Bush Outlines His Agenda for Patients’ Rights
In a letter to congressional leaders, President Bush yesterday outlined his own goals for a patients' bill of rights, the Los Angeles Times reports (Rubin, Los Angeles Times, 2/8). Bush drafted the letter, as well as a separate document titled "Principles for a Bipartisan Patients' Bill of Rights," in response to the new patients' rights legislation introduced this week in the Senate by Sens. John McCain (R-Ariz.) and Ted Kennedy (D-Mass.). Bush opposes several aspects of the McCain-Kennedy bill, including provisions allowing patients to sue their health plan in state courts as well as their employers in some cases. In his list of principles, Bush stated that lawsuits should only go through federal courts, where no punitive damages are allowed. He added in his letter that damages awarded by juries should be subject to "reasonable caps" (Fournier, AP/Philadelphia Inquirer, 2/8). These provisions, Bush wrote to the congressional leaders, would avoid "unnecessary [and] frivolous litigation" (Bush letter, 2/7). "Slow and costly litigation should be a last resort," Bush wrote, adding that patients should "exhaust their appeals process" before moving to the courts. Patients "should have the right to appeal a health plan's decision to deny care through both internal review and independent, binding external review." The president also stated that he wanted patients' rights legislation to protect employers from "frivolous" litigation ("Principles for a Bipartisan Patients' Bill of Rights" text, 2/7). "Employers, many of whom are struggling to offer health coverage to their employees, should be shielded [from lawsuits]," he wrote (Los Angeles Times, 2/8). But, he added, employers should be held legally accountable when they "retain responsibility for and make final medical decisions" (Pear, New York Times, 2/8). Bush did support several aspects of the McCain-Kennedy legislation, including guaranteed access to emergency and specialty care (Los Angeles Times, 2/8). His letter and statement "stopped just short of promising a veto" of the McCain/Kennedy bill (AP/Philadelphia Inquirer, 2/8). Nonetheless, Bush stated in his letter, "I do not believe that any bill currently in Congress meets all of [my] principles," he stated in his letter (New York Times, 2/8).
Democratic leaders "avoided commenting" on Bush's "differences with them," instead stating that they "welcomed his commitment to a solution" (Los Angeles Times, 2/8). Kennedy said, "I'm encouraged by the president's statement of principles" (New York Times, 2/8). Bush's statement "avoid[ed] specifics that could make it difficult to compromise" on the issue, thus leaving the door open for the possibility of cooperation between the White House and Congress (AP/Philadelphia Inquirer, 2/8). Kennedy added, "I am hopeful that we can achieve a constructive bipartisan compromise on our remaining differences" (Los Angeles Times, 2/8). House Minority Leader Dick Gephardt (D-Mo.) said that he agreed with some points of Bush's statement, although not with all of them. He added, "I am concerned that the president has not recognized the Bipartisan Patient Protection Act announced [Tuesday] as the hard-won compromise on issues that have been divisive for several years." Gephardt said that he looks forward to working with Bush on passing patients' rights legislation (Gephardt release, 2/7).
Managed care companies gave Bush's principles "modulated praise," stating that they hoped it would halt the McCain-Kennedy legislation. Karen Ignagni, president of the American Association of Health Plans, said, "The president's letters and his principles indicate we're at the beginning of this process and there will be other alternatives offered in the political middle." Business groups, however, were "more cautious" about the proposals, expressing concern over the president's "willing[ness] to entertain any increase in liability." Paul Zurawski, legislative counsel to the Business Roundtable, said, "I think the employer community is disappointed that the administration would have endorsed any expansion of liability" (Los Angeles Times, 2/8). The Health Benefits Coalition added that while the group is "pleased" that Bush's guidelines "do not embrace" the Kennedy-McCain legislation or last year's Norwood-Dingell bill, it has "very serious concerns about proposals that will increase employer-sponsored health care costs." The coalition stated, "We continue to believe that allowing new health care lawsuits against employers and health plans is a fatal flaw in any patients' bill of rights. ... Given the current state of our economy, we hope both Congress and the White House will carefully weigh the consequences of any health care policies they pursue" (Health Benefits Coalition release, 2/7).
In an op-ed in today's Washington Post, McCain and fellow Senator John Edwards (D-N.C.) call on Congress and the White House to swiftly pass a "meaningful" patients' bill of rights. McCain and Edwards state that members of the Senate "are not that far apart" on many issues of patients' rights legislation. All senators, they write, agree that patients "deserve basic rights" and should be given "the ability to enforce those rights without promoting frivolous lawsuits or unfairly holding employers liable." The two senators state that they believe their plan is a "solution" to the patients' rights dilemma. "While we applaud the success of managed care companies in reining in what were skyrocketing health care costs, we think quality of care and patients' control over their own medical decisions were sometimes sacrificed in the name of short term cost savings," they add. The new bill, they write, is an attempt to "restore a balance between providing health care and cutting costs." McCain and Edwards state that they "look forward" to working with Bush on the issue, adding, "To show the nation that we mean it when we talk about reaching consensus and finding common ground, we hope Congress shares [Bush's] enthusiasm and works together to put our bill on the president's desk" (McCain/Edwards, Washington Post, 2/8).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.