PATIENTS’ RIGHTS: House Republicans Unveil Comprehensive Bill
A House Republican task force convened by Speaker Newt Gingrich (R-GA) unveiled yesterday a patients' rights proposal, "trying to wrest control from Democrats over a new generation of health care reform." The bill, which incorporates several provisions backed by House Democrats and the White House, is a "significant turnaround" for GOP lawmakers who had dismissed President Clinton's urging of managed care reform as "big-government meddling," the Washington Post reports (Goldstein/Neal, 6/25). In response to the public outcry about managed care, Republicans had to move quickly to address "voter backlash against managed care" that could hurt them this fall, the Washington Times reports (Goldreich 6/25). "I think that listening to our constituents collectively, we heard concerns," said task force chair Rep. Dennis Hastert (R-IL).
Beyond The Ballot
The GOP bill, however, is more than an attempt to steal the fire from Democrats who have snatched up the health care reform issue for use on the campaign trail, the Los Angeles Times reports. "As managed care became the dominant form of health care, certain relationships have become distorted," said task force member Rep. Bill Thomas (R-CA). "Given the degree of distortions, we have to deal with them ... You ought to have a right to know what is in your plan," he said (Rubin, 6/25). Included in the proposal are guaranteed coverage for emergency care, direct access to gynecologists and obstetricians for women in HMOs and provisions for external reviews of cases in which insurers deny coverage for patients' care. Also incorporated are several Democrat-backed provisions, including a guarantee that "HMOs could not interfere with doctors' ability to tell patients about any treatment option, regardless of whether the health plan offers or pays for such services," the New York Times reports (Pear, 6/25). NPR's Brian Naylor reported that "the GOP plan also contains a long-sought Republican goal of capping liability damages doctors would have to pay out in malpractice cases to $250,000" ("All Things Considered," 6/24). The Baltimore Sun reports that the GOP bill "could come to a vote next month" (Weisman, 6/25).
But conspicuously missing from the bill is a provision included in Rep. Charlie Norwood's (R-GA) popular Patient Access to Responsible Care Act that would allow patients to sue their health plans if they are improperly denied care. The Wall Street Journal reports that several consumer protections championed by Democrats also have been left out. Vice President Gore criticized Republicans for leaving such protections out of the bill, calling it "nothing more than a bill of goods." The Journal reports that "scathing criticism" also came from Health Insurance Association of America President Bill Gradison, who said "everything but the kitchen sink has been thrown in here" (McGinley, 6/25).
"Democrats were quick to denounce the GOP proposal as a fig leaf," NPR's Naylor reported ("All Things Considered," 6/24). House Minority Leader Richard Gephardt (D-MO) blasted the GOP bill. "The Republican proposal is designed for show, not to become law. Republicans are proposing an over-the-counter remedy for a prescription-sized problem," he said (Baltimore Sun, 6/25). The bill has enough "conservative flavor" to secure the backing of House Speaker Newt Gingrich (R-GA), who sent the GOP task force back to the drawing board last month with instructions to create a more far-reaching plan (Washington Post, 6/25). Rep. Norwood, PARCA's sponsor, is supporting the new GOP plan, which he helped draft as a member of the GOP task force. "We have gotten about 75% of what we started out to do in my PARCA legislation. And I don't think anybody has any doubt that in a town where 435 people all get to have an opinion, that ain't bad," he said ("All Things Considered," 6/24) . Hastert said bipartisan support will be crucial to the bill's success. "[But] we will not tolerate people trying to kill this bill, then saying this is a do-nothing Congress. We've played that game before," he said (Sun, 6/25). Republican leaders in the Senate plan to introduce similar legislation soon, so GOP candidates will have a "finished product to show voters in the fall," NPR's Naylor reported ("All Things Considered," 6/24).
Consumer Groups Put In Their Two Cents
Consumer and industry advocates gave the plan mixed reviews, concerned that the proposal falls short in its protections of patients. American Association of Health Plans President Karen Ignagni said the GOP plan "moves in a better direction than what has been discussed thus far on Capitol Hill," but she said it "still tilts toward a reliance on government mandates." American Medical Association President Dr. Nancy Dickey said the GOP "'task force represents a step in the right direction, but it does not go far enough' in making HMOs accountable for the clinical decisions they make," the New York Times reports. Ronald Pollack, executive director of Families USA, sharply criticized the bill, calling it "an election-year stunt, a ploy to enable some members of Congress to claim they did something on managed care" (6/25).