Patients' Bill of Goods.

The proposed "Patients' Bill of Rights" has nothing remotely to do with extending basic traditional rights of citizenship to Americans or with providing protections against medical rationing to patients. It has much to do with providing a financial bonanza for the denizens of the sue-for-profit litigation industry, creating chaos in medical care, and paving the way for the government to come back to "solve" anew the resurgent problems of "spiraling health care costs" and the "growing number of the uninsured" that will result.

It is not well understood that the much-maligned health maintenance organizations (HMOs) are not the product of the free market, but rather the deliberate creation of collectivist academics and statist politicians. It was Senator Ted Kennedy (D-Mass.), who has been for years a champion of socialized medicine, and self-described "Keynesian" socialist Richard Nixon, who hatched the HMO Act of 1973 in Washington, supposedly to control mounting health care costs.

The road to the problem of rising health care costs was paved on Capitol Hill during World War II with the imposition of wage and price controls, which triggered the development of employer-provided health insurance. To bypass the problems of a limited workforce, employers began to offer health insurance to attract new workers. Health insurance became tied to place of employment. With insurance paying medical bills, the perception of workers was that they were spending someone else's money, and they began to spend health care dollars without the constraints prudent consumers normally use when they spend money in the marketplace. The problem was then acutely exacerbated when government plunged head-on into the health care field with the implementation of Medicare and Medicaid in the 1960s.

Now, some of these politicians - who have supported collectivism in medicine all along - want to turn over the regulatory machine and the writing of more mandates to non-elected bureaucrats, and the legal process of conflict resolution to their friends, the trial lawyers. No wonder the Patients' Bill of Rights has been dubbed "a lawyers' bill of delights"! Both the Senate and House versions of the bill considered the sky as the limit for malpractice damages. The original House version, for example, would have capped non-economic and punitive damages at $5 million each. At the last minute, President George W. Bush and Representative Charlie Norwood (R-Ga.), the original sponsor of the House bill, reached a compromise cap at $1.5 million each, essentially tripling the White House's original proposal of $500,000. President Bush and his allies were able to include the proviso that even though patients could sue HMOs in state courts, the judicial proceedings were to be guided by the more stringent federal lawsuit guidelines. Otherwise, the Patients' Bill of Rights remains a "lawyers' bill of delights."

Moreover, if implemented, the bill will increase the number of the uninsured by making insurance premiums, even for HMOs, less affordable. Studies performed by the Health Insurance Association of America have shown that for every one percent increase in premiums, the number of the uninsured increases by 300,000 people. The Senate version of this bill has been estimated to increase premiums by four percent, which translates into 1.2 million Americans who will be added to the roll of the uninsured. Yet even this figure may be too low. The Employment Policy Foundation estimates that the Patients' Bill of Rights could very well increase the number of the uninsured by a staggering 9.2 million Americans, suddenly increasing the proportion of the uninsured to a quarter of the population!

The Senate version could even jeopardize employers who could be made liable for health care decisions and dragged kicking and screaming into the courtroom. During the Senate debate, an amendment by Senator Phil Gramm (R-Texas) that would have exempted employers from liability, was defeated. Senator John McCain (R-Ariz.), who had denied his Senate bill contained employer liability, joined Senators Ted Kennedy and John Edwards (D-N.C.) - himself a multimillionaire trial lawyer - in voting against Gramm's amendment.

So the iniquitous political stratagem has been set: Patients will be hurt and trial lawyers, a core segment of the liberal Democrat constituency and the biggest contributors to the Democrat Party, will enrich themselves at the expense of suffering patients. Chaos would be deliberately created to give the government the pretext to step in and "solve" the crisis, a crisis created by government in the first place. The politicians will say that the "free market" in health care has failed and will deviously blame it for the problems of the "soaring numbers of the uninsured" and "price gouging" by insurers and providers. The "solution" will be more government control and more regulation, until the ultimate goal has been realized: socialized medicine with the government as the single payer of medical care, and no exit for patients, except in death.

Miguel A. Faria Jr., M.D., is editor-in-chief of Medical Sentinel, the official journal of the Association of American Physicians and Surgeons (AAPS),