Copyright 1999 Newsday, Inc.
Newsday (New York, NY)
July 13, 1999, Tuesday, ALL EDITIONS
SECTION: NEWS; Page A08
LENGTH: 1013 words
HEADLINE:
PATIENTS RIGHTS DEBATED
BYLINE: By Elaine S. Povich.
WASHINGTON BUREAU
DATELINE: Washington
BODY:
Washington - The Senate began debate
yesterday on the politically potent issue of patients rights, sparking a furious
nationwide advertising campaign by health-care-industry groups with billions at
stake.
Republican and Democratic leaders jockeyed for position on the
Senate floor yesterday and argued over whose legislation would help patients
more. Democrats said their bill, which would cover 161 million Americans and
allow them to sue their managed-care plans, was more comprehensive. Republicans
maintained that the Democratic bill would dramatically drive up the cost of
health care and said their more modest legislation, covering 48 million
Americans, was the way to go.
With health maintenance organizations and
other managed-care plans the targets of consumers wrath, both parties have
acknowledged the potency of the issue with voters. But with such dramatically
differing solutions being proposed and little room for compromise, advocates
give either plan only a 50-50 chance of being enacted into law. There is little
doubt the issue will be settled at the ballot box in November, 2000.
Under rules set for the Senate debate, final votes will be taken on the
issue by week's end. With Republicans holding a 55-45 majority, it's likely the
Republican plan will pass, but President Bill Clinton has promised to veto it.
It's not likely the Senate could muster the 67 votes needed to override a veto.
The House, which passed its own fairly comprehensive "Patients
Bill of Rights" during the last Congress, has not yet
acted this year. The House Commerce Committee may begin work on a bill this week
or next.
In the Senate, Republicans, in a surprise procedural maneuver,
decided to use the Democratic version of the bill as the starting point. This
was done to make it awkward for Democrats to amend their own proposal. But
Democrats countered with their own counter move and offered the Republican
version as a substitute, thus making it also a subject for debate.
Senate Minority Leader Thomas Daschle (D-S.D.) said the parliamentary
situation was less important than the votes he expects this week that will force
senators to take a public stand on everything from a patient's right to sue a
health maintenance organization to a woman's right to designate a gynecologist
as her "primary-care" doctor.
But Senate Majority Whip Don Nickles
(R-Okla.), predicted Republicans would "win the debate and win the vote."
Republicans argue the more comprehensive Democratic plan would drive up
the cost of health care and force companies to drop health insurance as a
benefit.
Democrats argue the Republican plan would leave too many
patients without recourse to battle managed-care companies and protect insurance
companies.
Nationwide advertising campaigns by doctors, HMOs and
insurance companies are competing to influence votes on the Senate floor and to
persuade Americans of their positions.
The American Medical Association
began running $ 200,000 worth of ads last week asking citizens to call Congress
in support of the liability and medical necessity provisions in the Democratic
version.
By contrast, a coalition of unions and consumer advocates ran
an ad asking: "Does the Senate support insurance industry protections or patient
protections?"
And The Coalition for Affordable Quality Health Care, an
alliance of insurance companies, trade associations and large employers,
launched a $ 10.5-million nationwide advertising campaign in Chicago yesterday
featuring television spots of doctors discussing positive experiences with
managed-care plans.
Republicans and Democrats held competing rallies on
Capitol Hill featuring ordinary people describing experiences with health
maintenance organizations.
Ron Pollock, president of Families USA, a
liberal consumer advocacy group, put the chances of passage of the Democratic
bill at "6 to 5, pick em." But, he said, if it doesn't pass: "Then the
Republicans are taking a big risk of having this be a big issue in the 2000
election, and it will be." Comparing Patient's Rights Here are some major
differences between the Republican and Democratic patient's rights proposals to
revamp laws governing health maintenance organizations. Democrat Republican
Covers 48 million Americans in company self-insured Covers 161 million Americans
who now get their plans. The estimated 110 million others insured would Coverage
health insurance through managed care plans. be governed by state laws.
CostEstimated 4.8% increase in health insurance premiums. Estimated 0.8%
increase in health insurance premiums. EmergencyProvides coverage for emergency
care without prior Provides coverage for emergency care that a "prudent room
careauthorization from managed care company. layperson" would deem necessary.
Allows patients to sue their HMO, insurance company or Includes no provision
termitting patients to sue their employer in state courts for malpractice or
HMO, insurance company or employer but provides for Lawsuits mismanagement
including denial of treatment. internal and external review to arbitrate
disputes. Doctors Doctors determine what treatments Insurers determine what
treatments decisions are "medically necessary." are "medically necessary."
Women's Allows women in plans underwritten by large companies health Allows
women to designate gynecologists as to see an OB/GYN provider w/o prior
permission care primary care provider. from primary care doctor. Continuity
Provides 90 days of continued treatment for an ongoing Covers 90 days of
appropriate treatment of careillness and unlimited care for terminal illnesses.
for terminal illnesses. Medical Makes tax-deferred savings accounts generally
savings available; they are now available to only self-employed accounts No
provision. or small employers. Gag Prohibits HMOs from restricting what
physicians Prohibits HMOs from restricting what physicians can tell rule can
tell patients. patients about a disease they are being treated for. SOURCE:
Congressional Research Service, party analyses.
GRAPHIC: Chart - Comparing Patient's Rights (SEE END OF
TEXT)
LOAD-DATE: July 13, 1999
