PATIENTS’ RIGHTS: Senate GOP Bill’s First-Day Fallout

      Senate Republicans introduced their managed care reform proposal as expected yesterday. The Raleigh News & Observer reports that "[i]n many respects, the GOP plan, presented by Assistant Majority Leader Don Nickles of Oklahoma, resembles the 'patients' bill of rights' advocated by President Clinton and Democratic congressional health care leaders Sen. Edward Kennedy (MA) and Rep. John Dingell (MI)" (O'Rourke, 7/16). Nickles "described the plan as a market-oriented solution to complaints that HMOs unfairly limit care to curb costs," emphasizing that the GOP plan would accomplish the same goals of the Democratic plan without raising premiums. "We're not really interested in the political game. We're interested in improving quality health care," he said (Goldreich, Washington Times, 7/16). The News & Observer reports that despite the similarities between the GOP and Democratic approaches, there "are major differences that are likely to erupt when the Republican-controlled Congress begins debate on health care, possibly next week" (7/16).

Disgusted Dems
      "Just minutes after" Nickles finished presenting the bill, "the Democrats denounced the effort" (Mishra, Philadelphia Inquirer, 7/16). Senate Minority Leader Tom Daschle (D-SD) called the GOP bill "a desperate attempt to dodge the American people's demands for real patient protections." Sen. Edward Kennedy (D-MA), author of the Democratic alternative, said the Nickles proposal "protects industry profits over protecting patients" (Sun, 7/16). White House health policy adviser Chris Jennings said, "This doesn't achieve the gold, silver, or lead standard. ... They've left millions of (Americans) unprotected," referring to the fact that the GOP plan only affects those in employer-sponsored plans (Goldstein/Dewar, Washington Post, 7/16). At an afternoon news conference, Health and Human Services Secretary Donna Shalala said, "I think I would describe this as too little and too late. ... [I]t's a very light proposal" (HHS release, 7/15). But Sen. Phil Gramm (R-TX), a key GOP player on health care, said "Americans would rather appeal than sue over HMO decisions." According to Gramm, the Democratic solution "is to bring a government bureaucrat and a lawyer into the examining room" (Zitner, Boston Globe, 7/16).

Parliamentary Procedures
      Nickles commented yesterday that he hopes the Senate can vote on both his and the Democratic proposal in the near future. But Democrats "warned they will not be railroaded into a quick debate and an up-or-down vote on what they hope will be a major election-year plus for them." In related news, CongressDaily/A.M. reports that Rep. Charlie Norwood (R-GA) has come to terms with the House GOP leadership bill and is prepared to support it. Norwood, author of the Patient Access to Responsible Care Act, "has repeatedly threatened to lead an effort to bring that measure directly to the floor through a discharge petition if his minimum requirements are not met." CongressDaily/A.M. notes that despite Norwood's move to support the House GOP bill, it appears the Senate will vote first on health care legislation (Rovner, 7/16).

Frist In The Hearts Of His Countrymen
      The Kingsport Times-News reports that Sen. Bill Frist (R-TN), a key player in the drafting of the GOP bill and the only physician in the Senate, "managed to attach a few of his pet health initiatives" to the bill. They include a "greater study of women's health issues by federal research centers, funding for medical research and the study of health care delivery in rural areas and redevelopment of an existing federal agency to evaluate and integrate new technologies into the medical profession" (Whaley, 7/16).

Knights Of The Round Table
      President Clinton attended a roundtable discussion on managed care abuses sponsored by the American Medical Association yesterday. Doctors, nurses, families of patients and benefits managers from around the country strongly urged the president and Congress to pass patients' rights legislation (release, 7/15). National Public Radio's Mara Liasson reported, "President Clinton spent the afternoon listening to heart-rending stories about people who died because their insurance companies wouldn't pay for their care." Carol Anderson, a billing manager in an oncologist's office, "told the president the horror stories were the rule, not the exception." She said, "The hardest part of my job is facing a patient and telling them you're insurance plan has told us that you are denied coverage. This is what the doctors recommended, but we're sorry. ... If you don't have cash, we can't treat you" ("All Things Considered," 7/15). The Los Angeles Times takes a close look at the Clinton-AMA alliance, noting that the partnership "is expected to boost the chances that" patients' rights legislation will pass in some form (Peterson/Rubin, 7/16). Today, Clinton will join congressional Democrats at a Capitol Hill rally for patients' rights.