PATIENTS’ RIGHTS: Dingell-Norwood Bill Has Wide Support
"A group of dissident Republicans reached agreement with House Democrats" yesterday on an HMO reform bill, predicting they could win enough cosponsors to force the measure to the floor, the New York Times reports (Mitchell, 8/6). "We need a bill that protects patients, not a bill that protects politicians at the November ballot box," said Rep. Charles Norwood (R-GA), who spent most of the week negotiating the terms of the bill with House Commerce ranking member John Dingell (D-MI). He added, "I don't believe a Republican leadership bill would ever be signed by the president," while a Democratic bill "won't survive conference. This is the best way to get an actual law" (Rovner, CongressDaily/A.M., 8/6). The bill, which would cover all persons enrolled in managed care plans, would establish an outside review process more stringent than that contained in the Senate bill. Patients who go through external review would still have the right to sue, but would be limited to recovering only compensatory, not punitive, damages ( AP/Baltimore Sun, 8/6). The measure would also "make it easier for patients to get bills paid when they go to hospital emergency rooms, to see medical specialists for chronic ailments and to take part in clinical trials of new therapies." Children would be able to select a pediatrician, and women an OB/GYN, as their primary care providers. The bill prohibits gag clauses and bonuses for doctors who go light on care. House Minority Leader Richard Gephardt (D-MO) said, "This consensus bill shows that the will of the people cannot be denied, that memebers from both sides of the aisle know this issue is too important to be put off for another year" (Goldstein/Eilperin, Washington Post, 8/6).
No sooner than the bill was unveiled, business and insurance groups unleashed a torrent of criticism, calling it a boon to trial lawyers and a sure-fire way to increase the number of uninsured. Patrick Cleary, vice president of the National Association of Manufacturers, said it "is a perfect example of the law of unintended consequences in that it will do nothing less than limit access (to health insurance) and raise costs for millions of American workers" (MacDonald, Hartford Courant, 8/6). American Association of Health Plans President Karen Ignagni said it "is built on the erroneous premise -- rejected this year alone in 24 states -- that trial lawyers are the sole guardians of good medical care" (release, 8/5). Health Insurance Association of America President Chip Kahn said the "Dingwood" bill shows a "total disregard for the consumers and employees who actually purchase health insurance" (release, 8/6). Rep. John Boehner (R-OH), who sponsored legislation favored by the leadership, said he and other Republicans met with business and insurance groups before the Dingell-Norwood announcement yesterday. He said, "We briefed them about the threat we believe employers are under. I think employers need to talk to employees about this issue, that employer-provided insurance may be a thing of the past" (CongressDaily/A.M., 8/6). The business interests "vowed to mount a major grass-roots lobbying campaign against the bill over the summer."
From Here to There
While it appears that "virtually all House Democrats would support the bill," along with a handful of Republicans, the House leadership may be the key to the entire legislation (Rubin, Los Angeles Times, 8/6). President Clinton said, "I call on Speaker [Dennis] Hastert (R-IL) to schedule a vote on this long-overdue legislation immediately upon return from the Congressional recess in September" (release, 8/5). Hastert said, however, that he would not support the bill because he thought the right to sue "was too far-reaching." Bill supporters would have the option of signing a discharge petition to force the bill to the floor, but the New York Times reports that such "a route rarely succeeds because signing such measure is considered tantamount to handing control to the opposition party" (8/6). Meanwhile, key GOP lawmakers on health care will continue to try to work out a compromise measure. Of the other high-profile GOP doctors in the House, Rep. Greg Ganske (R-IA) said he will go along with Dingell- Norwood, while Rep. Tom Coburn (R-OK) is "reportedly still working with the Republican leadership" (CongressDaily/A.M., 8/6).