March 15, 1999

[Identical letter sent to all Members of Congress]

Dear Senator or Rep. [name]:

As members of both the Presidentís Advisory Commission on Consumer Protection and Quality in the Health Care Industry and the National Coalition on Health Care, we are writing to seek your commitment to help improve the quality of health care for all Americans.

The Commissionís report, issued last March, concluded that “Ö today, in America, there is no guarantee that any individual will receive high-quality care for any particular health problemÖ. The health care industry is plagued with overutilization of services, underutilization of services, and errors in health care practice.”

Our report contained more than 50 recommendations for steps that should be taken as part of a sustained national effort to improve the quality of care. Some of those steps require federal legislation. We believe that a number of proposals being discussed in Congress this year are consistent with our recommendations. Among these are the strengthening of the Agency for Health Care Policy and Research and proposals to protect the privacy of medical records and to foster the computerization of health care record keeping under a uniform federal framework.

Despite all of the attention to and popular appeal of a patientsí bill of rights, it alone cannot reduce unnecessary operations or inappropriate prescriptions and medical tests. Nor can it reduce medical errors or assure that patients get the preventive care they need. Rather than continuing to focus on the difficult issues of whether health plans or health professionals should decide what is “medically necessary,” we are calling for improvements aimed at lessening those disagreements and building a foundation for greater consensus on appropriate care for all Americans. Only systemic improvements, built on scientific evidence, can accomplish these goals. Improving the quality of care is also, we believe, the best way to restrain the growth in health care costs over the long term.

Finally, we urge Congress to keep uppermost in mind that the greatest impediment to quality of care in America today is the lack of health insurance. Currently, over 43 million Americans are uninsured and that number is growing at the rate of over 1 million a year. This undermines not only the quality of care but also our ability to restrain the growth in health care costs. The National Coalition on Health Care, to which we belong, contends that the major problems in health care — the lack of

coverage for all Americans, the absence of effective cost containment, and the serious problems with quality of care — must all be solved for the health care system to be fundamentally improved.

As Congress moves forward with its work on behalf of the country, we ask you to support and encourage changes in our health care system that over time will ensure that all Americans have access to affordable, high quality health care.

Sincerely,