Politics

Bush Threatens Patients' Rights Veto

By CBSNews.com staff CBSNews.com staff

June 13, 2001 / 1:28 PM EDT / CBS

President Bush issued a veto threat Thursday against a Democratic-backed patients' bill of rights, saying it was riddled with serious flaws that would jeopardize the ability of Americans to afford health insurance.

The threat was issued in writing by the Office of Management and Budget, and within minutes, read aloud on the Senate floor by Sen. Tim Hutchinson, R-Ark.

"The president will veto the bill unless significant changes are made to address his major concerns," the administration said.

The president's aides had long signaled opposition to the measure, and Mr. Bush himself had spoken often about his desire to sign legislation that was markedly different from the bill that Democrats pushed to the floor as the first order of business after gaining a Senate majority.

At the same time, Republicans had expressed concern in recent days that the White House would issue a formal position paper that stopped short of a veto threat, thereby undercutting their efforts in the House and Senate to derail passage of the measure as drafted.

Mr. Bush acted as the Senate moved through its third day of debate on the measure, and Hutchinson advanced an amendment to allow the self-employed to deduct their health insurance costs fully starting Jan 1, one year ahead of the schedule fixed in current law.

The amendment underscored the political stakes involved in the debate. Hutchinson faces a difficult re-election campaign next year, and his amendment addressed a politically popular issue

Much of the dispute surrounding the legislation stems from the issue of when and where patients may sue for denial of care, and how much in damages they should be permitted to seek.

Opponents have warned that the measure would increase health care costs for millions of Americans by permitting jury awards of up to $5 million in federal court and unlimited punitive damages under state law.

There is less disagreement among lawmakers about the type of protections to provide patients.

Earlier Thursday, the Senate voted to take up the far-reaching patients' bill of rights proposed by Democrats Edward Kennedy of Massachusetts and John Edwards of North Carolina and Republican John McCain of Arizona. The vote brought an end to procedural delays that had held up consideration of the measure.

"How can you possibly call something a patients' bill of rights when the practical effect of the bill is to create more people without any insurance?" asked Sen. Judd Gregg, R-N.H.

Gregg, who contends 1.2 million people would lose their insurance if the Democrats' patients' bill of rights becomes law, said, "Those people aren't going to get any new right to sue. They lose all the rights they have."

The Senate's Democratic majority wants to pass far-reaching rules designed to help patients sue HMOs whose delays in or denial of care leads to disastrous or fatal results. In general, the bill also would grant patients access to emergency care, the rigt to select a pediatrician as a child's primary care physician and access to specialists.

What has kept the five-year debate politically charged is when and where patients may file lawsuits for denial of care and how much in damages they should be entitled to seek.

Republicans, aligned politically with managed care companies and businesses, generally favor a more limited right to sue.

In the Senate, they could pepper the Democrats' bill with proposed changes to the number of people covered by the bill, allowable treatments, which courts could hear lawsuits and the pre-lawsuit appeal process.

Majority Leader Tom Daschle has threatened to cancel a July 4 break scheduled to begin at the end of next week if the measure hasn't come to a final vote by then.

"I don't think we'll win every amendment," said Sen. McCain, a co-sponsor of the plan. "But it will be difficult to defend to Americans that (the Republicans) are blocking a piece of legislation that simply deserves to be decided upon."

House GOP leaders, trying to solidify support for a similar plan in their chamber, worked Wednesday on an emerging draft that would let a patient sue an HMO for denial of care if the patient won an appeal and the insurance company refused to abide by the ruling.

Patients would be permitted to bring suit in state courts and seek punitive damages, which are unlimited in some states. The bill backed by most Senate Republicans offers no new right to sue in state court, where juries are presumed more sympathetic to plaintiffs.

Rep. Ernie Fletcher, R-Ky., who has been involved in drafting the new GOP language on lawsuits, said some Republicans might welcome an alternative.

"It's important to offer them something that is better policy," he said.

"What we should not do is expose insurers and employers to frivolous lawsuits," said Fletcher, himself a family practitioner.

Meanwhile, a new CBS News/New York Times finds that 65 percent of Americans favor a law that would allow people in HMOs the right to sue their plan for denying them coverage, while 26 percent oppose it. Support for such a law drops to 50 percent if that meant the costs of managed care would increase.