Frist, Breaux and Jeffords to Introduce New Patients’ Rights Bill Today with Bush’s Backing

Sen. Bill Frist (R-Tenn.), with support from Sens. John Breaux (D-La.) and James Jeffords (R-Vt.,) on May 15 will introduce a new bipartisan patients' rights bill endorsed by President Bush that would "safeguard patients without unleashing excessive lawsuits or undermining states that have adopted similar protections," the Washington Post reports. The new bill permits suits against managed care companies but with two constraints -- "in most cases," the bill would require patients to first bring their complaints to a new outside review panel, and patients would be allowed to sue only if the panel "rejected" their complaint. In addition, while the legislation would not "expand" patients' rights to sue in state court, it would allow patients to win more money in federal court than under current law -- an "unlimited sum" in economic damages and up to $500,000 in "other injuries." The new bill also "omits" exemptions that would allow states to "skirt" the federal law (Goldstein, Washington Post, 5/15). These constraints "generally follo[w]" principles for patients rights' legislation set forth by Bush earlier this year, the New York Times reports (Pear, New York Times, 15).

'Truer' Compromise?
The new bill, however, stands in "contrast" to the patients rights bill (S 283) sponsored by Sens. John McCain (R-Ariz.), Edward Kennedy (D-Mass.) and John Edwards (D-N.C.) that Bush "rejected immediately." Unlike the Frist bill, the McCain-Kennedy-Edwards measure would allow patients more flexibility to sue in state courts, where they could win up to $5 million in penalties. But the Frist and McCain-Kennedy-Edwards bills are similar in "less controversial areas," including emergency room treatment coverage, prescription drug access, and access to obstetrician/gynecologists without prior approval. Although Bush favors the Frist bill, it "remains unclear" whether Senate Republican leaders, "who have resisted any expansion of lawsuits against health plans," or Democrats and House Republicans, "many of whom" have voted for more expansive rights, will support the bill (Washington Post, 5/15). But the new bill's sponsors say it represents a "truer" compromise than previous proposals. "My hope is that this bill encourages both sides to leave their entrenched, intransigent position and come to the middle," Frist said, adding, "This bill is aimed to achieve balance in terms of liability and scope" (Washington Post, 5/15).

McCain, Edwards Push Bill Through Senate
Meanwhile, Edwards and McCain are "frustrated" that White House officials "won't sit down and discuss ... reservations about" their bill, McClatchy Newspapers/Washington Times reports. In a recent interview, Edwards said, "Up until now, we've seen no indications they're interested." Because of the "lack of dialogue" on the bill, McCain and Edwards are trying a "new strategy," McClatchy/Times reports (Wagner, McClatchy Newspapers/Washington Times, 5/14). McCain -- who "has vowed all year to force a vote on [his] measure by Memorial Day" -- last Wednesday filed the bill as a "potential amendment to the education bill currently under debate in the Senate" (Kaiser Daily Health Policy Report, 5/11). CongressDaily reports that the debate could come up as early as this week on the Senate floor if McCain pushes the amendment (Fulton, CongressDaily, 5/14). McCain and Edwards hope this effort "quickly" lands the bill on Bush's desk, forcing Bush to "[e]mbrace it or veto it." Edwards said, "I think the president needs to decide where he stands on this thing: whether he stands with the big HMOs or whether he stands with patients and families" (McClatchy Newspapers/Washington Times, 5/14). However, if McCain successfully pushes the amendment, Frist may also present his bill as a "second-degree amendment," sources say (CongressDaily, 5/14).

Op-Eds Say Bush Stance 'Undermines Patient Protection' ...
Bush's "apparent insistence" that he will veto a patients' bill of rights that does not enforce "reasonable" caps on awards won by patients in HMO lawsuits "will derail any chance for agreement," Rep. Rob Andrews (D-N.J.) writes in a Philadelphia Inquirer op-ed. Even though the McCain-Kennedy-Edwards bill includes a $5 million cap on punitive damages in state court, Andrews says that this amount "is evidently too high for the president's liking." Andrews adds that the liability limits Bush has advocated "undermin[e] patient protection" by "undercut[ting] the deterrent power of patient protections." Andrews concludes, "The position the president has taken shuts the courthouse door for many patients, denies complete compensation for many others, and fails to turn the tables in favor of patient protection in the daily decision-making practices of health insurers" (Andrews, Philadelphia Inquirer, 5/14).

... And Is 'Bad Policy,' 'Bad Politics'
In an accompanying Inquirer opinion piece, Craig Dimitri, a 1999 Villanova University School of Law graduate, writes, "Bush's stance on [patients'] right to sue is both bad policy and bad politics." Dimitri, describing himself as a "conservative Republican" who campaigned heavily for Bush last year, warns that Bush's stance is "bad strategy" because it could "trigger an unpleasant civil war within the GOP," thereby giving the Democrats "a gift-wrapped opportunity to thwart Bush's political momentum and sap his high approval ratings." In addition, Bush's opposition to the McCain-Kennedy-Edwards bill is "bad policy," noting that HMOs are currently "blissfully protected from being held responsible for their negligence -- which often results in death for patients." Dimitri concludes, "The president has an opportunity to sign historic legislation, a vivid example of 'compassionate conservatism.' He should not squander this chance" (Dimitri, Philadelphia Inquirer, 5/14).