PATIENTS’ RIGHTS: Senate Compromise Bill Released Today
Bipartisan managed care reform legislation will be unveiled today in an effort "to avoid parliamentary gridlock on an issue popular with both Republicans and Democrats," the Washington Times reports. The bill, sponsored by Sens. John Chafee (R-RI), Bob Graham (D-FL) and Joseph Lieberman (D-CT) has "no more than six sponsors, but they hope to position themselves as swing voters crucial either to avoiding a threatened veto by [President] Clinton or shutting down a possible Democratic filibuster against the GOP leadership bill." Chafee said, "I see gridlock down the track. So I think it's terribly important to have a good bipartisan bill that does not have some of the provisions that one side or the other objects to." White House health adviser Chris Jennings said President Clinton believes the bipartisan Senate bill "shows some promise." Jennings said, "They're trying to reach across partisan lines and produce something that would be acceptable. If we're going to pass something in this Congress and the public's going to feel confident about it, it has to be bipartisan" (Goldreich, 7/29). Chafee is critical of both the Democrats' insistence on allowing patients to sue health plans and some Republicans' efforts to expand access to medical savings accounts. Chafee noted that MSAs "'have nothing to do with' protecting HMO patients from arbitrary medical decisions by their insurers" (MacKay, Providence Journal-Bulletin, 7/28).
Senate Action This Week?
The Washington Times notes that Senate Democrats and Republicans have been unable to reach agreement on how debate would proceed on HMO reforms. Minority Leader Tom Daschle (D-SD) "wants to offer numerous amendments instead of accepting up-or-down votes." A Daschle "spokesman said it is unlikely the two sides can come to agreement in time for action before the Senate recesses for August." The Times notes that President Clinton has threatened to veto both the House and Senate GOP leadership bills (7/29).
Washington Post columnist David Broder notes that the debate over health care access and coverage continues to crop up in Washington because "the problems are real." However, he writes that "[f]ew people in either politics or the press want to acknowledge the tough trade-offs involved. ... The key dimensions of a realistic discussion are three: cost, coverage and quality. All three are inextricably linked. But Washington has chosen to deal with them one at a time -- and by doing so, it has almost guaranteed that realistic solutions will not be found." Broder continues: "If politics and journalism operated by rules of logic, we would recognize that the anecdotes of patient abuse in managed care -- while nauseating -- are exceptional. ... We would seek a regulatory regime that would allow victims of outrageous conduct to vindicate their rights but not burden routine transactions between patients and caregivers with requirements that force doctors to practice defensive medicine and push up costs." However, Broder says this approach "is all too logical," and he notes that "Democrats, who revel in polls showing the public trusts them more than Republicans to do what is right on health care, are insisting that the way to guarantee patients' rights is to let everyone sue the managed care companies and the employers who hire them." He concludes, "That's the kind of absurdity you get because no one wants to acknowledge there are real trade-offs to be made" (7/29).
Also writing in today's Washington Post, columnist Robert Samuelson says of the HMO reform debate: "Whatever happens -- whether some proposal becomes law or not -- patients' 'rights' will remain elusive. It's a clever phrase that obscures larger social choices. Medicine is the most personal of services; yet, its promise makes it ever-more technological, bureaucratic and costly. The dilemmas ensure many deceptive debates and disappointing 'reforms'" (7/29).
Editorials! We Got Editorials!
Here's some of the latest editorial takes on the great patients' rights debate:
- Ft. Lauderdale Sun-Sentinel: "The House cynically dodged its responsibility by passing the inadequate Republican plan by a 216-210 vote. Now the burden to craft a meaningful-yet-acceptable patients' bill of rights has fallen squarely on the Senate" (7/28).
- Las Vegas Sun: "The House GOP leadership has belatedly come around on health care reform because of the fear that it is resonating with the public. ... The real danger for House Republicans, however, is that the American people will see this for what it is -- damage control -- and reject Republicans for doing too little too late" (7/28).
- San Jose Mercury News: "It's a shame that Americans have to turn to Washington to obtain things they should already be getting from their health plans, things that Democrats and Republicans alike want to offer. It would be a greater shame if Congress and Clinton fail to come up with meaningful reforms this year. We urge the Senate and the White House to work together on changes aimed at really helping HMO patients, and not just on helping or harming members of Congress' reelection campaigns" (7/29).