Washington Post Examines President Bush’s Position on Patients’ Rights

The Washington Post on Monday looked at how President Bush's stance on patients' right to sue HMOs has evolved since he was the governor of Texas. Bush said during a 2000 presidential debate against Democratic candidate Al Gore that he would put in place a patients' bill of rights like the one in Texas, including a right to sue HMOs for wrongfully refusing to cover treatment. However, legislation to enact a national patients' bill of rights has stalled in Congress, and the Department of Justice under the Bush administration has asked the Supreme Court to block lawsuits against HMOs filed under the Texas law, saying that suits allowed under the legislation would "undermine" federal law. "The big story is the total flip-flop here," Gregg Bloche, a Georgetown University professor of law specializing in health care issues, said. However, White House spokesperson Trent Duffy says that there is no contradiction in Bush's position, noting that "The president continues to support Texas's law, which applies to actual health care treatment decisions," but "decisions of an HMO to deny coverage have always been covered by federal law." According to the Post, the Bush administration's current position on "a part of the president's Texas record that he had once unequivocally praised" is a "case study in the shifting politics of health care," in which voters "no longer place as high a value on suing HMOs as they do on other concerns, such as drug costs." A July 2000 Washington Post/Kaiser Family Foundation/Harvard University poll found that 15% of voters said that "protecting patients' rights in health plans" was the most important health care issue in determining their presidential vote. In contrast, a February 2004 survey by the Kaiser Family Foundation the showed that 6% of voters identified "insurance company concerns" as a top health issue for the government to address while 44% listed "costs" as a leading health concern. Health care analysts say that this shift comes in part because the issue of HMOs denying physician-recommended health care treatment has abated as the employment growth of the late 1990s increased employees' bargaining power and ability to demand more flexible coverage. State and federal legal developments have "also aided consumers," the Post reports (Lane, Washington Post, 3/5).