PATIENTS’ RIGHTS: Debate Heats Up Over Weekend

      Managed care reform remains the hot issue in the nation's capital, and the topic dominated the weekend talk shows. Democrats, who have been pushing a patients' bill of rights for months, contended that "Senate Republicans, who have kept the Democrats' measure from reaching the floor, began crafting their own version only after they realized their failure to take up the matter could cost votes in this fall's congressional elections." On CBS's "Face the Nation," White House adviser Rahm Emanuel said, "Not until their pollsters and political advisers said there was political damage did they find any inkling or interest" (Kim, AP/Philadelphia Inquirer, 7/13).
      Senate Majority Leader Trent Lott (R-MS) responded to Democratic criticism: "As usual, the Democrats have an answer and it's a government takeover, just like we had the Clinton health care government takeover program. That's what they'd like to do here. Their ultimate goal is for the government to control and run everything in our life in health care. They want HCFA, federal bureaucrats, in the room with you and your doctor." ("Face the Nation," CBS, 7/12).

The GOP Plan
      Appearing on ABC's "This Week," Sen. Bill Frist (R-TN) outlined some aspects of the coming Senate GOP HMO reform bill: "Our particular bill will focus on four different areas. One is the bill of rights, which you've already focused on today. Very strong, our bill will be, on gag clauses, prudent lay person, continuity of care. In addition, a second component will focus on quality. ... And a third component is choice, a basic Republican principle. People should be able to choose their own doctor. ... And then a fourth component will be very strong in this bill ... research of how better to deliver health care to rural communities, to use technology, to use telemedicine to reach out to people broadly." Sen. Bob Kerrey (D-NE), appearing opposite Frist on the program, criticized the GOP for "us[ing] the language of the insurance industry to deflect legitimate concerns that the American people have." Specifically, he criticized Republicans for opposing a Democratic-backed plan to allow HMO enrollees the right to sue their health plans. But Frist responded to Kerrey's comments by saying, "[Y]ou can't sue your way to better quality in health care. What you need to do is build accountability into the system," Frist said ("This Week," ABC, 7/12).

Shalala Speaks
      Secretary of Health and Human Services Donna Shalala said the Republican proposal to cap the amount of damages that individuals can sue for is "a poison pill ... The [American Medical Association] said get it out of there, let's do a solid patient's bill of rights" ("Late Edition," CNN, 7/12). Shalala also responded to allegations that Democratic patient protections would drive premiums up "between $1 and $5 for a family a month." She said, "Most American families are prepared to pay for that for the security of knowing that their health care plan will be there when they need it" ("This Week," ABC, 7/12).

Shouting Across The Aisle
      The Washington Post reports that Lott "said he may schedule votes within a week or so on" the rival HMO reform plans. Minority Leader Tom Daschle (D-SD) applauded Lott's move, calling it "the beginning of something that is much more positive than anything we've had thus far" (7/11). But although they were moving toward compromise, Lott sharply warned Daschle against adding health care amendments to other spending bills. "I'll pull (off the Senate floor) anything moving if they try to play games with me. I'll yank it off the face of the Earth," he said (Godfrey, Washington Times, 7/11). Lott also said, "The Republicans are united and are not going to put up with that crap any more" (Washington Post, 7/11).
      In addition to the components of the legislation outlined by Frist, CongressDaily reports that health care tax breaks for small businesses and the self employed "may be revived in the" Senate GOP bill. Sen. Phil Gramm (R-TX) said, "I believe we will have a tax component. I also think it will have a pretty strong (medical savings account) component." Sen. Edward Kennedy (D-MA) criticized the GOP guidelines Thursday, calling the plan "Gingrich lite" and a "dishonor roll of loopholes and omissions" (Norton, 7/10).

Does It Have Legs?
     The Weekly Standard's Tucker Carlson: "Trent Lott has been trying to turn out the old Republican saw, this is all big government, higher taxes. And it's true that Americans do not like big government in a lot of ways, but in some ways they do. And they like big government when it's seen to protect them against a force they cannot control themselves. And the HMOs have become that. This is not 1993 where Ira Magaziner and Hillary Clinton and the squad of experts imposed an idea on the American public" ("Late Edition," CNN,7/12). But GOP columnist Bob Novak disagrees: "This is the last thing the Democrats have for this campaign. The tobacco thing isn't playing, campaign reform, finance reform, who cares about that? ... This is the last thing. And this is not going to be a big issue either" ("Capital Gang," CNN, 7/12).

More Talk Shows
      On PBS' "NewsHour," political columnists Mark Shields and Paul Gigot looked at the patients' rights issue. Gigot: "HMOs are hardly laissez-faire ... they're already a bureaucratic entity. So Republicans might be more willing to regulate something like that than they would other subjects." Shields: "The Democrats have by every measure of public opinion a 15 to 25 point edge over the Republicans on the issue of health care and particularly taming the excesses of HMOs or representing patients' rights. So I think the political element of it ... is real. It's permanent. It's not going to go away." Click here to read the full transcript (7/10).
      "Washington Week in Review" also took a look at the patients' rights issue. Click here to read the full transcript.

Weekend Headlines
      Other news articles on the politics of HMO reform:

• "Managed care finds itself in the hot seat" -- U.S. News & World Report notes, "The irony in all this HMO bashing is that most experts agree that managed care has saved patients money and perhaps left them healthier, too. While studies comparing the quality of managed care with that of fee-for-service plans are inconclusive, it appears that in some fields, such as preventive care, managed care is better" (Headden/Garrett/Walsh, 7/20 issue).
• "Campaigns turn focus on managed health care" -- the Dallas Morning News reports, "With more people than ever in managed care plans, public anger about the quality of treatment has boiled into a campaign issue. Concerns about access to care and quality are being debated in congressional and state political races, including the Texas gubernatorial campaign" (Dodge, 7/13).
• "Health-care reform back on front burner" -- the Chicago Tribune reports, "Health care is back. In the Senate and in the House, it has suddenly turned into the hottest topic of debate, emerging as the one issue that could energize an otherwise lackluster, themeless midterm election and -- at least in the dreams of some Democrats -- overturn Republican control of one or both houses" (Neikirk, 7/13).