PATIENTS’ RIGHTS: Progress ‘Slow Going;’ No Deadlines Set
With the previously set deadline on patients' rights legislation now long past, conferees still are trudging along the path to compromise, CongressDaily/A.M. reports. The pace has been "slow going," with some Democrats calling the tentative deal made before the break "a bit premature." According to Democrats, there are a "number of holes remaining," including what should determine which decisions are eligible for outside medical reviews, who selects the reviewer, how to resolve potential conflicts with state review laws and how much discretion the reviewer should have. Staff members also are working toward final language on "how free" women should be to visit an OB/GYN without a primary physician's referral, and "how much and in what form patients should be given information about their health plans." But the two "biggest issues" remaining include patients' right to sue their health plans and how many people the legislation should cover (Rovner/Mitchell, 5/3). To "reignite progress," President Clinton is inviting leading conferees to the White House Monday, hoping to hear a "status report" (Koffler, CongressDaily, 5/3). Conference Committee Chair Don Nickles (R-Okla.) said that he would not "set arbitrary deadlines" for the legislation's completion, but would "accelerate the pace" on several issues, particularly scope and liability (CongressDaily/A.M., 5/3). But Nickles might be forced to pick up the pace, as it "appears he will be asked" to set a deadline of some sort during the White House meeting. National Partnership for Women & Families Public Policy Director Joanne Hustead, who was attending a White House meeting of top health organization officials who support the Democratic-sponsored patients' bill of rights, said, "I would like the leadership of Congress, particularly the Senate, to come out and say they are committed to getting a strong bill out and they're going to do it before Memorial Day" (CongressDaily, 5/3).
Pressing the Issue
In the meantime, several players are urging the committee to push the legislation along. Rep. Pete Sessions (R-Texas) and 13 other members of Congress sent a letter to Commerce Committee Chair Tom Bliley (R-Va.), saying that they would be "receptive to constructive alternatives likely to emerge from the conference committee," although they each had voted for the House-passed measure. The group urged better protection from potential lawsuits for employers who offer health insurance. They wrote that their votes for the bill were "a statement of [their] firm conviction that this important issue needed to move forward through the full legislative process" (CongressDaily/A.M., 5/3). At the same time, Republican Leadership Coalition Chair Scott Reed sent a memo to all Republican members of Congress, imploring them to encourage their leaders to "finish the job" on patients' rights, ensuring that the "Republican Congress sends President Clinton a balanced, fair Patients' Bill of Rights." The coalition praised the tentative agreement, calling it a "breakthrough" and "a major step in the right direction." Further, the coalition asserted that the legislation must be passed to "ensure [Republicans'] majority in Congress." The memo noted a recent Wall Street Journal poll that shows Republicans behind Democrats, 41%-19% on the issue of health care. Republicans recognized in 1994 that HMOs were "health care rationing machine[s]," when they rejected President Clinton's health care plan. They must do so again and give patients the right to sue, Reed asserted (Coalition memo text, 5/1).
Going against the grain, Kaiser Permanente CEO David Lawrence told the Bloomberg Forum Tuesday that he would "support legislation granting limited" rights to sue. He said, "Some kind of right to sue is inevitable. I favor making sure it's a very narrow right to sue," clarifying that the legislation should limit what court damages a patient can win. He urged the committee to get the legislation "off the table" to convince the public that "their concerns about HMO coverage have been heard." He added that enacting patients' rights legislation would "enable Congress to take action to reduce medical errors," saying, "It's very hard to have conversation about patient safety while the (patient-rights) issue is still on the table" (Bloomberg News/Alameda News Group, 4/3).