PATIENTS’ RIGHTS: Debate Scenario Taking Shape

      Key players on managed care reform have begun to jockey for position as the House Rules Committee is expected to debate the rules for the patients' rights debate next Wednesday or Thursday, CongressDaily/A.M. reports. Rep. Tom Coburn (R-OK) confirmed yesterday he will not abandon the bill he cosponsored with Rep. John Shadegg (R-AZ) to join the Dingell-Norwood effort. Rather, he and Shadegg are working with Rep. Bill Thomas (R-CA) to craft a version more palatable to moderate Republicans. The revised bill will be unveiled today or tomorrow, a Coburn aide said. For his part, Rep. Charlie Norwood (R-GA) has "filed two discharge petitions 'as a backup,' said a Norwood aide." The first will introduce in succession the original Patients' Bill of Rights by Rep. John Dingell (D-MI), the bill passed out of the Senate in July, the recent bill by Rep. John Boehner (R-OH), followed by Dingell-Norwood -- the strategy being to demonstrate the relative lack of support the alternatives have next to the bipartisan bill. The second discharge petition will bring to the floor Norwood's "access" bill, introduced in February with Rep. Dave Weldon (R-FL). The Norwood aide said the congressman is particularly concerned that the GOP leadership will "try to force the access bill by Shadegg and Rep. James Talent (R-MO) into the Dingell-Norwood managed care bill." He said that while Norwood's "forces are confident they can defeat a rule that would automatically merge the access and managed care bills, they remain concerned that if the rule goes down, the leadership would simply cancel the debate" (Rovner, 9/30).

AAHP Says Find Another Issue
      A new poll released by the American Association of Health Plans reveals that managed care reform is not a major issue with most Americans. When asked an open-ended question on which issues are most important, voters ranked HMO regulation 21st, falling far behind education, taxes, Social Security and Medicare. HMO reform was also viewed as politically motivated issue: 77% of respondents, including a majority of both Democrats and Republicans, believed HMO reform is not a sincere gesture on the part of Congress. The survey also found that 52% would vote for a third party candidate, however, only one respondent of the 1000 registered voters surveyed mentioned health care reform in relation to their choice of such a candidate. AAHP President Karen Ignagni said, "This survey shows that the issue of regulating health plans does not resonate with voters on either side of the aisle and is not likely to be a major factor in determining which party will control Congress after the 2000 elections. This survey sends a clear message that Washington is missing the mark." The poll, conducted by Ayres, McHenry & Associates, has a margin of error of +/- 3.16% (release, 9/29).

Federal Law Would Bolster State Efforts
      A new Urban Institute study comparing existing state laws with four federal patients' rights bills finds that the proposals before Congress would "alter the operation of health coverage nationwide by extending new protection to many people." More specifically, authors Jill Marsteller and Randall Bovbjerg found that the number of patients protected would increase because all bills would impose at least some new restrictions on workplace health benefits that use managed care; and the level of impact on patient protection would vary state by state, but add comprehensiveness and breadth to state laws (Urban Institute release, 9/28).

Patients In Charge?
      Heritage Foundation President Edwin Feulner writes in a Washington Times op-ed that allowing patients to sue health plans for damages would be "about as effective as leeches." Feulner argues that the proposed legislation would only bring about "more lawsuits," which in turn would drive up premiums and create higher out-of-pocket costs. Feulner adds that our current managed care system is an "outgrowth of a health care system that makes it all but impossible to buy insurance except through one's employer." He supports a conversion to an employer-based premium support system in which employers provide their employees with the money to purchase health insurance (9/29).