U.S. Reps. Mark Kirk (IL-10) and Charlie Dent (PA-15), co-chairs of the GOP Tuesday Group, unveiled legislation today to guarantee the rights of patients to control their own health care decisions. The Medical Rights Act, authored by Congressmen Kirk and Dent, guarantees that private (non-government) health care cannot be denied by government restrictions. The legislation bans government interference into the doctor-patient relationship by protecting the right of Americans to get the care they need when they need it. Congressmen Kirk and Dent were joined by fellow Tuesday Group members U.S. Reps. Leonard Lance (NJ-07) and Erik Paulsen (MN-03).

“President Obama rightly placed health care reform among his top priorities for this Congress,” Congressman Kirk said. “Health insurance premiums have increased by nearly 120 percent since 1999, with approximately 45 million Americans uninsured. We need reform that lowers costs, increases choice and expands access while protecting the basic right of patients to control their own medical decisions.

“Government-run health care programs in Canada and the United Kingdom show us the dangers of taking away personal choice. Long waits and denied care for routine procedures are rampant in both countries as bureaucrats dictate when and if patients may be treated. Make no mistake – delayed care is denied care. The Medical Rights Act guarantees that the government will not come between a doctor and a patient. I look forward to working with President Obama and the congressional leadership to make sure we do not repeat the mistakes of Canada and Britain. Congress should ensure these protections are the centerpiece of a comprehensive health care reform plan.”

“As Congress begins to discuss how best to address America's health care challenges, we must protect the sacrosanct relationship between a patient and a doctor," Congressman Dent said. "We should look for common ground in reforms that make health care more accessible and affordable, while improving quality and promoting personalized care. One of the greatest strengths of our health care system is that Americans can rely on getting the care that they need when they need it. This legislation will assure Americans that their health care decisions will continue to be made between themselves and their physician."

“Congress must work in bipartisan fashion to expand health care access for Americans while reducing the high cost of medicines,” said Congressman Leonard Lance (NJ-07). “At the same time, we must protect the rights of doctors to make decisions about the best care for their patients.”

In March President Obama outlined three principles for health care reform: lower costs, increased choice and expanded access. The Medical Rights Act strengthens these goals while adding safeguards to protect the doctor-patient relationship and improve American medicine.

Congress is preparing to debate health care reform proposals this summer. However, legislation allowing the government to take over health care decisions for families could have dire consequences. A close examination of government-run health care in Canada and the United Kingdom shows sharp contrasts in the quality of medical services:

• Delay is denial of care. In the U.S., only 26 percent of sick adults waited more than four weeks to see a specialist. In Canada and the UK, more than twice as many citizens wait longer than a month to receive the care they need (60 percent and 58 percent, respectively). Source: 2008 Commonwealth Fund International Health Policy Survey of Sicker Adults.

• The sickest patients need intensive care. In Britain, government hospitals maintain nine intensive care unit beds per 100,000 people. In America, we have three times that number at 31 per 100,000. Source: High-Priced Pain: What to expect from a Single-Payer Health Care System, Heritage Foundation, 9/22/2006.

• U.S. Care for infants outpaces UK and Canada. In the U.S., we have over six neonatologists per 10,000 live births. In Canada, they have fewer than four and in Britain fewer than three. In the U.S., we have over three neonatal intensive care beds per 10,000 births, just 2.6 in Canada and less than one in Britain. Source: High-Priced Pain: What to expect from a Single-Payer Health Care System, Heritage Foundation, 9/22/2006.

• Long waits increase pain and morbidity. In the U.S., over 90 percent of seniors receive a hip replacement within six months. In Canada, less than half of patients are treated in the same time (43 percent) with many waiting over a year. In the UK, only 15 percent of patients are treated within six months. Source: Doing Your Own Health Care Thing: American Seniors vs. Canadian Citizens, Heritage Foundation, 7/1/2005.

• New technology finds cancer quicker. In America, doctors use 27 MRI machines per million people. In Canada and Britain, it is less than a fifth of that at approximately five MRI machines per million people. Source: Health Status, Health Care and Inequality: Canada vs. the U.S., National Bureau of Economic Research, September 2007.

• Americans take advantage of preventative care. Nearly 90 percent of American women age 40 – 69 have had a mammogram, while only 72 percent of Canadian women have had a screening. Likewise, 96 percent of American women age 20 - 69 have had a Pap smear, with 88 percent of Canadian women undergoing the test for cervical cancer. Source: Health Status, Health Care and Inequality: Canada vs. the U.S., National Bureau of Economic Research, September 2007.

• Cancer survival rates higher in the U.S. One study puts the five-year cancer survivability rate for American women at 63 percent, but only 56 percent for European women. For men, the difference is starker with 66 percent survivability for Americans and only 47 percent for Europeans. A separate comparison of U.S. and Canadian citizens shows similar results. American women’s survival rate is 61 percent, compared to 58 percent in Canada. American men’s survival rate is 57 percent, and 53 percent in Canada. Sources: Lancet Oncology, 2007, No. 8; Health Status, Health Care and Inequality: Canada vs. the U.S., National Bureau of Economic Research, September 2007.

Stories of poor care under a government-run system are common in Britain. Last February, the Daily Mail reported on Mrs. Dorothy Simpson, 61, who had an irregular heartbeat. Officials at the National Health Service (NHS) denied her care and told her she was "too old." The Guardian reported in June 2007 that one in eight NHS hospital patients wait more than a year for treatment.

By enacting the Medical Rights Act, Congress will ensure Americans keep the choice, quality and access currently denied citizens of the U.K. and Canada (Canadian law actually bans patients from paying for care themselves, even if denied care).

THE MEDICAL RIGHTS ACT OF 2009

In Brief: Congress should guarantee the right of every American to make their privately-funded health care decisions with their doctor. The Medical Rights Act protects each patient’s doctor relationship, the integrity of the medical profession and the right of Americans to choose the care they deem appropriate without federal delay or restriction.

Section-by-Section Analysis

Section 1

This section entitles the bill as the ‘‘Medical Rights Act of 2009.’’

Section 2

This section prohibits the federal government from regulating privately supported medicine, legally protecting the doctor-patient relationship against federal controls or rationing for care not paid for by the federal government. The same applies to the practice of other health care professionals (nurses, physician therapists, etc.). In addition, this section prevents the federal government from regulating the hiring practices of organizations that provide health care, such as hospitals, clinics, and the like.

Exceptions are provided to enable the federal government to manage its own operations – that is, existing federal facilities that directly provide health care services such as military treatment facilities, VA hospitals and clinics, and other similar agencies. Under this section, the federal government can control care at federally-owned hospitals and facilities, but not private-sector, state, or local health care facilities.

Section 3

This section protects the right of patients to obtain health care services themselves, regardless of any federal program that might apply. For example, Canadian patients are prohibited from paying for their own health care, even if the government system denies or delays treatment needed to keep the patient alive.

Section 3 enables the Congress to protect the right of each American to obtain his or her own health care, free of government interference. This section also protects the rights of patients to buy health insurance, or make any other arrangements to pay for their own health care. Several foreign countries and several current health care reform proposals substantially restrict this right.

This section also guarantees American access to care under a federal health care program (such as Medicare and Medicaid) even if a patient obtained their own health care outside the program. Under some policy proposals, patients would be denied coverage if they arranged it outside of government-backed programs, even if denied care. In the UK, cancer patients who were denied cancer-fighting drugs by the National Health Service (the UK’s universal government health care system) and bought the drugs themselves were later denied health care by the “universal” health care system because they bought – and paid for – their own cancer-fighting drugs.

Even in the U.S., if a Medicare patient pays a doctor for a service that would otherwise be covered by Medicare, the doctor is suspended from participating in Medicare for two years. This substantially restricts the ability of Medicare patients to pay on their own if Medicare decides they are ineligible for a particular service normally covered by the program. A doctor who provides a single service to a single Medicare patient outside the scope of the Medicare program, even without asking Medicare to pay, gives up the right to get paid for any Medicare services for any Medicare patient for two years. Not many doctors are willing to take that penalty, so this substantially (if indirectly) restricts the right of seniors and the disabled to access the health care of their choice.

Section 4

This section prohibits the federal government from requiring states to impose restrictions prohibited by this Act, and from using eligibility for federal funds as an inducement to do so.

Section 5

Nothing in this Act shall be construed to permit the expenditure of funds otherwise prohibited by law.

Section 6

This section repeals the two-year Medicare kick-out discussed in Section 3.

Section 7

This section contains various definitions.

The term “health care services” means any lawful service intended to diagnose, cure, prevent, or mitigate the adverse effects of any disease, injury, infirmity, or physical or mental disability, including the provision of any lawful product whose use is so intended.

This definition has been chosen very carefully. For example, it specifies that the service be “intended” to produce health benefits. This is meant to prevent the government from excluding services that are not, in the minds of politicians, appropriate or cost-effective by claiming they are not actually “health care services.” Decisions on appropriateness and to whether something is worth its cost should be up to health care professionals and patients, not bureaucrats or regulators. Therefore, anything “intended” to have health benefits in the view of the patient and the health care professional.

Section 8

The provisions of this Act shall apply to Federal entities, including employees and officials of such entities, beginning on January 1, 2009.

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