|Author||Subject: Re: Oregon AFL-CIO files Washington DC Lawmakers near aggreement of Patients Bill of Rights|
|Webmaster|| Posted At 17:03:18 03/04/2000
Hot Off The Press
Lawmakers near agreement on some patients rights
By KAREN GULLO
The Associated Press
3/3/00 3:28 AM
WASHINGTON (AP) Looking for common ground in two competing patients' rights bills, House and Senate negotiators agreed on a provision that would allow pediatricians to serve as primary care doctors for children under their parents' health plans.
Tougher questions, such as whom that provision would apply to and should patients be able to sue health plans if care is denied, have yet to be worked out as members of a congressional committee begin forging a compromise between House and Senate passed bills designed to enhance patients' rights against HMOs.
"My effort right now is to go through some of the patient protections where we have a lot of similarities," said Sen. Don Nickles, R-Okla., the conference committee chairman. "Let's get some wins; let's get some things we agree on."
At the committee's inaugural meeting Thursday, Nickles said negotiators agreed to the pediatric care provision and were close to adopting a compromise on provisions that would let women see gynecologists without prior approval and allow patients to go the nearest hospital -- even if it's not in their plan -- for emergency room care and have it covered.
People covered by managed care plans complain that they must get approval from their primary care doctor to use even routine specialists. Another concern is that in an emergency some patients can't use the nearest hospital if it's not in their plan.
Working out differences on the thorny issues of lawsuits and applicability may not be as easy. The bipartisan House bill allows patients to sue and covers 161 million Americans with private insurance. The Senate bill, crafted by Republicans, prohibits lawsuits and applies to 55 million people whose health plans are exempt from state laws.
Democrats believe patients should be able to sue if health plans deny care to cut costs and patients suffer as a result. President Clinton, who supports the House bill, warned conferees Thursday that he would veto the compromise bill if it prohibits lawsuits.
"I will not sign legislation ... that is a patient's bill of rights in name only," Clinton said at a White House rally.
Sen. Edward M. Kennedy, D-Mass., told conferees that the House bill should be the benchmark against which to measure alternatives.
"I hope all members can agree to accept its major provisions," said Kennedy.
Republicans say lawsuits will drive up premiums and force employers to drop coverage. They're also against creating a federal law that would encompass plans that are regulated by states, arguing that state officials have a better understanding of what protections are needed.
Nickles said the Senate bill gives consumers a way to fight HMO decisions. The bill lets patients appeal care decisions to an external board and requires HMOs to provide the care if that's what the board decides or reimburse patients if they go to another provider for treatment.
"I think maybe the president and many members aren't aware of how far we are," said Nickles. "We don't have punitive damages. Maybe that's what he wants, but I hope we don't go for that.
Not all GOP lawmakers oppose patients' right to sue. Sen. Arlen Specter, R-Pa., who is not on the committee but co-authored a patients' rights bill in 1998, said Thursday that lawsuits are a "fundamental American right when there is a dispute between the parties and there are serious injuries."
And sixty-eight Republicans joined Democrats to pass the bipartisan House bill last fall.
The question now is, with Americans strongly in favor legislation establishing patients' rights, will re-election-minded lawmakers work out their differences, craft a compromise that Clinton won't veto and take a popular issue home to their districts.
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