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Congress Prepares For HMO Debate

Clinton lobbies for patients' bill of rights legislation

HMO debate

WASHINGTON (AllPolitics, July 15) -- As Congress moves toward its summer break, lawmakers from both parties are shaping dueling proposals on an issue that resonates with voters: regulating health maintenance organizations [HMOs].

Senate Republicans introduced their own patients' bill of rights legislation, on the heels of a plan introduced by the White House.

President Bill Clinton pressed for his proposed patients' rights legislation Wednesday, appearing at an American Medical Association roundtable discussion with people who had loved ones die while battling over the terms of their HMO coverage.

"We need progress, not partisanship," Clinton said, who called on Congress to approve "a strong and enforceable patients' bill of rights."

Clinton

The Senate Republican proposal, which was put in legislative form Wednesday and introduced to reporters, differs with the Democratic plan which would allow patients and doctors to sue the HMO for coverage and for mistakes made by the companies making the decisions.

The Republicans say they want a multistage process which would allow patients to go first to the company with an internal appeal and then outside the company to an independent arbiter.

Within the Republican plan, there are also health savings plans: pre-tax savings accounts allowing patients to pick whatever doctor they wanted because the money to pay for the care would already be set aside.

At a news conference, GOP senators promoted their proposal.

"First, it will protect patients' rights and hold health plans accountable," said Sen. Susan Collins (R-Maine). "Second, it will expand consumer choice and access to affordable health care. And third, it will improve health care quality and outcomes."

Santorum

Sen. Rick Santorum (R-Pa.) said with medical savings accounts, people would have full flexibility to choose their doctors.

"Right here is a provider, an HMO provider directory," Santorum said, holding up a directory. "If you have an HMO you've got to page through and see who's covered and who's not. If you have a medical savings account and basically take this thing and tear it right up. It's gone. You don't need it. You go to whatever doctor you want. You don't need to page through the yellow pages of provider directories to get a doctor that will see you. You see the doctor you want to see."

But Senate Minority Leader Tom Daschle ripped the GOP proposals as inadequate.

Daschle

"Why does their proposal exclude over 100 million Americans from its limited number of protections?" Daschle asked. "They're slicing this issue as thin as they can and hoping the American people don't see through their strategy. Why do they include a poison pill -- unlimited medical savings accounts that could make health insurance unaffordable for many Americans? Well, my guess is they really don't want legislation to pass this year."

Meanwhile, Senate Democrats held hearings Wednesday featuring still other people with horror stories about HMO care.

Dr. John Hankins told senators of a 50-year-old woman with breast cancer who had been hospitalized and diagnosed as terminal.

"We were asked to prematurely discharge the patient from the hospital," Dr. Hankins said. "The HMO's director's explanation, and this was a direct quote, I don't think I will ever forget it: 'We are not in the business of sympathy.' You can't say anything after that."

House Republicans also offered reporters a sneak preview of their HMO reform legislation due to be unveiled Thursday.

Boehner

House Republican Conference Chairman John Boehner (R-Ohio) declared the plan "will empower consumers, not empower lawyers."

Rep. Dennis Hastert (R-Ill.), chairman of the task force writing the legislation, said the bill is based on the principles that "people have access to health care, that that access is affordable, and it's accountable." He said doctors must give patients the best judgment from their education and experience.

Rep. Bill Thomas (R-Calif.) said, "If you examine the core areas you'll find great commonality between the president's commission proposal, the Democrat plan and the Republican plan."

He added the key difference between Republican and Democratic proposals is the Democratic plan allows patients to sue doctors and health care plans, and the Republican plan provides a review process which discourages legal action.

Lawmakers hope to complete action on some form of legislation before the August recess, as this the health care issue is expected to factor strongly into the 1998 elections.

CNN's Candy Crowley and Ann Curley contributed to this report.
In Other News

Wednesday, July 15, 1998

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Congress Prepares For HMO Debate
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Larry King Live Transcript: Should Secret Service Agents Have To Testify?


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