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Copyright 1999 St. Louis Post-Dispatch, Inc.  
St. Louis Post-Dispatch

July 16, 1999, Friday, FIVE STAR LIFT EDITION

SECTION: NEWS, Pg. A1

LENGTH: 755 words

HEADLINE: SENATE PASSES GOP BILL ON PATIENTS' RIGHTS;
REPUBLICANS KILL DEMOCRATS' MORE COMPREHENSIVE PLAN;
CLINTON WILL VETO IT, AIDES SAYS

BYLINE: From News Services; Deirdre Shesgreen of the Post-Dispatch's Washington bureau contributed

DATELINE: WASHINGTON

BODY:


Senate Republicans, rolling over Democrats in a week of party-line votes, approved a modest set of patient protections Thursday aimed at millions of Americans who fear cost-conscious HMOs may deny them needed care.

"This bill addresses the real problems many Americans face," said Senate Majority Leader Trent Lott, R-Miss. The final vote was 53-47.

Sen. Peter Fitzgerald, R-Ill., who made a campaign promise last year to work for legislation that would make it easier to sue HMOs, was one of only two Republicans to vote against the GOP bill. Sen. John Chafee, R-R.I., also joined all 45 Democrats in opposition.

"I believe HMO care would be improved if HMOs were not shielded from the consequences of any negligent behavior," Fitzgerald said.

Looking toward next year's elections, Democrats promised to revive the politically potent issue. Polls suggest Americans overwhelmingly favor new rules for health maintenance organizations and other managed-care plans, which try to save money by eliminating unnecessary care.

President Bill Clinton called the bill unacceptable and aides said he would veto it.

"If Congress insists on passing such an empty promise to the American people, I will not sign the bill," Clinton said in a statement after the vote. "This should be about protecting patients, not insurance companies."

Still, Republicans noted that Clinton has changed his position on other issues.

Momentum for a bipartisan compromise crumbled when Fitzgerald and Sen. John McCain, R-Ariz., bolted from it minutes before a news conference announcing the plan. With only two Republican senators still behind it, the compromise ultimately was not even introduced.

Throughout the week, Republicans argued that the Democratic plan would sharply increase the cost of health insurance.

The final GOP measure offers an array of new rights to the 48 million Americans whose health plans are exempt from state regulation. They include easier access to specialists, emergency rooms and obstetricians-gynecologists. In most cases, the Democratic provisions are broader and they cover more people.

The House also is working on HMO legislation, but conflict among Republicans on its scope has kept it tied up in committee. Last year, the House narrowly passed an HMO bill, but the Senate failed to act.

Democrats compared the Senate debate to last month's debate over gun control, predicting that rank-and-file Republicans would defy their leaders and support at least some of the Democratic provisions.

But the GOP majority held firm, never losing more than three members on any given vote.

While Congress has been able to agree on other health issues, this week's debate has been the most contentious congressional fight over health care since Clinton's plan for universal health coverage died in 1993.

Republicans defeated outright the most sweeping Democratic proposals, including an effort to apply the new rights to all 161 million Americans with private health insurance and to give doctors final say over what care is medically necessary.

But on other issues, the GOP offered modest alternatives. Democrats, for instance, wanted to force insurance companies to pay for routine health costs when patients go into clinical trials on experimental treatments. On Thursday, Republicans offered their own version, which included only cancer trials.

Democrats ridiculed the approach. "You can put lipstick on a pig but it's still a pig," Sen. Edward Kennedy, D-Mass., told reporters.

One of the provisions in the GOP version was offered in an amendment by Sen. John Ashcroft, R-Mo. It is designed to keep HMOs from dragging their feet when responding to appeals from patients who have been denied medical care.
 
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Highlights of the patients bill of rights

For the 48 million Americans in health plans that are exempt from state regulation, the bill would:

* Prohibit managed care plans from charging patients more for using emergency rooms outside of the plan.
 
* Give women direct access to gynecologists and obstetricians.
 
* Cover clinical trials for cancer patients only.

* Require all managed care plans to allow mastectomy patients to remain in a hospital as long as determined necessary by a doctor.

For the 124 million people in most managed care plans, the bill would:
 
* Create an appeals process in cases of denial of treatment.

* Impose a $ 10,000 fine for managed care plans that do not comply with the ruling of the external appeals panel.

LOAD-DATE: July 16, 1999




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