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Copyright 2000 Phoenix Newspapers, Inc.  

November 8, 2000 Wednesday, Final Chaser


LENGTH: 653 words


BYLINE: ROBERT ROBB, The Arizona Republic

Aso-called Patients' Bill of Rights has been one of the key national issues this election. Democrats sought to ride perceived hostility toward HMOs to victory, while Republicans tried to defuse the issue.

But in terms of actually getting something done, Arizona Congressman John Shadegg is the House Republican's man in the pivot.

Shadegg's version of the bill has the greatest support among House Republicans. It is the chief alternative to the more widely discussed approach sponsored by liberal Democrat John Dingell, D-Mich., and Republican dentist Charlie Norwood, R-Ga. This is the Dingell-Norwood bill that Al Gore, in one of his smarty-pants moments during the debates, demanded to know whether George W. Bush supported.

Both bills would enact a number of procedural reforms, such as requiring that gynecologists and pediatricians be accepted as primary care physicians, and forbidding restrictions on what doctors can advise.

But the major difference, and the issue on which progress has bogged down, concerns the circumstances under which patients could sue their HMOs. Dingell-Norwood allows full access to state courts virtually at any time. Shadegg's bill would require that an independent medical panel review the case and issue findings before a federal lawsuit would be permitted.

The issue is now in conference committee. And even though Shadegg's alternative was outvoted by Dingell-Norwood on the House floor, Shadegg is on the conference committee and was named one of two chief negotiators by Speaker of the House Dennis Hastert, R-Ill. Shadegg also appeared with Hastert at a national press conference last Thursday, where the Speaker said that he remained committed to passing a Patients' Bill of Rights this session.

There was more than a little political posturing in the Speaker's comments. The press conference was intended to take the wind out of the sails of a Clinton press conference later that day, in which the President was to denounce the lack of progress on important national issues by congressional Republicans, including a Patients' Bill of Rights.

But if something gets through Congress this session, it will likely be primarily Shadegg's handiwork. It's been an interesting odyssey and an unusual position for the philosophical conservative, who was elected convincingly to his fourth term last night over token opposition.

Shadegg, whose father was one of Barry Goldwater's chief political advisers, is more frequently found outside the tent, organizing to keep the Republican leadership from straying too far from conservative principles. He cleaned up Newt Gingrich's mess at GOPAC, a conservative political action committee. And he currently leads the 60 or so House members of the occasionally cantankerous and always conservative Congressional Action Team.

You would ordinarily expect to find Shadegg among those questioning what business it is of the federal government to be dictating the terms of employment benefits.

But Shadegg, an attorney by training, finds the notion of HMOs being granted immunity by federal law from lawsuits holding them accountable for their actions deeply offensive and unconservative. Ideally, he would like to return health insurance regulation to the states, and increase the extent to which people insure themselves rather than being locked into plans provided by their employers.

But, at least on this subject, Shadegg has decided to weigh in on the art of the possible. Right now, that means trying to leverage the American Medical Association, which Shadegg believes is shortchanging doctors to maintain an alliance with trial lawyers and Democrats behind Dingell-Norwood, whose passage in the litigation-averse Senate is highly improbable.

In an interview, Shadegg's passion to actually get something done on this issue is palpable. The pivot may be a new position for Shadegg, but it's clearly one he relishes.

LOAD-DATE: November 30, 2000

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