House OKs GOP 'Patient Protection' Measure
WASHINGTON (AllPolitics, July 24) -- The House passed the Republicans' "patient protection" legislation Friday, after first defeating a White House-backed, Democratic alternative.
The managed-care bill cleared the floor on a 216-210 vote, bringing to an end an intense and largely partisan debate over health care reform in the House, at least for now. The Democratic "patients' bill of rights" legislation fell by the wayside earlier in the afternoon on a 217-212 vote.
"We have provisions so that more people will be covered by
health insurance," said House Speaker Newt Gingrich, who sponsored the GOP bill. "We have a proposal that says more patients have more rights by ... appealing directly to an independent council of medical professionals."
The GOP bill, which was introduced to the House just a week ago, was rushed through by the GOP leadership in response to what is perceived as widespread public concern over abuses by health maintenance organizations (HMOs).
But the Republican bill faces veto threat from the White House. The Office of Management and Budget (OMB) issued a statement Thursday saying the GOP bill "provides too few patient protections, and it contains unnecessary and irrelevant provisions that undermine the chances for bipartisan agreement."
"The president's senior advisers would recommend that he veto this bill if it were presented to him by the Congress," the OMB added.
Democratic lawmakers say that the bill will not provide adequate patient protections, stressing the need for direct access to specialists and the necessity of allowing patients to sue their HMOs.
Democratic Leader Richard Gephardt characterized the bill as a "fig leaf," saying that "it won't work to solve the real problems and concerns of the American people."
"The GOP bill ... has language in it that basically still allows the HMO's to define waht is mediacally nedessary despite going through a complicated appeals process," said Rep. Greg Ganske (R-Iowa), one of the Democratic bill's co-authors. "If at the end of the day the HMO is the one that defines what's medically necessary, then all those patient protections in there don't mean very much."
Republicans, for their part, have said that Democratic bill would have benefitted lawyers as much as patients, and would likely drive up the cost of health care plans.
"This is an issue of the trial lawyers seeking to enrich
themselves at the expense of everybody else in this country," said Gingrich.
Twenty moderate Republicans had appealed to Gingrich to make significant changes in the proposed legislation. The lawmakers, while praising Gingrich's action on the issue, want to add amendments that will bring the bill more in line with its Democratic counterpart.
The requested amendments would have added provisions which would allow patients access to information on the quality of care provided by a health care plan; a measure to ensure that health care providers cannot use financial incentives to deny care; an assurance of patient access to specialists; and a measure that would require plans to disclose patient appeals records to prospective clients.
The provisions of the current GOP "patient protection" act include the following:
- A guarantee that health plans will pay for any necessary emergency room procedures.
- A ban on restrictions that keep doctors from telling patients about expensive treatment options.
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Women would be able to see a gynecologist, obstetrician or pediatrician without prior doctor approval.
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Small businesses would be offered the same bargaining power as large corporations with health care providers.
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Tax-exempt medical savings accounts would be made a health care option for all workers.
Under the Republican plan, disputes between consumers and care providers would be settled by outside medical experts. Patients could be charged for the mediation, but if the provider did not comply with the reviewer's recommendation, patients would be allowed to sue the provider. The maximum fine that could be assessed through such a suit would be $250,000.
Democratic opponents have criticized the bill as benefitting mainly business owners and the wealthy. In particular, they have criticized the plan for failing to lift federal protections shielding some health care plans from patient lawsuits. Democrats argue the only way to ensure ethical practices and enforce patient protections with profit-motivated businesses is through the threat of high-cost lawsuits from unhappy consumers.
The defeated Democratic legislation contained many of the same provisions as the GOP plan but would also have made health plans pay for outside specialists when they are necessary, and would have allwed for out-of-court legal mediation, which would be overseen by the government.
Similar legislation is waiting in the Senate, which could begin debating managed-care legislation as early as next week.
While much of the debate over health care has been highly partisan, Sen. Robert Torricelli (D-N.J.) emphasized the fact the issue reaches beyond party lines.
"We are in the midst of a great debate in this country that some will characterize as simply a partisan squabble between the Democratic and Republican leadership in the United States Senate," Torricelli said. "Every American is invested with the need to understand that this fight is about them."
CNN's John King and The Associated Press contributed to this report.
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