America has the most advanced health care system in the world, but tragically not all Americans have the access they need to lifesaving treatment. Health Maintenance Organizations (HMOs) were developed in response to rising health care costs. While managed care plans tend to be more affordable, they are also less flexible than traditional health insurance. So, while HMOs have helped reduce the cost of health insurance, they have also given rise to concerns about the quality and availability of care.

This Congress has the opportunity to pass reasonable managed care reform legislation to ensure that patients get high quality and timely health care and have the right to hold HMOs accountable should they fail to do so. Nevertheless, Congress should not pass laws in the name of HMO accountability that end up doing little more than increasing the cost of health care, thereby making it less affordable and putting coverage out of the reach of more Americans.

For example, the Norwood-Dingell bill, which recently passed the House, includes basic patient protections such as emergency room coverage, access to OB-GYNs and pediatricians without referrals, and better access to specialists. But I opposed the bill because it also encourages patients to settle disputes with their health insurance company in court even if the insurance company was never contracted to provide the service in dispute. Moreover, damages would be unlimited. Baseless lawsuits combined with unlimited damages would drive up costs and make health insurance unaffordable to more Americans. Studies show that every time health care premiums go up one percent, up to 400,000 more Americans would lose their health insurance. With more than 43 million Americans already uninsured, we must reject any proposal that would make the problem worse.

Although we must protect patients from legislation that would turn our health care system over to trial lawyers, we must also reject bills representing the other extreme. I joined a majority of my colleagues to defeat the Boehner bill, which would have enacted patient protections similar to Norwood-Dingell, but do virtually nothing to expand liability for insurance companies to provide competent care that they are contracted to provide. In many ways, it resembled the legislation that passed the Senate earlier this year.

The Goss-Coburn bill, which I supported, would have addressed the most common complaints of consumers in managed care, without compromising the rights of patients and the stability of the American health care system. The bill offered even better patient protections than the Norwood-Dingell bill. For example, patients would have been provided coverage for ambulance services, more flexible access to specialists, and much faster appeals of insurance decisions. Just as important, the Goss-Coburn bill would have allowed patients to sue HMOs for cost of care, pain and suffering, and punitive damages in federal court if the insurance company denied necessary care that it was contracted to cover, and if harm was done to the patient. But the legislation would have kept insurance affordable by ensuring swift and binding appeals of denied claims, providing for binding arbitration, and, if court action is necessary, capping damages at reasonable levels.

Of course, the most important patient protection is having an affordable health plan in the first place. A recent study shows 11.3% of New Hampshire residents are without health care insurance. I supported tax relief and related provisions to increase access to private insurance coverage. Among the provisions in The Quality Care for the Uninsured Act, which passed the House along with the Norwood-Dingell bill, are tax deductions to self-employed business owners and everyone who works but doesn't have employer-provided health insurance.

Legislation is the art of compromise. Soon, members of the House and Senate will begin negotiations to reconcile the differences in the patient protection bills passed in each chamber. I urge them to negotiate a balanced and responsible plan, similar to the Goss-Coburn bill, that would make health care more affordable, accountable, and accessible for all patients. I am confident that is an achievable goal. One alternative is to rely on lawsuits and courtrooms, not doctors and examining rooms, which would dramatically increase health care costs and decrease the number of insured Americans. Another alternative is to do too little to protect patients and hold insurance companies accountable. Neither of these extremes is acceptable.