PATIENTS’ RIGHTS: President Issues Executive Order
At a Friday appearance at the Holiday Park Senior Center in Wheaton, MD, President Clinton formally announced "that he was imposing a 'patients' bill of rights' on the government health programs," the Washington Post reports. The president's order is likely to affect the "nearly 90 million Americans" covered by federal health plans. Clinton's announcement "struck a chord with" the senior center's audience, "for whom medical care is a major concern," the Post reports (Levine, 2/21). "With the authority of the federal government we will ensure that a third of all Americans ... are protected by a Patients' Bill of Rights. Now, that's every person on Medicare, every person on Medicaid, including children and people with disabilities, all of our federal employees and their families that are covered, all of our military personnel, and members of the biggest health care system in America -- all of our veterans and all their families," Clinton said. "A third of the American people will have now a Patients' Bill of Rights that says this: You have the right to know all your medical options, not just the cheapest," the president said (transcript, 2/20). The president issued an "Executive Memorandum to ensure that these federal agencies come into substantial compliance with the Consumer Bill of Rights" by no later than next year, according to a White House memo (White House release, 2/20). CNN's Kyoko Altman reported, "The bill of rights promises nearly 90 million Americans, those who belong to federally administered health programs, access to specialists, coverage of emergency services and an appeals process to resolve disputes quickly. The directive also guarantees confidentiality of medical records and disclosure of information that allows patients to participate in decisions about their own treatment" (CNN transcript, 2/20).
More To Come?
While Clinton's order only extends to federal agencies, the Baltimore Sun reports "[i]t might prod Congress to follow suit for patients covered by private health plans" (Weisman, 2/21). "With this step we are setting a standard for the nation. But we must not stop here ... [b]ecause now the Congress must pass national legislation to protect all Americans with a patients' bill of rights," the president said Friday (transcript, 2/20).
Clinton's top health policy aide, Chris Jennings, said the Labor Department "had concluded that it could not force private employers to comply with the standards decreed" by Clinton (Pear, New York Times, 2/21). But Labor Secretary Alexis Herman said her department "will propose amendments to ERISA's regulations governing plans' internal claims procedures ... to ensure that participants receive a fair and efficient benefits review." The department will also propose amending ERISA's disclosure regulations to ensure that group health plan enrollees are provided "clear and understandable information" about their plans (Labor Dept. release, 2/20).
The patients' rights "issue is already provoking a fight in Congress," the New York Times reports. "Most Democrats and many Republicans favor stringent new federal standards for health insurance and health maintenance organizations. But Republican leaders" -- including Senate Majority Leader Trent Lott (R-MS) and House Majority Leader Dick Armey (R-TX) -- "oppose such regulation, saying it will increase the cost of health care and health insurance" (2/21). And others, like Rep. Bill Thomas (R-CA) "grouse that the president is trying to build 'Clinton Care' piecemeal." That assertion may not be far from the truth, notes David Weissel in today's Wall Street Journal "Outlook" column. Weissel reports that Jennings described the patients' rights efforts as "targeted pragmatic reform that tries to address health care shortcomings as a step-by-step basis." By "positioning themselves" as the defenders "against managed care companies," the Clintons and their administration "escape the blame they surely would have shouldered had their plan been enacted," writes Weissel (2/23). However, "White House officials acknowledged" that the order "was largely symbolic, meant to bring government programs into full compliance and to chip away at insurance industry opposition."
The AP/Philadelphia Inquirer reports that "[p]rivate insurers balked" at Friday's executive order. "If it could be done in a moment and at no cost, I don't think the president would be giving these agencies two years to do it," said Health Insurance Association of American President Bill Gradison. And some "interest groups, including the U.S. Chamber of Commerce and the Blue Cross and Blue Shield Association, have said they would oppose any effort to turn the bill of rights into law" (Sobieraj, 2/21). "The answer is not more government rules to correct the problems government created in the first place," states an Investor's Business Daily editorial. "Rather, it's to put more control in the hands of patients" (2/23).