Senate debates patients bill of rights |

Senate debates patients bill of rights

WASHINGTON (AP) – The Senate debated long-delayed legislation Tuesday to combat HMO horror stories and plunged instantly into partisan struggle. Republicans sought to slow action, and Majority Leader Tom Daschle vowed to ”stay on this bill for whatever length it takes.”

The maneuvering unfolded as House Republicans, struggling to gain control over a politically popular issue, weighed a concession in the critical area of patient lawsuits. GOP officials said discussions were under way on a proposal that would include a limited new right to sue in state court.

Speaker Dennis Hastert, R-Ill., called key lawmakers to his office for an evening meeting on the subject. Rep. Ernest Fletcher, R-Ky., said that under the proposal, HMOs would be open to state court suits – and punitive damages – if they refused to honor pro-patient decisions made by outside experts.

The discussions underscored the potential for a GOP split on the issue of lawsuits. Most Senate Republicans oppose any new right to sue in state court, and spent much of the day attacking Democrats on the issue.

Additionally, several Senate GOP sources said Republican campaign consultants cautioned the rank and file at a closed-door meeting that passage of a patients’ bill of rights and prescription drug coverage for Medicare recipients were imperative before the next election.

Daschle, D-S.D., who catapulted the patients’ bill of rights measure to the top of the Senate calendar after Democrats gained a mid-session majority, opened debate. ”We’ve talked enough” in the past five years, he said. ”We need to pass a real, enforceable patients’ bill of rights. Now.”

”I don’t think we should be railroaded into passing bad legislation,” countered Sen. Don Nickles, R-Okla., adding the measure could raise insurance costs, open the floodgates to lawsuits and ultimately cause employers to discontinue coverage for their workers. ”And we won’t, frankly.”

Ironically, after several years of debate in the House and the Senate, many of the issues are beyond dispute. The legislation, backed by Sens. Edward M. Kennedy, D-Mass., John Edwards, D-N.C., and John McCain, R-Ariz., would guarantee patients access to emergency care; direct access to obstetricians, gynecologists, and other specialists; overnight hospital stays for mastectomies; and payment of costs associated with clinical trials.

Much of the dispute centered on the question of lawsuits – when, where and whether patients could sue for damages, and how much money they should be permitted to recover.

That’s the issue that House Republicans were struggling with, as well. Several sources, speaking on condition of anonymity, said Hastert has spoken favorably of the proposal for lawsuits in state courts, part of an attempt to fashion a bill that could serve as an alternative for the Democratic-supported measure.

Fletcher, a physician, said the proposal would ”separate out the bad players from the good players” in the HMO industry by allowing lawsuits only in cases in which companies ignored rulings by outside experts who rule in favor of patients.

The arguments were well-known, but the political circumstances brand new as Daschle, majority leader for less than a month, stood on the Senate floor at midday and made good on his promise to call up the legislation as the first Democratic priority.

Republicans objected to a routine parliamentary request to make the bill open for amendment, then backpedaled by day’s end and agreed to allow a vote on that procedural motion on Thursday.

Beyond that, they objected strongly to a provision that would permit patients to sue insurance companies in either federal or state courts for punitive damages and open employers to suits in some circumstances.

Sen. Judd Gregg, R-N.H., said ”20 or 30 new law schools” would be required to produce the lawyers needed to file the lawsuits that would follow. ”Limitless lawsuits help lawyers, not patients,” said Sen. Mike Enzi, R-Wyo.

Democrats said Republicans were merely trying to protect their political benefactors, the insurance companies. ”Rights without remedies are no rights at all,” said Daschle.

The legislation has been debated numerous times in both the House and Senate in recent years, but with Republicans in control of Congress and a Democrat in the White House, gridlock prevailed each time.

This time, Democrats have a Senate majority, and a new majority leader in Daschle, Republicans are struggling to hold their ranks on the issue in the House and Bush, a Republican, is in the Oval Office. White House aides have threatened to veto the Democratic-backed bill if it passes, but GOP sources, speaking on condition of anonymity, said debate was intense within the administration over a formal position paper to be issued in the next few days.

Bush outlined his own position in March, calling for legislation that covered everyone and gave patients the right to a ”fair and immediate review” by an independent panel if care were denied, all ”without inviting frivolous lawsuits.”

Daschle, staking out an uncompromising position on his party’s first legislative initiative, said, ”It is my intention to stay on this bill for whatever length it takes.” He added he was prepared to cancel the Senate’s upcoming weeklong break over the July 4 holiday if necessary.

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