It is hard for me to imagine that there is anybody in this body who has not received lots of mail from their constituents about the abuses that are taking place every day.  I have been hearing both from people who give care, nurses and physicians, and people who receive care, who are seeking the care, the patients.  

I want to give my colleagues one example of a heartbreaking letter that I received. It starts,  

Dear Representative Schakowsky: 

I am a 31-year-old nurse with breast cancer. Because I am an HMO member, I have had recurrent problems with receiving health care. As a patient, I have not yet received compromised care, but I have been denied services or have been told where to get care and who could give me care.  I recently also was made to change primary doctors, giving up one that I had for 8 years because of my HMO.  

I heard you speak on behalf of the Patients' Bill of Rights, and I need you to know that, as a health care provider and receiver and HMO member, I am certain that care is being compromised and restricted and refused to us.  

I am knowledgeable about the health care system, and I am still able to be my own advocate, but I am sure one day I will not be able to make telephone calls endlessly pleading for standard of care. Who will do it for me? Why do I need to beg for treatments or for the right to remain in the care of my own doctor?  

I am receiving follow-up care from my oncologists after having a stem cell transplant for metastatic breast cancer, and I am worried that continuity of care will be compromised. And I will only be treated if the HMO sees fit rather than being able to rely 
on the judgment of a physician who had known me for eight years and an oncologist who has seen me every month for a year. I want managed care to stop making medical decisions. I have a right to health care.  

As a nurse, I also know that quality health care is the issue. Having cancer has changed my life. Having adequate health insurance was a wise choice I made 10 years ago. Today I am fearful that I have no rights as an HMO member. That is one battle too many for me to take on.  

It frustrates me so much after having received this letter, and it is one of many that I have received, probably one of the most articulate descriptions of the problem, that we have to go through such a cumbersome process of marching down and gathering enough signatures for a petition simply to have the right to debate this issue fully in the House.  

One would think that all the Members would jump at the opportunity to do that on behalf of our constituents. The only thing I can think is that the concerns of the health care industry, of managed care companies, of insurance companies has superseded 
concerns for ordinary patients and consumers in our districts.  

I do not think it is sound health care policy to force a breast cancer patient to give up a physician of eight years. It is not sound health policy to force a breast cancer patient like my constituent to beg for treatment. It is not sound health policy for insurance 
companies to make medical decisions. It is not sound health policy for the United States Congress to delay action on preventing these abuses.  

We have a number of excellent proposals, H.R. 358, the Patients' Bill of Rights, and as a prior colleague of mine said, there may be many who disagree with that, but we certainly should be able to discuss a bill that has provisions such as providing full and fair 
access to specialists and to emergency care, giving patients the right to timely appeals, including the right to appeal to an external and independent entity, holding managed care plans accountable for all their decisions, including the decision to deny care, and 
letting medical professionals and their patients make the medical decisions.