Join AFSCME
 About AFSCME
 The AFSCME Web
 Privatization
 Legislative Action
 Health & Safety
 AFSCME LaborLinks
 Publications
 What's New
 AFSCME en Español

Summer 2000

PATIENTS' RIGHTS

On June 8, 2000, the U.S. Senate voted 51 to 48 to defeat the Norwood/Dingell bill, the bipartisan patients' rights legislation approved by the House of Representatives last October. Every Democratic Senator voted in favor of the bill, with the exception of Sen. Kent Conrad (ND) who was out of town. All but four Republicans voted to defeat the bill. The four who parted with the GOP leadership were Sens. Arlen Specter (PA), Peter Fitzgerald (IL), Lincoln Chafee (RI) and John McCain (AZ).

Senate Democrats forced the vote in an effort to jumpstart the stalled negotiations in the patients' rights conference. The conference committee of selected senators and representatives has been meeting since early March to reconcile differences between the Norwood/Dingell bill passed by the House and the sham patients' rights bill passed by the Senate (S. 1344) on July 15, 1999. Despite months of discussions, the conference committee has resolved few of the differences between the House and Senate bills. It is not surprising that the discussions have proceeded slowly because the House and Senate bills differ sharply.

The House Bill

The House bill (H.R. 2723) is a bipartisan compromise sponsored by Representatives Charles Norwood (R-GA) and John Dingell (D-MI). The "Norwood/Dingell" bill provides meaningful reform of managed care with significant protections for consumers and health care professionals.

Why AFSCME nurses should support H.R. 2723:

• Applies all protections to all people covered by managed care plans, including state and local government employees.

• Includes whistleblower protections that prohibit employers from retaliating against doctors, nurses and other certified or licensed health care professionals who report quality problems to their employers, accrediting entities or public regulatory agencies.

• Allows patients to appeal denials or limitations of care to an external reviewer who makes an independent judgment about the patient's medical needs and the appropriateness of the proposed treatment.

• Expands liability so that all plans can be held legally accountable when they harm patients by wrongly denying or limiting care.

• Ensures that patients have access to emergency services and specialists.

• Prevents plans from financially rewarding health care professionals for limiting a patient's care.

The Senate Version

Largely along party lines, the Senate passed its own patients rights bill (S. 1344) last year. It has many serious deficiencies and only covers about one-third of the families who are in managed care plans.

Why AFSCME nurses should oppose S. 1344:

• Excludes state and local government workers, many workers in small and medium-sized firms, and those who do not receive coverage through employment but instead purchase individual insurance policies.

• Lacks patient advocacy protections (whistle-blower) for health care professionals and has weaker patient protections. Furthermore, it fails to hold all plans legally accountable when they injure patients by delaying or denying care and the bill's external appeals process is rigged in favor of plans.

Call your Congresspersons and let them know that you want the Congress to pass the Norwood/Dingell bill. Let them know that this legislation provides meaningful protections for patients, holds managed care organizations accountable for improper denials of care, covers all families in managed care plans and provides patient advocacy protections for nurses.

The debate over comprehensive reform of Medicare has faded due, in part, to improvements in the financing projections for the trust fund. Instead, the debate this year has centered on the establishment of prescription drug coverage for seniors. The Clinton administration is proposing the establishment of a prescription drug benefit under Medicare.

The House GOP leadership has reacted to the popularity of a drug plan by creating a task-force to develop legislation. However, their approach will not be broad-based in the tradition of the Medicare program. While congressional Democrats and President Clinton favor a plan that would cover all seniors under Medicare, House GOP leaders favor one that would only help low-income seniors pay for prescription drugs. Limit-ing the benefit to only low-income seniors is the direction that the drug industry has been support-ing. The details of the House GOP proposal are still being worked out, but Speaker Dennis Hastert (R-IL) wants to bring the bill to the floor this summer.

In the Senate, Democrats have begun to offer amendments to federal budget legislation on the issue of Medicare prescription drugs. In early April, the Senate rejected an amendment, offered by Senator Charles Robb (D-VA), to delay any broad tax cut until prescription drug coverage has been added to Medicare. The vote was 51-49 in favor of the amendment, but supporters needed 60 votes in order to waive procedural rules connected to budget bills.

The Health Care Worker Needlestick Prevention Act (H.R. 1899/S. 1140), was introduced last year by Representatives Pete Stark (D-CA) and Marge Roukema (R-NJ) in the House and by Senators Barbara Boxer (D-CA) and Harry Reid (D-NV) in the Senate. The bill would require health care workplaces to identify, evaluate and utilize needles and sharps designed to reduce needlestick injuries to health care workers.

The bill would amend the federal Occupational Safety and Health Administration's (OSHA) Bloodborne Pathogen Standard to require the use of needles and sharps engineered with safety features. In those states where public employees are not covered by OSHA standards, the bill would require public hospitals to meet the OSHA requirement as a condition of participating in the Medicare program.

Importantly, the bill would require employers to involve direct care workers in the selection of safer devices and would also require that employers provide these workers with training in the use of safety-designed devices. The bill would require employers to create an injury log to record any sharps injuries. Such a log would create a database from which more could be learned in order to prevent injuries.

Write your Congresspersons and urge them to cosponsor the Health Care Worker Needlestick Prevention Act (H.R. 1899/S. 1140). Remind them that 600,000 to 1,000,000 needlestick injuries occur each year and that 1,000 nurses and other health care professionals contract serious diseases, including Hepatitis B and C and HIV, each year.