The United States House of Representatives last month passed the Quality Health Care Coalition Act by a vote of 276 to 136. The bipartisan bill, sponsored by Republican Tom Campbell of California and Democrat John Conyers of Michigan, was strongly supported by the American Medical Association.
The bill gives doctors, as individual contractors, exemption from the antitrust laws when negotiating with health maintenance organisations (HMOs) and insurers over fees and contracts.
Under existing law, doctors who are employees of hospitals or clinics can already join labour unions and negotiate as a group with their employers, but doctors who are individual contractors have not been able to do so.
Dr Michael Pierce Connair, a Connecticut orthopaedic surgeon and vice president of the Florida based Federation of Physicians and Dentists, said in testimony before Congress: “This bill would restore balance and fairness in the healthcare delivery system and is a necessary complement to a strong patients' rights law.”
Dr Connair said that health insurers can unilaterally increase premiums, reduce patient care, and cut back reimbursement for doctors. For example, in the Miami area reimbursement schedules average 50-60% of what Medicare pays.
Nationwide lobbying by the federation, a labour union with 8500 members in 25 states, helped pass the bill. The effort included a boycott of Merck pharmaceutical products: Merck's subsidiary, Merck-Medco Managed Care, which manages drug benefits for 52 million people, was a member of the Antitrust Coalition for Consumer Choice in Health Affairs, which opposed the bill.
Other members of the coalition included Aetna US Healthcare and the Blue Cross and Blue Shield Association.
Full story in News Extra at bmj.com