DOCTORS’ RIGHTS: Bill Would Allow HMO Negotiations

      Physicians could gain new rights to bargain collectively with managed care plans, under new legislation being considered in Congress, the AP/Baltimore Sun reports. The measure, being considered by the House Judiciary Committee, would amend antitrust laws to give doctors the same collective bargaining rights as unions when they negotiate with HMOs regarding fees and contract terms. The bill does not give doctors the right to strike, and exempts Medicare and Medicaid from the bargaining process. Rep. Tom Campbell (R-Calif.), the bill's author, explained that the legislation would allow doctors to challenge gag rules, question limits on patient testing and challenge other managed care restrictions. Campbell has 207 co-sponsors, and the support of the American Medical Association, the American Dental Association and the National Association of Community Pharmacists. But the legislation "faces strong opposition from a coalition of health insurance, HMO, hospital and business groups." The groups contend that the bill would lead to anti-competitive practices by physicians, which they argue would "drive up private health insurance premiums by more than 10% and add to the ranks of uninsured." In ads running in Capitol Hill publications, the Antitrust Coalition for Consumer Choice in Health Care writes: "Doctor cartels are bad medicine for patients." But Dr. Donald Palmisano, a New Orleans surgeon and AMA trustee, noted that there "was no evidence that the legislation would raise health care costs." He argued that bargaining rights would make doctors "better advocates for their patients and stop HMOs from imposing contract terms that interfere with patient-physician relationships" (3/23).