PATIENTS’ RIGHTS: Conferees Meet, Optimism Apparent
Stressing optimism, Senate and House conferees on patients' rights met for the first time yesterday, the New York Times reports. Conference Committee Chair Sen. Don Nickles (R-Okla.) said, "My objective is to complete this conference this month and have a bill passed by both houses of Congress by Easter. We have a much better chance of passing good legislation that's not so partisan, not so political, if we work sooner rather than later." Nickles said that conferees were "very close to agreement" on guaranteeing coverage for emergency medical care and allowing patients to visit pediatricians and OB/GYNs without first getting a referral from a primary care physician. He also stressed similarities between the separate bills passed by the House and Senate, including guaranteeing timely access to specialists, allowing doctors to discuss all treatment options, allowing patients to continue to receive care from a doctor dropped from their health plan and giving cancer patients greater access to clinical trials (Pear, 3/3). However, three issues likely will be the most difficult to resolve -- whether patients should have the right to sue their health plan for denying care, whether health plans should make determinations of "medical necessity," and who the protections should cover. The bill passed by the House would cover virtually all Americans with private health insurance, while the bill passed by the Senate would cover only the 55 million "self-insured" individuals who are in plans that states cannot regulate (Rovner/Fulton, CongressDaily/A.M., 3/3). President Clinton yesterday said that he would veto legislation "that is a patients' bill of rights in name only. ... It's not a real patients' bill of rights if it denies people the right to see a specialist, if it fails to guarantee access to the nearest emergency room care, if it denies the right to stay with the health care provider throughout a course of treatment." Clinton said he would also veto any bill that does not "include a strong enforcement mechanism to hold the health care plan accountable" (Associated Press, 3/2).
A Political Process
The conference will first consider what new rights patients should have and then move on to discuss the "scope" of the bill (New York Times, 3/3). Conferees will be careful to "ensure there is no increase in the cost of health care as a result of the bill and that the overall health care system is not undermined." During the process, political posturing probably will be inevitable in an election year. House Republicans "who worry that the November elections could cost their party its shaky House majority want a bill that Clinton can sign so they can boast to voters of their pro-consumer record." However, Republican senators "face little risk of losing control in November, and they have less reason to give ground." As for the Democrats, they have "no desire to move toward a weaker Senate version of the bill and expect to stay united and close to the White House position" (Los Angeles Times, 3/3).