Copyright 1999 Times Mirror Company
Los Angeles
Times
June 24, 1999, Thursday, Home Edition
SECTION: Part A; Page 5; National Desk
LENGTH: 700 words
HEADLINE:
NATIONAL PERSPECTIVE;
UPDATE;
ATTEMPT TO FORCE HEALTH CARE
DEBATE SHUTS DOWN THE SENATE
BYLINE: ALISSA J. RUBIN,
TIMES STAFF WRITER
DATELINE: WASHINGTON
BODY:
Democrats on Wednesday brought the Senate to
a standstill in an effort to force a wide-ranging debate on legislation to
guarantee patients certain rights in dealing with their managed care plans.
Under heavy pressure from the health insurance industry and business,
Republican lawmakers rebuffed the Democrats' request for a chance to offer
multiple amendments to a GOP version of the legislation. The Democrats, who had
attached their patients' rights provisions to the annual agriculture spending
bill, responded by blocking action on that bill or any other.
The
bickering about whether to have a full-fledged debate concerning the managed
care bill reflects an ambivalence by both parties on whether to enact
legislation or save the issue for next year's election campaign.
"It may
be that both parties find it advantageous to do nothing," said Sen. Bill Frist
(R-Tenn.). Such has been the case for the three years since the parties pledged
to enact a "patients bill of rights."
At least
two-thirds of all people who buy health insurance through their employers are in
managed care plans, which typically try to hold down costs by limiting access to
specialists and certain expensive treatments and tests.
The Democrats'
bill would allow patients to appeal treatment decisions to the courts, where
they could win substantial damage awards.
The Republican version would
permit access to independent review boards, but not the courts, and only for the
one managed care client in three who is in a self-insured plan--one in which the
employer, rather than an insurance company, assumes the risk. It would also
permit awards only to the extent of the denied test or treatment, as is the case
under current law.
The public broadly--but not deeply--favors
guaranteeing patients more rights in dealing with these health plans. Health
insurers and employers caution that such legislation would raise their costs.
"Is this a high-ranking issue on which people decide whether to vote for
a candidate? No, it really isn't," said Bob Blendon, a professor of health
policy at the Harvard School of Public Health. "But is it a popular thing to do?
Absolutely," he said.
For Republicans, who listen closely to the
concerns of business and the insurance industry, this suggests that they can
side with these groups without great political risk. Furthermore, they argue
that the higher insurance costs under the Democrats' bill would add to the
number of uninsured Americans.
"I know there's little sympathy out there
for business, big or small, but there ought to be, because we drive the
economy," said Patrick Cleary, vice president for the National Assn. of
Manufacturers. "It's unassailable that every time you raise costs, you drive
down insurance coverage," he said.
Some Democrats, who know the issue is
popular with consumers and who receive less campaign funding from business,
believe it may be in their interests to resist compromise and use the issue to
tag Republicans as anti-consumer in next year's elections.
Because the
Democrats are outnumbered in Congress and unlikely to be able to pass their
version of a patients' rights bill, their main goal seems to be to have a
debate, in which they can bring out the differences between the two parties'
approaches to the issue.
The differences are deep and sometimes subtle.
Both parties, for example, would require coverage of emergency room visits--but
the Democrats would also require that the insurer pay for post-stabilization
care. That means that if a patient came into an emergency room with a smashed
elbow, the insurer would have to pay to stabilize the elbow and to have it set
at that hospital if the emergency room doctor recommended it. The Republican
bill would allow the insurer to ask that the patient go elsewhere for the
surgery.
"When you look closely at their 'patient bill of
rights,' it's a bill of wrongs," said Senate Minority Leader Tom
Daschle (D-S.D.).
Republicans respond that the Democrats' bill would
raise the cost of health insurance by 5% over five years, pricing as many as a
million people out of health insurance.
Times staff writer Blair Golson
contributed to this story.
LOAD-DATE: June 24, 1999
