SUNDAY TALK SHOWS: GOP Candidates Chat About Reform

      GOP presidential contender Gov. George W. Bush (R-TX) gave his first Sunday morning interview to "Meet the Press" yesterday and spoke up about managed care. Bush said that he would support a right-to-sue provision as president. "Yes ... so long as it looks like the Texas law," he said. Bush explained that in Texas, patients who have a dispute with their HMO are allowed to take their claim to an independent review board. If the independent review board rules in favor of the patient, and the HMO refuses to accept that ruling, then that becomes a cause of action. "In other words," Bush said, "we put in place a dispute resolution mechanism, but if the findings of the objective and independent organization are ignored by the HMOs, then you bet people ought to have a claim of action." Bush also talked about the congressional leadership's disagreement with him on the right to sue: "Well, we just disagree. I think it's important for people to have access to the courts of law. ... People ought to have some kind of access to express their concerns, both in an arbitration panel and ultimately in the courts." But he also said that he is in favor of tort reform. "I fought for tort reform in the state of Texas. I signed seven pieces of major tort legislation because our civil justice system was unfair. I thought the plan we passed in Texas was fair." Bush said he believes the provision works in Texas as long "as there's the independent review organization in place. I let it become law because I was sending a clear signal that if the IRO provisions had unwound and they weren't as protective as I thought they'd be of keeping doctors and entities out of the courts, that I'd come back and ask for an amendment. But the plan has worked according to what we thought it would be" (NBC, "Meet The Press," 11/21).

Forbes Reacts to George W.
      Last night Steve Forbes responded to Bush's stance on suing HMOs. He told CNN, "I think we have another situation where I have an entirely different approach, a real plan of action. And that is, instead of this top-down approach where you have to go to Congress to get permission to do something with your HMO, I propose to let patients choose directly their own doctors, their own health care plans, their own specialists. So if you're not satisfied with the diagnosis, you just go to another doctor, get a second opinion, get a third opinion. That's what we should do instead of giving great breaks to lawyers. I want to do it right now." CNN's Wolf Blitzer asked Forbes: "But if the HMO makes a mistake, should the patient be able to sue that HMO?" Forbes replied: "If an HMO makes a mistake, absolutely. As long as it's the HMO, not the employer, who is providing the plan. But the key is again, why do you have to go through all this kind of appeals process, all this bureaucracy, gate keepers and the like? If you don't like what a doctor does, you should be free immediately to choose another doctor. And I've got specific proposals on the table to give the American people a health care declaration of independence. The problem with health care, Wolf, is simply this: ... there's a disconnect between the providers of health care services and the customer. In this case, the patient. By putting the patient in charge of resources, by giving patients true choice, we'll solve the health care crisis in America" ("Late Edition," CNN, 11/21).

McCain on Patients' Bill of Rights
      Sen. John McCain (R-AZ) told CBS's "Face the Nation" that the Patients' Bill of Rights is "the classic example of what's wrong in Washington." McCain accused the Democrats of catering to trial lawyers. He said that Democrats "want anybody to sue anybody for anything under any circumstances." But he also criticized his own party for its ties to the insurance industry and "the HMOs with their huge amounts of money keeping us in their grip." He added that "five Americans who are knowledgeable could sit down in a room and come up with a Patients' Bill of Rights that would resolve many of these problems that are so aggravating and many times destructive to Americans who are members of HMOs. Let a woman see her gynecologist of her choice, get a second opinion outside of the HMO, be eligible for emergency room care, let the doctor make the decision on certain types of treatment. I mean, it's easy, and yet we are gridlocked to the point where we can't even take action on that. It's distressing and disturbing" (CBS, "Face the Nation," 11/21).