CONSIDERATION OF THE PATIENTS' BILL OF RIGHTS
(Senate - September 03, 1998)

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[Pages S9921-S9922]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




             CONSIDERATION OF THE PATIENTS' BILL OF RIGHTS

  Mr. KENNEDY. Mr. President, just about an hour ago, we had the 
majority leader taking the floor and making the request that we go to 
the bankruptcy legislation, as is his authority, and then making a 
motion to move toward the bankruptcy bill and filing cloture. And I 
assume, as others would, that we will be debating this legislation next 
week.
  In an exchange with the majority leader, I questioned him as to why 
we were not considering taking up the HMO legislation, the Patients' 
Bill of Rights. We could either take up the legislation that had been 
introduced by the Republicans and lay that down as our leader, Senator 
Daschle, has suggested, or permit some other way or means that we could 
have a full debate and discussion on that legislation.
  As I pointed out in the very brief exchange with the majority leader, 
we are talking considering legislation that affects about 1.4 million 
bankruptcies, with all the importance and consequences that has, as 
expressed by our friends and colleagues from Iowa and from Illinois and 
stated eloquently by both of them in recent times, or whether we should 
be considering a measure that affects 165 million Americans with health 
insurance coverage.
  When I go home to Massachusetts and travel around the state, I hear 
from families wondering when the Congress is going to take action to 
make sure that health care decisions are going to be made by medical 
officials, by doctors and by nurses, rather than by accountants and 
insurance company personnel. That is what the people are talking about. 
That is what they were talking about during August.
  I asked the majority leader whether we would be able to have the 
opportunity to debate this issue. And as is the wont of the majority 
leader and the assistant majority leader, Senator Nickles, they have 
said, look, you are either going to take it or leave it with our 
proposal. You are either going to take it the way we want it--that is, 
you can offer two or three amendments, and we can offer two or three 
amendments --and, if you are willing to take that, we are willing to 
schedule it; otherwise, we are not.
  They are, for all intents and purposes, gagging the Senate. We do not 
have any such condition on the measure that is before us this 
afternoon, the bankruptcy bill. There are a number of very worthwhile, 
substantive amendments for this measure. The majority leader did not 
come out here and say take it or leave it on the bankruptcy bill. No, 
no. Why? Because the credit card industry and the banking industry have 
the votes to pass this legislation, and, as has been publicly 
recognized, they have expended some $50 million in order to support the 
movement of this legislation.
  Yet, we find out that there are children in our country today who are 
being denied a CAT scan because of an automobile accident or because of 
a bicycle accident or because of some other kind of an accident. They 
do not make large contributions to push forward legislation that will 
help them. Nor do the women who are denied access to clinical trials or 
obstetrical and gynecological care.
  And so, Mr. President, we are being effectively gagged by the 
Republican leadership in debating and discussing and voting on the most 
important health measure that we will be faced with this year. Again, 
when asked

[[Page S9922]]

when we can proceed to this important legislation, the majority leader, 
as is his wont, calls for regular order: We are not going to listen to 
any voices in the Senate that have been trying to get to this measure 
for over a year and a half, either a hearing or a markup in the 
appropriate committee. No, thumbs down. Scheduled on the floor of the 
Senate? Absolutely not, unless you take it our way.
  Now, Mr. President, you can--and the majority leader has been 
successful up to this time--avoid having the opportunity for such a 
debate and discussion, but I do not really understand the reasons why. 
Why are the Republicans objecting to debating the gag issue or about 
emergency room access? Why shouldn t patients who believe they are 
having an emergency based on a reasonable person's judgment be assured 
coverage at the nearest emergency room? Why shouldn't we be able to 
debate what would be the appropriate responsibility of HMOs on these 
issues?
  Why shouldn't we be able to debate whether you can keep your own 
doctor or whether you have access to specialists or whether you are 
able to have specialists for primary care, as many women, in 
particular, so need in our society today? And why not discuss the 
importance of access to clinical trials, or a right to timely appeals--
both internal and external--and health plan accountability? Why should 
the health insurance industry be the only industry that can cause death 
and disability and be excluded from accountability in the United States 
of America? Should we not have the opportunity to debate that issue and 
call the roll? Not according to the majority leader. No, no, not 
according to the majority leader. You either take it or leave it.
  Now, that has been the position effectively on HMOs, the position on 
campaign financing, the position on any increase in the minimum wage: 
Take ours or leave it.
  Now, he is entitled and has authority as the majority leader to make 
these decisions, but we also have prerogatives in this body, and we can 
exercise those prerogatives and, as Senator Daschle has indicated, will 
either do it in a regular way according to the rules of the Senate or 
we will have some other opportunity to do so.
  This body should not be gagged, as the majority leader is doing when 
he responds: You will take three amendments and that is it. It is very 
clear what the priorities are for the Republican leadership--protect 
the banks and the credit card companies--protect the insurance 
industry--protect their friends. All you have to do is look at who is 
going to benefit from the HMO reform and patients' rights and who is 
going to benefit from the bankruptcy legislation.
  Who is going to benefit from the bankruptcy legislation? The banks 
and the credit card companies that have been among the most profitable 
industries in this country in the last few years. Who benefits from 
Patients' Bill of Rights? Working families benefit from it. Children 
benefit from it. Senior citizens benefit from it. The average citizen 
in this country benefits from it.
  But, no, no, the Senate hasn't got time for that. Make no mistake. 
What was determined this afternoon by the leadership is that the Senate 
is favoring the banks and credit card companies and we are giving short 
shrift, short shrift to those who are dependent upon, in too many 
instances, the kinds of HMOs in this country that are not putting the 
medical decisions in the hands of doctors.
  Why is it that nearly 200 of the leading national medical 
associations, nursing organizations, patient coalitions, disability 
groups, mental health groups, religious organizations, small businesses 
and consumer groups support the Daschle bill? I have been in the 
Chamber when I have listened to the majority leader and my friend from 
Oklahoma, Senator Nickles, talk about their bill. We haven't heard of 
one single patients' organization that supports their bill. Every one 
of them supports the Daschle bill. So, when we say let us at least have 
the opportunity to debate it, we mean let's discuss each of the various 
elements. Let us have an opportunity to address those measures, with 
relevant amendments--they are right here. I would settle for amendments 
on the particular measures on this chart this afternoon, if I were 
asked, with time limits. But let's have accountability. Let's have 
accountability. Why is the Republican leadership saying to every doctor 
who is represented by those organizations, to every nurse, to every 
patient or survivor of every breast cancer group, ``No, we can't debate 
your proposal''?

  So we are going to work at it and we are going to keep at it, time in 
and time out.
  I know there are others who want to speak. How much time do I have?
  The PRESIDING OFFICER. The time of the Senator has just expired.
  Mr. KENNEDY. Mr. President, I ask consent to have the same privilege 
as has been extended to the Senator from Iowa and the Senator from 
Illinois, to proceed for 4 more minutes.
  The PRESIDING OFFICER. The Senator from Iowa spoke for 20 minutes. 
The Senator from Illinois spoke for 15 minutes.
  Mr. KENNEDY. I ask for 5 minutes.
  The PRESIDING OFFICER. The Senator may ask for 5 minutes more. 
Without objection, it is so ordered.

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