There has been much public concern that health maintenance organizations deprive patients of the ability to challenge health care decisions. Business and insurance companies are concerned about the cost of potential lawsuits if patients are given more power. Congress considered a so-called Patients' Bill of Rights in 1998.

Insurance companies and other opponents of managed care reform spent $60-million on lobbying in the first half of 1998, about $112,000 per lawmaker. Those pressing for the "Patients' Bill of Rights", such as the American Medical Association, spent $14-million. Much was spent on high-priced lobbyists. In addition, $11-million was spent on advertising against the legislation, and more was spent on campaign contributions.

The chairman of one anti-regulation group stated that it was money well spent -- because the legislation did not pass. He said that the stakes are high and the industry would do the same in 1999 when the issue resurfaces.

(Updated January 1, 1999)

1.	a) Who stood to gain from the Patients' Bill of Rights? In what ways?
	b) Who stood to lose? In what ways?
	c) Given your answers above, why did the opponents of the legislation spend more money on lobbying?
2.	The chairman of one anti-regulation group stated that it was money well spent.
	a) What were the groups' costs?
	b) What were the groups' gains?
	c) Given your answers to a) and b), why was the money well spent?
3.	a) What are the implications for national output of spending huge sums of money on lobbying?
	b) Why, then, do groups persist in lobbying?