PATIENTS’ RIGHTS: It’s Not Easy Being the Majority
Odds of the House GOP passing a consensus managed care bill dimmed further yesterday, as special meetings yesterday designed to placate both the rank-and-file as well as the more hard-line faction led by health professionals bore no fruit. "It's a 70-yard field goal," said House Speaker Dennis Hastert (R-IL) (Meckler, AP/Nando Times, 7/29). House Ways and Means health subcommittee Chair Bill Thomas (R-CA) added that having a bill ready for floor action next week looks increasingly impossible. "Every day we don't have (a bill) makes things more difficult," he said (Rovner/Morrissey, CongressDaily/A.M., 7/30). Some of the Republican doctors even began to reveal their disappointment and a lack of confidence in the leadership. Rep. Greg Ganske (R-IA) said, "[Hastert's] cover for months and months was well, you know, we'll just let the committee process do its job. But when it became obvious that we had the votes to bring out a good bill, all of a sudden, man, that just goes by the wayside" (AP/Nando Times, 7/29). He added, "He's simply going back to the old way, stacking the deck against anything that doesn't happen to fit with the special interests" (Scully, Washington Times, 7/30). Rep. Tom Coburn (R-OK) said of the leadership, "They're not talking to me." Coburn said he and other dissenting Republicans will consider instead talking to the Democratic leadership. Rep. Charles Norwood (R-GA) said, "We've got the votes. It's just a matter of getting into position" with a majority of Democrats in order to pass a bill. (CongressDaily/A.M., 7/30). That may involve signing the Democrats' discharge petition in September that would force floor debate (Morrissey/Rovner, CongressDaily, 7/29). Sue Harvey, a spokesperson for House Minority Leader Richard Gephardt (D-MO), said "'serious' talks with other like-minded Republicans are continuing" (AP/Nando Times, 7/29).
Meanwhile, Rep. John Shadegg (R-AZ), who helped develop a medical access bill with Coburn and Norwood, said he and other conservatives are dismayed that the leadership's bill would include only pooling mechanisms like association health plans and HealthMarts. If those are the only access provisions in the bill, he said, "I will walk and I will work to take conservatives away from that kind of short-term fix" (CongressDaily/A.M., 7/30). One GOP aide said, "In many cases it's a zero-sum game. In many cases some won't vote for the bill if 'X' is there, and some will only vote for the bill if 'X' is in there" (Mitchell, New York Times, 7/30).
In an op-ed in today's New York Times, Coburn writes that while the "vast majority of [HMOs] are doing a good job and provide quality care at an affordable price, the frequency of abuse across the nation justifies prompt congressional action. Unfortunately, the managed care bill recently passed in the Senate does little to solve the problems." He concludes: "I certainly don't believe that excessive government involvement in health care will lead to long-term solutions. But Congress can write legislation that allows the market to control our health care system while also protecting patients. Indeed, modest protections won't harm the industry any more than child labor laws slowed the Industrial Revolution" (7/30).