Bill Will Allow Doctors to Negotiate Jointly With HMOs

The House Judiciary Committee overwhelmingly approved what has been a controversial bill (H.R. 1304) allowing independent physicians in a given community to negotiate jointly with a managed care plan. Doing so is currently against antitrust law. But H.R. 1304, which passed by a vote of 26-2, would provide an exemption that has been sought by nearly every medical provider group, including the AMA, in Washington. Sponsored by Rep. Tom Campbell (R-CA), the bill is opposed by the managed care industry and the Clinton administration, both of which claim that it will enable physicians to greatly increase their fees. “Antitrust exemptions are intended to augment providers’ incomes,” argues Chip Kahn, president of the Health Insurance Association of America (HIAA). But Donald J. Palmisano, MD, an AMA trustee, argues that managed care plans have too much market power over physicians. “The role of physician as patient advocate can be easily undermined when a physician has no leverage in the face of a large, controlling health plan,” states Palmisano. Nearly a majority of House members are cosponsors of H.R. 1304, the House should pass it. Prospects for Senate approval are good, too.