There is an old axiom in medicine: first, do no harm. As the ranks of the uninsured continue to grow to more than 43 million Americans Congress must ensure that in passing something called a "Patients' Bill of Rights," it doesn't make a chronically-bad situation even worse.
I've spoken to many small-business owners in Arizona. They've told me the difficulties that they've faced in finding affordable health-care coverage for themselves, their families and their employees. In fact, the National Federation of Independent Business reports that the vast majority of uninsured Americans are those who own or work for America's small businesses.
Every employer, large or small, wants to offer their employees high-quality health care, if for no other reason than that is the best way to attract and retain skilled workers. But health-care costs are skyrocketing, and employers particularly small-business owners are faced with the choice of continuing to provide health care amid rising costs, reducing the coverage they offer, or dropping insurance altogether. Sadly, many companies struggling to stay afloat are choosing to drop coverage. In fact, a recent study by the Lewin consulting group found that for every one percent increase in health-care premiums, 300,000 Americans lose their health insurance.
Unfortunately, I believe a bill introduced by Senator Kennedy would actually worsen this situation. His bill would raise premiums by as much as 4.2 percent, which the nonpartisan Congressional Budget Office (CBO) estimates would cause 1.2 million additional Americans to lose their health insurance. Those who maintain their existing coverage will pay roughly $300 in additional costs, on average, every year, according to estimates. No matter how well-intentioned, this plan is not progress.
Since many employers are struggling to keep health-care coverage, it makes sense to me that we should avoid taking steps that would actually increase the burdens on them. For this reason, many of us worked hard to exempt employers from any legal actions contemplated by the Kennedy version of the Patients' Rights Bill. We believed that small employers who voluntarily make the sacrifices necessary to maintain coverage for their employees should be rewarded, not made the victims, for example, of lawsuits by a small number of unscrupulous employees. Why should they be held accountable for the actions of an HMO? As possible targets of lawsuits, many businesses understandably won't want to risk maintaining health-care coverage and losing possibly millions of dollars in court. They very likely will drop coverage altogether.
Another major factor behind rising health-care costs is the increased potential for frivolous lawsuits against insurance providers. HMOs forced to spend more money to defend themselves in court will find some way to keep making profits and that means higher premiums passed on to consumers. Under all of the plans under consideration by the Senate, patients with a medical dispute would first go through an internal HMO review, then, if necessary, another external review before their dispute could proceed to court. The hope, of course, is that the review processes will allow many patients to settle their claims, and that the legal system would be rarely used, except as a last resort.
But there are real disputes over how legal remedies should be devised. Some favor directing lawsuits to state rather than federal courts, where recoveries against HMOs could be higher. While everyone agrees patients should recover all of their actual economic damages from bad decisions by their HMO, there is also a dispute over how big of a cap should be imposed on pain and suffering awards. There's little reason to doubt that HMOs will only pass the costs of exorbitant judgments against them to their customers.
I will continue to push for legislation that does not raise premiums unnecessarily nor increase the risk that more Americans would join the ranks of the uninsured. Patients deserve the best medical care their insurer has promised them. But our goal in passing a Patients' Bill of Rights should be to ensure good medical treatment, not lawsuits, where lawyers are the only real winners.