Politics

One More Try For Patients' Rights

By CBSNews.com staff CBSNews.com staff

February 6, 2001 / 4:01 PM EST / CBS

A coalition of Republicans and Democrats said Tuesday that they believe they finally have the votes to pass a Patients Bill of Rights.

The legislation, opposed by the HMO lobby, would give millions of Americans more power to challenge decisions by their managed health care plans, including the right to sue.

"After four long years of working, long hard years of working, we believe this will get us to the Rose Garden," said Rep. John Dingell, D-Mi.

Part of that confidence, reports CBS News Chief Washington Correspondent Bob Schieffer, came with the addition of a prominent new Republican supporter — Sen. John McCain of Arizona.

"For too long achievement of this vital reform has been frustrated by special interest gridlock," said McCain, the powerful champion of campaign finance reform and opponent of President Bush in the GOP primaries.

Mr. Bush said Tuesday he'd like to see a Patient's Bill of Rights on his desk soon, and during the campaign, he expressed support for such legislation.

But Monday night, Georgia Republican Rep. Charlie Norwood, who sponsored last year's HMO reform bill, was called to the White House and strongly urged not to join this year's coalition until the president "studies" the legislation.

Mr. Bush said he was concerned the proposal did not tightly cap damage awards that patients might win if they sued their health insurers.

"We can't have a patients' bill of rights that encourages and invites all kind of lawsuits. The ultimate effect would be to run up the cost of business," Mr. Bush said. "I'm a little concerned about the size of the cap on punitive damages."

White House spokesman Ari Fleischer said, "We emphasized to the congressman, as well as to others, that the president deserves his chance to put forward a patient bill of rights."

In a letter expected to be sent later this week to congressional leaders, Mr. Bush intends to outline his principles on patients' rights, including allowing patients to challenge decisions by their insurers.

"It will stress that consumers need the right to have an external review, followed by the right to sue," Fleischer said.

White House aides, speaking on condition of anonymity, say they also want to see all lawsuits directed to federal courts, where monetary awards typically are lower than state court judgments.

The new legislation allows for what amounts to $5 million in punitive damages in federal court and puts no new caps on state court awards.

Norwood, who helped develop the compromise and arranged the news conference to introduce it, pulled out after meeting for about three hours with White House officials including senior adviser Karl Rove.

"I intend to support it if and when it comes to the floor of the House," Norwood said Monday. "I simply would like our new president to have the opportunity to provide some input on the issue before we declare this versin to be final."

Rep. Greg Ganske, R-Iowa, another patients' rights supporter who attended the meeting, said the White House wanted Republicans to withhold their support. "The suggestion was made that we hold off," Ganske said.

The bill is the latest attempt to offer new rights for patients, including a modified right to sue, and McCain said: "The American people have waited too long."

Among the other supporters are Democratic Sens. Edward Kennedy of Massachusetts and John Edwards of North Carolina, GOP Sen. Lincoln Chafee of Rhode Island, and Rep. John Dingell, D-Mich.

House Speaker Dennis Hastert, R-Ill., who had a representative at the White House meeting, wants to move ahead but will take his cues from the White House, an aide said.

Patients' rights legislation passed the House in the last Congress but was stymied in the Senate, where Republican leaders long have insisted on a much narrower bill. Democrats and their GOP allies now say that since November's election, which gave both parties 50 Senate seats, they have gained close to 60 votes in the Senate, enough support to cut off debate and bring the issue to a vote.

The legislation attempts to reach middle ground on the right to sue, the most contentious issue in the patients' rights debate.

It would direct many legal claims to state courts, where plaintiffs frequently win substantial damage awards. But it forces others into federal courts, where damages typically are more modest.

Health insurers were not pleased with the compromise, said Karen Ignagni, president of the American Association of Health Plans.

Among her concerns: lawyers will bounce between federal and state courts, looking for their best chances; patients can claim they are in danger of immediate harm and skip the independent appeals step altogether; and the legislation appears to allow for new lawsuits on unrelated health law.