PATIENTS’ RIGHTS: President To Order Government Compliance

      President Clinton is expected today to instruct all federal health care programs to implement the directives proposed in the patients' "bill of rights" package he outlined last fall. USA Today reports that the president's "executive order will affect health plans covering more than 85 million Americans, including 9 million federal workers, 6 million Defense Department workers and 3 million veterans who receive health care through Veterans Affairs." The mandate also will impact "38 million seniors in Medicare and more than 30 million low-income Americans in Medicaid" (Page, 2/20).

Bill's Bill
      The Washington Post reports that Clinton's "bill of rights" is "intended to ensure patients better treatment and greater clout in the nation's changing health care system." More specifically, Clinton's decree will ensure that "people who are either employed or insured by the federal government will be guaranteed information to help them select doctors, better coverage of emergency room visits, appeal rights if they are dissatisfied with their care and greater ability to participate in decisions about their medical treatment." The Post also reports that federal "health programs will be forbidden to discriminate on the basis of ... race or sex, and, under most circumstances, to disclose confidential medical information about individual patients" (Goldstein, 2/20).

What About Us?
      Clinton's "bill of rights" will affect the "roughly one in three Americans" who receive coverage through federal programs. However, the Los Angeles Times notes the directive "will have the least effect on the private sector, where congressional legislation is needed to give workers similar consumer protections." The president "plans to call on Congress to enact legislation to ensure that individuals in private-employer health insurance plans will be guaranteed the same minimum standards of care" (Rubin, 2/20). "Taken together," the Post reports, Clinton's directives "to the agencies and the prodding of Congress" represent his "most aggressive response to the mounting dissatisfaction among the American public with the condition of health care" since his "reform failed three years ago" (2/20). USA Today calls today's expected action the "most sweeping and controversial initiative on health care -- affecting about 40% of all Americans who have health coverage -- since [Clinton's] 1994 overhaul plan failed" (2/20).

On The Hill
      While Democrats are expected to embrace Clinton's announcement -- just a week ago "congressional Democrats named a patients' bill of rights as a priority for the party this year" -- Republicans continue to "oppose increasing federal regulation of managed care" which they believe "will be costly and burdensome" (Los Angeles Times, 2/20). The Wall Street Journal notes that "Clinton wants to keep the heat on congressional GOP leaders" who complain his reforms would adversely affect the health care industry (McGinley, 2/20). House Ways and Means health subcommittee Chair Bill Thomas (R-CA) called the president's order "a political stunt," maintaining that "Clinton is trying to 'blackmail' Congress to enact legislation to extend the 'bill of rights' to everyone" (USA Today, 2/20). "I guess it's just too bothersome to work with Congress when you want to make political points," Thomas said. He also "said some of the provisions contained 'apparent contradictions' with basic rules of some government health programs," (Post, 2/20).

House In Order
      Vice President Al Gore will submit a report to the president today showing that "federal health programs already are close to complying with the bill of rights, but fall short in a few respects," the Journal reports. "[W]hile Medicare and Medicaid have already adopted many of the protections, they don't assure beneficiaries direct access to specialists as recommended in the bill of rights," and the Office of Personnel Management will have to change its policy regarding "access to emergency-room services and specialists," Gore's report shows. "We need to get our house in order first to have credibility in the push for federal standards," said an administration official (2/20).