HMOs and the insurance industry won a round in their fight against quality, affordable health care for working families when the U.S. Senate defeated a strong Patients' Bill of Rights June 8. That same day, workers and workplace safety also lost out to profits and Big Business when the House voted to ban the federal government from issuing new ergonomics standards designed to help prevent the nearly 2 million injuries workers suffer each year from poorly designed workplaces and repetitive, stressful motions. Both bills were part of larger fiscal year 2001 spending bills.

The Senate vote was primarily along party lines, with four Republican lawmakers joining all 44 Democrats supporting the strong Patients' Bill of Rights, which was offered as an amendment to a Department of Defense appropriations bill. The amendment was killed by a 51-48 vote.

"The Senate Republican leadership has irresponsibly avoided key issues—including holding health plans accountable and making sure workers with private insurance are covered—while working families continue to be held hostage to their health plans by HMO bureaucrats," said AFL-CIO President John Sweeney.

The Democratic leadership offered the Patients' Bill of Rights amendment, which was similar to the bipartisan House bill passed last year. That version ensures patients have the right to treatment decisions made by doctors rather than insurance company bureaucrats, the right to see specialists, the right to emergency room care, the right to appeal a health care decision and the right to sue managed care companies.

The GOP-controlled Senate passed a far weaker Patients' Bill of Rights last year, and a House-Senate conference on the two versions has stalled.

"Working families have had to wait far too long for Congress to pass meaningful managed care reform which protects patients, not profits," Sweeney said.

In the House, lawmakers voted 220-203 to retain a provision in the Labor, Health and Human Services appropriations bill that bans the Occupational Safety and Health Administration from going forward with proposed ergonomics rules. Fourteen Republican lawmakers voted with the vast majority of Democrats for an amendment to remove the anti-ergonomics provision, but 16 Democratic defections sealed the amendment's fate.

Big Business has made defeat of OSHA's proposed standard one of its key congressional goals. The new rule, proposed in November, is designed to reduce work-related musculoskeletal disorders (MSDs) that injure nearly 2 million workers each year and force some 600,000 to take time off from work. OSHA held more than nine weeks of public hearings around the nation on the proposed legislation this spring.

The Senate Labor/HHS spending bill does not contain an anti-ergonomics provision, and President Clinton has said he will veto a bill that includes the ban.

The House is expected to vote on the full spending bill (H.R. 4577) the week of June 10. The AFL-CIO opposes it because, along with the attack on workplace safety, it cuts funds for OSHA, the National Labor Relations Board and skills training programs and contains no money to reduce school class size or to repair and modernize the nation's schools.