PATIENTS’ RIGHTS: Coburn, Shadegg Unveil Leadership Bill
Seeking to compete with the well-supported Dingell-Norwood HMO reform bill, Reps. Tom Coburn (R-OK) and John Shadegg (R-AZ) Friday presented a bill that the GOP leadership is expected to endorse, although House Speaker Dennis Hastert (R-IL) is still holding out. "This bill provides the patient protections that the American people have been demanding for years," said Coburn. Shadegg added, "This measured bill demonstrates that Congress can protect patients without prescribing costly new benefit mandates or encouraging frivolous lawsuits" (Meckler, AP/Nando Times, 8/21). The Health Care Quality and Choice Act, which has been on the drafting board for two weeks, grants the 161 million Americans in private insurance plans most of the "standard" patient protections contained in Dingell-Norwood, and also includes significant health care access provisions authored by Shadegg.
One Big Shift
Its most notable difference from the bipartisan bill lies in how narrowly it defines patients' right to sue their health plans. Coburn said, "This bill contains a rigorous appeals provision that makes the right to sue a last resort, not a first resource. Only those patients who have suffered a personal injury due to the negligence of a plan will have the right to sue. Liability will be limited to federal court and employers will be protected from lawsuits. Also, if a health plan contradicts the decision of an external appeals panel, they will be subject to severe fines" (release, 8/20).
Not There Yet
The two members released the plan at an American Medical Association policy meeting in Chicago. An aide said Coburn "is really trying to keep the AMA on board. He really wants to have their support."The Washington Times reports, however, that Coburn and Shadegg have yet to even secure the expected support of Hastert. Darren Wilcox, an aide to Rep. Porter Goss (R-FL), Hastert's point man on the issue, said "the bill is nearly ready for introduction." But a leadership aide said, "We don't feel like we're quite there yet. That (liability) is what we're trying to negotiate." Another aide said Hastert has "made it clear he wants as limited liability as possible." The leadership is reportedly considering yet another liability proposal, this time a measure modeled on Texas' right-to-sue law by Rep. Van Hilleary (R-TN) (Boyer, 8/21).CongressDaily also reports that the leadership's other two big guns on health care, Reps. Bill Thomas (R-CA) and John Boehner (R-OH), do not support any expanded liability. (Thomas and Boehner) would rather lose (a floor vote to Norwood) than agree to something really stupid on policy," said one lobbyist (Morrissey, 8/20).
Don't Tread on Me
Shadegg criticized the ads that health and business lobbies are currently aiming against expanded liability for health plans, Shadegg warned against trashing the new bill. He said, "I would caution the Health Insurance Association of America against propagandizing this common sense and focused liability provision as a benefit to trial lawyers. Such a campaign will invite a backlash and confirm the widespread sentiment among the public and members of Congress that the insurance industry's primary motivation is profit, not patient care" (release, 8/20).
An editorial in today's Washington Post notes that the "managed care issue is particularly difficult for Republicans, in that it is forcing them to choose between two traditional constituencies, physicians and employers." Speaker Hastert's maneuvering on the issue indicates that he "wants to hold a vote, lest Democrats charge him and the party with keeping a popular -- not to mention mostly worthy -- bill from becoming law. But a loss if he lets the bill onto the floor would embarrass him and disappoint important Republican constituencies alike." The editorial concludes that the Norwood-Dingell effort is "in some respects an improvement on the original Democratic bill; it's amazing what good ideas old-fashioned legislative give-and-take sometimes can produce when the members try. The administration supports the compromise. That's what Mr. Hastert still hopes to defeat. It's as good an emblem as any for the year thus far" (8/23).