Hastert Prods Patients Rights Negotiations

Looking to "break a longstanding impasse" over a patients' bill of rights, House Speaker Dennis Hastert (R-Ill.) hosted a May 10 meeting between Josh Bolten, President Bush's deputy chief of staff for policy, and Reps. Charles Norwood (R-Ga.) and John Dingell (D-Mich.), long time backers of a patients' right to sue managed care organizations, the Wall Street Journal reports. Hastert, noting that he has never discussed the issue with Dingell, said, "I have been working on this for 10 years and would like to see something happen. We need to keep everybody at the table and I'm probably the glue that does that" (Rogers, Wall Street Journal, 5/11). Earlier this year, Dingell gave his support to patients' rights legislation (S 283) proposed by Sens. Edward Kennedy (D-Mass.), John McCain (R-Ariz.) and John Edwards (D-N.C.) that would allow patients to sue managed care companies over denials of care in both state and federal courts, with damages obtained in the latter capped at $5 million (Kaiser Daily Health Policy Report, 2/7). In March, Bush threatened to veto the measure if passed, saying that the $5 million cap was "too high and [would] drive up the costs of health care in America" (Kaiser Daily Health Policy Report, 3/22). The Journal reports that the president's advisers "have been surprised by the bitter divisions on the issue," but are "intrigued by the idea of moving ahead with a simpler patients' bill of rights" that is neutral on the liability issue (Wall Street Journal, 5/11). McCain and Edwards have called such a proposal "unacceptable" (Kaiser Daily Health Policy Report, 4/26). Like the two senators, Dingell said he was "reluctant" to endorse a no-liability measure, saying that "Congress has a responsibility to act on the issue" (Wall Street Journal, 5/11).

Looking for Physician Support
Meanwhile, CongressDaily/AM reports that supporters of the Kennedy-McCain-Edwards bill are competing with those who support a proposal by Sen. Bill Frist (R-Tenn.) to gain the backing of the nation's physicians (Fulton/Rovner, CongressDaily/AM, 5/11). Under Frist's draft proposal, patients would have a limited right to sue in federal court, with a $500,000 cap on non-economic damages and unlimited economic damages (Kaiser Daily Health Policy Report, 3/13). While the American Medical Association has been a "steadfast supporter" of Kennedy-McCain-Edwards, CongressDaily/AM reports that Frist may have won over the Patients Access Coalition -- a group of 70 specialty provider groups and patients' groups -- by agreeing to drop a provision in his bill that would allow states to opt out of implementing new patient rights protections if they demonstrated that such measures would increase health insurance premiums by more than 2%. Camille Sorosiak of the American College of Cardiology, a member of the coalition, said, "Our concern is that the bill must cover everyone. If the waivers are in there, there's no way we're going to support the bill." She added that the coalition "has stayed away from the issue of liability altogether." The American Society of Anesthesiologists has sent a letter saying it is "ready to endorse and support [Frist's] critically important legislation when introduced." The American Association of Health Plans has launched a campaign designed to limit physicians' support for new laws that "the industry says only puts physicians at risk and drives up the cost of health care." The AMA, however, has called the campaign a "smokescreen" and has "argued that the Frist bill ... would subject physicians to new lawsuits --- since they now are liable only in state courts."

A May Showdown?
As both camps seek physicians' support, McCain -- who "has vowed all year to force a vote on [his] measure by Memorial Day -- on Wednesday filed the bill as a "potential amendment to the education bill currently under debate in the Senate." Frist said he would "officially introduce his bill if McCain presses for an immediate debate" (CongressDaily/AM, 5/11).