An
Inside View: Congressman Mike Doyle on the Patient’s Bill of Rights
by
Doug Moore, RHU
On
Friday February 16th, the Pittsburgh Chapter of the National
Association of Health Underwriters hosted our quarterly membership meeting at
Tambellini’s Restaurant. Our
speaker was Congressman Mike Doyle.
Congressman
Doyle briefly addressed several topics such as the impending loss of two
congressional seats for Pennsylvania, physician anti-trust legislation,
long-term care insurance, and tax-cut legislation. However, the real focus of Congressman Doyle’s
address was the Patient’s Bill of Rights.
Congressman
Doyle serves on the House Commerce Committee which overseas the introduction of
all health related legislation. Congressman
Doyle feels strongly that Congress needs to pass a Patient’s Bill of Rights
this year and he believes that they will.
His optimism stems from the fact that the version of the bill up for
consideration this year contains several key differences from the Norwood-Dingell
bill that ended up abandoned last year.
The
updated bill known as HR-526, still would allow for managed care companies to be
sued in state or federal court. Suits
could only be brought after all internal and external appeal avenues have been
exhausted. Federal courts would
hear cases involving administrative decisions affecting patient care only, while
the state courts would hear all suits involving medical decisions.
Damages awarded in federal court would be capped at $5 million dollars.
States would set their caps individually.
The
issue that perhaps has caused the most opposition to the Patient’s Bill of
Rights has been the issue of employer liability. Many employers stated publicly that they would consider
dropping health benefits for their employees if they were left open to suit.
Congressman Doyle feels that employers are very well protected under the
new version of the bill. Employers
could only be sued if they exercised “discretionary authority” in the delay
or denial of treatment. Since
employers cannot do this under their fully insured plans and most self-funded
employers do not get involved in exercising this authority, the chances of a
suit being brought are very slim.
Under
HR-526, employers cannot be sued for failing to provide a particular benefit as
a part of their plan. Also,
employers cannot be held liable for their choice of health plans.
Congressman
Doyle also addressed the issue of physician anti-trust agreements.
He informed us that while there is no current bill before Congress, he
expects one to be presented later in the year.
Due to the failure of last year’s bill to win wide support, a
bi-partisan committee, including NAHU representatives, is working on crafting a
bill that can gain acceptance. Congressman
Doyle is firmly against physicians forming a union, but does believe that the
current system does not adequately protect their rights.