Wall Street Journal Outlines Patients’ Rights Debate; AAHP Reiterates Opposition of McCain Bill

The June 7 Wall Street Journal outlines the "new debate" over a patients' bill of rights, on which Senate Democrats -- in charge of setting the Senate's agenda for the first time since the "demise of the Clinton health care plan in 1994" -- intend to "speed up action." The issue already has "stalemated two Congresses and featured prominently in two elections," the Journal reports. The Journal calls the debate "thoroughly American," citing "conflicting values": "On one side is the dream of providing health care to millions in a private market, where decisions have to be made to hold down costs. On the other is the time-honored right of individuals to stand up for themselves in court." As it stands, "all sides are close to agreement on most ... elements of a bill," including "basic protections, such as guaranteed emergency care," and "building an independent review mechanism." But the "pivotal issue" is the question of liability: "how and where patients can bring suit against HMOs and insurance companies," the Journal reports (Rogers, Wall Street Journal, 6/7). Congress currently is considering two bills. One (S 283), by Sens. John McCain (R-Ariz.), Edward Kennedy (D-Mass.) and John Edwards (D-N.C.), would allow patients to sue in state courts for denial of benefits or quality of care issues and in federal court for non-quality of care issues, such as those involving violations of a health plan contract. Damages awarded in federal court would be capped at $5 million, but state courts could award as much money in damages as the state allows (Kaiser Daily Health Policy Report, 2/7). The other bill (S 889), by Sens. Bill Frist (R-Tenn.) and John Breaux (D-La.), would afford all patients with private health insurance a "slender" right to sue their health plans after exhausting an appeals process by an outside review panel. Patients could only sue health plans in federal court, not state court, and awards would be capped at $500,000 (Kaiser Daily Health Policy Report, 5/16). To "get around the liability roadblock," Rep. John Dingell (D-Mich.), sponsor of an earlier patients' rights bill, has "begun offering up some new options," and Democrats have said that they would accept language that would "better protect business employers from lawsuits." If lawmakers can reach a deal on the liability issue, the Journal predicts that "a bill almost certainly will be enacted this year. If not, the risk is another protracted battle." According to House Speaker Dennis Hastert (R-Ill.), the chances of "successful compromise" are "50-50" (Wall Street Journal, 6/7).

AAHP Criticizes S 283
In other patients' rights news, the American Association of Health Plans yesterday reiterated its opposition to the McCain-Kennedy-Edwards bill, saying that the measure would "hurt patients more than it would help them," CongressDaily reports. AAHP President Karen Ignagni said, "It would be impossible not to conclude ... that this is a trial lawyer takeover of the health care system." She added that the bill would "dramatically increase the cost of health insurance," saying that the "only way" employers could "recoup" costs would be to have workers "pay more directly for health care." Ignagni predicted that hospitals, which have "largely" supported patients' rights, would soon join insurers and businesses in their opposition because the bills would "expose" them to new lawsuits. Although AAHP "has been steadfast" in its opposition to liability expansion, Ignagni "was careful" not to rule out the possibility that AAHP might "ultimately back some expansion of liability" but in federal court only. She added that the decision to back any patients' rights bill would be made by the organization's members (Rovner, CongressDaily, 6/6).