The Forest vs. The Trees on Patients’ Rights

Published August 1, 2001

“Patients’ rights” legislation is once again taking center stage in Washington, DC. The new leadership in the Senate is making the curbing of the HMO industry a priority, and the nature of the subject overall is making it news.

Health care affects everyone, so when our elected officials talk (or even just posture) about it, most Americans do, indeed, listen. In that way, health care is unlike so many other issues that are debated in our nation’s capital; it is truly important to one and all.

Unfortunately, it is also one of the more complicated policy issues legislators grapple with . . . not to mention one of the most financially significant.

Whether you purchase health insurance on your own, sell health insurance to others, or provide it to your employees, the cost is critical. There are billions of dollars involved: The health-care industry as a whole (including not just insurance, but the care itself—doctors, nurses, hospitals, pharmaceuticals, medical supply companies, and on and on) makes up one-seventh of our overall economy. There is much money to be made . . . and to be lost.

And if the money alone didn’t make this thing huge, the level of passion surrounding an issue as important as our health has helped turn it into one of the media’s favorite issues.

So we read about it in the paper. We see it on TV. And it is still difficult to decipher the “truth” about the “patients’ bill of rights.”

Is it good for patients or not worth the cost? Is the insurance industry telling the truth? Or are they protecting their enormous assets? Are so-called consumer groups telling the truth? Or are they fronting for fat-cat personal injury lawyers? The forest and the trees become one.

There is one group in the lobbying fray who, I promise you, is not interested in whether they make or lose money. They are only interested in being able to afford health insurance for themselves, their families and, hopefully, for their employees. And they are interested in protecting themselves from being sued for decisions they weren’t involved in. Period. Who are these people? They are America’s little economic engine-that-could: small-business owners.

They, their families, their employees, and their employees’ families represent three-fifths of the nation’s 43 million uninsured lives. To them, the so-called “rights” in this legislation are meaningless. Having health insurance is the only thing with real meaning to them, and the “bill of rights” does nothing to help them achieve that dream.

Those in the small-business community who are insured are struggling each year to afford the cost of increasing premiums. The Congressional Budget Office has determined that the “rights” bill will increase premiums an average of 4.2 percent. That number will mean the difference between “insured” and “uninsured” for thousands of these people.

There is legislation in Congress that would address the problem of the uninsured. A new law allowing the creation of Association Health Plans, for example, would help the small-business community in particular. It is therefore disappointing to me that “patients’ rights” takes up so many headlines when it really addresses only a small aspect of our overall health care troubles.

If you, like so many Americans, are passionate about improving health care in this country, please take a few moments to look at the big picture, to think about whether “patients’ rights” legislation is anything more than just a band-aid that would give a temporary sense of justice and a political feather in the caps of some groups. Think about how we can get this phenomenal free market of ours the chance to lift the quality of the system up while bringing the prices down.

And if you need to sort out the forest from the trees after watching the evening news . . . just ask your favorite small-business owner what the biggest challenges are and what they think ought to be done. They are the real experts.

Jack Faris is president of the National Federation of Independent Business, the nation’s largest small business advocacy group. More information is available online at, or contact Jean Card, NFIB Special Assistant to the President, at 202/314-2018.