.

The Kennedy-Kassebaum bill made the problem worse, not better. Rather tan write insurance which they fear will be a money loser, insurance companies are just not writing the insurance at all.

The "fraud" provisions of that bill has put doctors at the mercy of a federal coding system which requires the use of a complex government written "code" for every procedure. The code, which is the most complex and lengthy set of government regulations anyone has ever seen doesn't even HAVE a code for some of the newer medical procedures. However, should the doctor use an "incorrect" code, or a code that some non-medical auditor THINKS is an incorrect code, he or she can be accused of "fraud" and will be fined thousands of dollars which has to be paid in less than 10 days. The "code" naturally has required huge expenditures of time and money (it's about five feet of printed material when stacked on the ground, I'm told.) and has prompted many doctors to avoid Medicare and Medicaid patients altogether. So, in some communities, such as thee one I left in California a few months ago, Medicare patients can't even FIND a doctor who will treat them. The cut in pay the doctors experienced from the Kennedy-Kassebaum bill, combined with what one called "making bounty hunters out of my patients" means that treating Medicare or Medicaid patients often costs more than the reimbursement schedule pays and puts the doctor at risk of being accused of a felony if someone in his office uses an incorrect code. Invariably the doctor is declared guilty of fraud until he can prove it was an innocent error.

I began the five state research effort in August, interviewing doctors, nurses, hospital administrators, medical equipment engineer and a pharmaceutical researcher to find out which bill in Congress was the bill that I could recommend-the Republican approach or the Democrat approach. What I concluded was that, based on what has already occurred, neither bill will solve the problems. What I believe is happening is a concerted effort to make things so bad that the American people will DEMAND a socialized medicine system-which of course will make all the problems we have now worse. Because the Clinton Health Care system was not adopted back in 1994, the HMO problem could still be solved. If Clinton-care had passed, the private health system which enabled American medicine to be the best in the world, world, would have already been dismantled.

That is not to say that the members of congress who are trying to address some of the problems which have been created by Federal meddling are all schemers. They aren't. Many of them actually believe that somehow more laws and more regulation will solve problems created by the last laws passed and the last regulations written.

The insurance companies are right when they say that passage of even more medical mandates will cause an increase in the cost of health insurance, which is already very high. Every new mandate passed by Congress creates a need for more administrators in the hospitals and doctors' offices-and with Congress cutting back on the amount of many doctors and hospitals get-the result is less and less medical care, and more and more paperwork.

What is needed is not more regulation-but less regulation. Less regulation will bring DOWN the cost of medical care. We need to find a candidate next year for President who will de-regulate medicine, as Ronald Reagan de-regulated the banking industry. It was Reagan's de-regulation in the 1980's that has crated most of the economic boom of he 1990's. If a similar form of deregulation of medicine is not is not undertaken, expect medical gridlock in the 2000-2010 decade at some point or toher, just at the time when more and more aging Americans are going to need more medical care.

This article was written by Mary Mostert, Analyst for Original Sources on October 6, 1999. It was published on the Reagan.com website and is copyrighted © 1996-1999 by Waveshift, Inc.