Kaiser Daily Health Policy Report Rounds Up Recent Patients’ Rights Commentary

As the Senate continues to debate patients' rights legislation, the Kaiser Daily Health Policy Report summarizes recent commentary on the various proposals under consideration.

Op-Ed Contributors

• Michael Weinstein: In a New York Times op-ed, Weinstein, a senior fellow at the Council on Foreign Relations and former Times columnist, writes that both the McCain-Kennedy-Edwards bill and the Frist-Breaux-Jeffords bill "fail" to address the problem of the uninsured and the underinsured. Instead, these bills act as a "smokescreen" from the "real crisis" in health care -- the "quality of care" given to patients (Weinstein, New York Times, 6/24).
• Philip Howard: Howard, a lawyer and author, writes in the Washington Post that the patients' rights debate in Congress is "not a solution to health care," but rather the "death throes of the medical profession." Howard writes that both bills "encourage mutual destruction" for doctors and managed care organizations although "greater legal liability." Instead, Congress needs to create a "reliable legal system" that protects "sound medical judgement," yet "penaliz[es] bad judgement" (Howard, Washington Post, 6/24).
• Bill Pryor: In a Contra Costa Times commentary piece, Pryor, Alabama's attorney general, writes that the court system is "simply ill-equipped to regulate the health care industry." Likening class action suits against HMOs to litigation against the tobacco and firearms industries, Pryor writes that suits against HMOs around the country are an attempt to "create different models" for health care payment while bypassing the "political process." By suing HMOs, lawyers can obtain "huge ... fees" and "frustrated liberal politicians" will receive "glitzy publicity" while advancing their goal to "force a settlement regardless of the merits of their legal arguments." He concludes: "What Hillary Clinton could not conquer in the political process they hope to do now in the courts: create a new model for the regulation of health care" (Pryor, Contra Costa Times, 6/24).

Syndicated Columnists

• E.J. Dionne: In a column for the Seattle Times, Dionne writes that the debate over patients' rights legislation indicates the "real debate" is not about "local power," but about "economic power." With the GOP usually favoring states' rights and the Democrats supporting "national government," Dionne says the debate over patients' rights is more about the GOP desire to have the market "rule" versus the Democrats' push for "modest economic regulation." He concludes: "If both parties could be honest about the nature of their differences, we could drop the euphemisms and the phony talk about 'states' rights" and 'local control.' And then we could have a real debate" (Dionne, Seattle Times, 6/22).
• David Broder: Writing in the Washington Post, Broder says that the Senate debate has become a "battle of anecdotes" that pits "human lives vs. business profits." However, the issue is not that "simple and straightforward" and the anecdotal evidence used by both sides "gives no guidance to the scope of the problem being addressed." But Broder notes that, "[p]olitics aside, there is plenty on which the opposing sides can agree. That agreement defines the bill that should be passed - and soon" (Broder, Washington Post, 6/26).
• Steve Chapman: In a Washington Times piece, Chapman notes that the American Medical Association, which supports the McCain-Kennedy-Edwards bill, had once said that malpractice litigation "serves as 'a barrier to quality improvement.'" Given that malpractice litigation against physicians has done "such a poor job of identifying and rectifying errors by doctors," Chapman writes "there is no reason to think" lawsuits will improve HMOs and insurance companies. Chapman concludes: "In the end, turning medical decisions over to lawyers and juries promises to raise health care costs without improving quality. ... That may come as news to you. But doctors should have been able to figure it out on their own" (Chapman, Washington Times, 6/23).
• Ellen Goodman: In a column for the Boston Globe, Goodman writes that debate on patients' rights in the Senate is more over "a Bill of Rights for People who have Insurance." While both bills expand the right to sue HMOs to patients, the legislation is "also a bill of rights without the right to health care." With the United States the "only industrialized country" that does not have a right to health care, the debate in the Senate is "academic" for the more than 43 million Americans without coverage. While it is "time to pass" patients' rights legislation for those with coverage, Goodman concludes, "there's a waitress out there who can't afford a mammogram and a maintenance worker who can't afford prostate screening, and neither of them has an insurer, let alone a lobbyist. Their great American dream is not, I promise you, finding someone to sue" (Goodman, Boston Globe, 6/24).

Editorials

• Austin American-Statesman: The "core problem" with both bills is that neither "breaks the job/insurance link and liberate consumers from HMOs." Instead, Congress should expand "Medicare to everyone" or switch to a system that uses Medical Savings Accounts. Dubbing the two bills the "Band-Aid heath care bills," the editorial says there are "good" and "bad" aspects for both of them. While it is "good" that patients will have the right to sue their HMOs, the editorial concludes it is "bad" that damages are not capped in an attempt to "prevent an explosion of litigation" that benefits trial lawyers (Austin American-Statesman, 6/25).
• Baltimore Sun: With the "sticking point" in the Senate debate centered on the right to sue, the editorial says the "key to quieting HMO disputes is a rapid-response grieving process" that "satisf[ies]" patients. Noting that lawsuits do not address "immediate medical needs," a "better approach" would be for Congress to expand state jurisdiction to cover those "exempted" from federal laws. The editorial says that state insurance commissioners or state panels should have "grievance powers" with patients given "limited, expedited court appeals" (Baltimore Sun, 6/25).
• Hartford Courant: "Patients would best be served" if McCain-Kennedy-Edwards or "something close to it becomes law," as it "covers more people and offers more protections" than the competing legislation. Noting that President Bush has indicated the bill will be "dead on arrival" if passed by Congress, the editorial says that a compromise may be reached with the Frist-Breaux-Jeffords bill. "A good compromise would be to lower the cap on punitive damage awards and establish limits on pain and suffering awards in the McCain bill," the editorial says. Regardless of any compromise, the "end product should be a bill of rights for patients, not for the HMOs" (Hartford Courant, 6/24).