Bright Prospects for the Collective Bargaining Bill

I HAVE ONE SIMPLE THESIS-that you ought to be allowed to practice your profession. That's it. What a sad thing that that becomes a controversial issue... The antitrust laws of the United States apparently are now going to permit Exxon and Mobil to merge, but they can't allow two doctors to present a united front in a health care negotiation...

It's a law that was passed in 1890. And, you know, it was never intended to address the actual sort of professional service that you provide. That was how the antitrust laws were applied for 70 years, in fact 80 years. It wasn't until the 1970s that a new interpretation was made that antitrust would apply to persons and the services that people provide in a professional way. Indeed, that was contrary to the legislative history...

H.R. 1304 has an interesting history because... I actually drafted it on my own....We worked with the AMA. We worked with NMA. We worked with the professional associations....

We were all scheduled for a [Judiciary Committee] hearing with two weeks to go in the legislative session this year when Speaker [Dennis] Hastert pulled the bill...Well, I went to see the Speaker of the House personally. I spent the chits that I had, everything I had, and explained to him the merits, what the bill really was, and I think it's fair to say, without putting him in a bad spot, that the other side mischaracterizes.

That's something we understand in politics, and having understood what the bill did, he not only gave me back that which he had taken away, ...a promise of a vote in the Judiciary Committee, but a promise of a vote on the House floor...

This bill will pass. This bill will pass the House of Representatives. With 175 cosponsors, all we need is 218 [votes] to pass. It will then go over to the Senate...

What this bill does is simply say that you are a professional, and that when you present a position to a health care insurer, what you are saying is that I wish to take care of my patients in the way that my best professional judgment dictates. And that if the capitation rate is so low that I have to see so many patients per hour in order to pay the electrical bill, I cannot deliver the quality of health care that I took an oath to deliver.

And that when I am told that a certain procedure is just too exceptional to be subject to reimbursement because the patient is too old or too high risk, I know what I'm being told. I am being told how to practice medicine by somebody who does not even have a license to practice medicine. And I'm standing up for your right because we, you and I, are standing up for the interest of the patients you serve...

I understand how it hurts the sense of importance, the sense of worth that you bring- because you are professionals-to your patients, to have the attribution made that everything you do must necessarily be driven by profit. That if you make a decision, that you wish to provide a particular kind of service, it must be because you have a financial interest in doing so-when, in truth, you have chosen to become a professional, giving up what might otherwise have been a more lucrative endeavor, in order to provide a service.