PATIENTS’ RIGHTS: House Republicans Want Quick Action

      House Republicans may bring their managed care reform legislation to the floor "as soon as tomorrow," the Wall Street Journal reports (7/23). CongressDaily/A.M. reports that the return of "wandering Republicans ... to the fold Wednesday" was key to bringing the GOP bill to the floor this week. Rep. Bill Thomas (R-CA), who helped draft the proposal "before he pointedly declined to cosponsor it," said yesterday that he "never actually said he would not vote for" the GOP bill (Rovner, 7/23). House Republicans also may make changes to their bill, including one change that "involves fining employer-sponsored health plans for improperly denying care." The current bill would impose a fine of "$250 for every day a health plan is found by a judge to have improperly denied care, to a maximum $100,000." But Rep. Lindsey Graham (R-SC) is "pushing to increase those amounts to $500 a day, up to $250,000." Graham said, "if you have a legitimate hammer over HMOs, they will do the right thing" (Wall Street Journal, 7/23).

Democrats Seek Delay
      CongressDaily reports that Democrats are "blasting" Republicans for "rushing a bill to the floor." Rep. John Dingell (D-MI), author of the Democratic leadership's bill, said, "If I were not here to witness this, I would not believe it. The Republican leadership wants to ram through a bill before it's understood" (Rovner, 7/22). Rep. John Boehner (R-OH), a member of the GOP leadership, said Republicans want "to pass the bill quickly so that opponents can't 'demonize' it" (Wall Street Journal, 7/23). However, CongressDaily reports that "it appears unlikely that either the GOP or the Democratic bill could garner a majority of House votes" (7/22).

Maverick Republican
      One Republican House member remains critical of the GOP bill. Rep. Greg Ganske (R-IA) joined Democrats at a press conference yesterday to tout the American Small Business Alliance's support of the Democratic bill. Ganske said the GOP version fails to include needed protections. "What is in the GOP bill on the appeals process basically doesn't accomplish anything," he said (Goldreich, Washington Times, 7/23). Today's Baltimore Sun profiles Ganske. Click here to read the article. In today's Washington Post, columnist Mary McGrory salutes Ganske as "a profile in courage." She writes, "Ganske doesn't say much about the pressure he is under. He doesn't need to. People can see Ganske was muscled off the Medicare commission after he showed up at Clinton's Capitol Hill press conference on HMO reform" (7/23).

Senate Action
      The Washington Times reports that Senate Majority Leader Trent Lott (R-MS) "wants to bring patient rights legislation to the floor by the end of next week." However, Minority Leader Tom Daschle (D-SD) "said that might have to be delayed until Congress returns from its August recess if he and Mr. Lott cannot agree on rules of debate" (7/23).

Hillary Speaks
      First lady Hillary Rodham Clinton devotes her syndicated newspaper column to the topic of patients' rights. She relates several stories about patients' bad experiences with managed care plans and says President Clinton's patients' bill of rights is aimed at correcting those problems. She also takes a swipe at the GOP reform plans: "Now, with fewer than 40 days left in this congressional session, Republicans have outlined their own 'Bill of Rights.' Unfortunately, their plan would not guarantee access to specialists, such as oncologists and cardiologists, require disclosure of financial incentives to doctors who limit treatment or adequately compensate those who suffer serious harm. And, the Senate Republican plan leaves out 100 million American who need these protections" (Washington Times, 7/23).

Not A Hot Political Issue
      Writing in today's New York Times, Roper Center for Public Opinion Research President Everett Ladd looks at recent public opinion polls to see if the patients' rights issue is important to the American public. He writes, "Managed care plans have become the focal point for public anxiety about the country's essential but expensive health care system. But people covered by HMOs say they are satisfied with their coverage, only a hair less so than those in traditional fee-for- service plans. Public opinion today is about where it was four years ago when the big Clinton plan failed. We aren't content with the status quo, but neither are we angry. We certainly don't want a significantly expanded federal role" (7/23).

Unintended Consequences
      From an editorial in today's Lexington Herald-Leader: "In the current HMO debate, unintended consequences will ensue from either the stronger plan offered by Democrats or the Republicans' fallback version. These unintended consequences include rising costs and pushing more people into the ever-increasing ranks of the uninsured. If the Democratic plan exposes employers to lawsuits over HMO decisions, as some fear, some employers would protect themselves by no longer offering health insurance as an employee benefit. The Republican plan, with its emphasis on tax-exempt medical savings accounts and letting more companies self-insure, would drain healthy people from the broader insurance market. This would have the effect of pushing premiums beyond the reach of those who need coverage the most" (7/23).