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Senate Democrats, GOP square off on patients' rights
July 12, 1999 WASHINGTON (July 12) -- After a year of talk about the issue, senators began floor debate Monday on health care legislation. Democrats and Republicans both have bills they call a "patients' bill of rights," but major differences separate the two and each side has political goals it hopes to achieve. 
Republicans, due to their 55-45 majority, are likely to pass the bill they prefer -- one that is more limited than the Democrats' plan but still offers patients some new powers in dealing with their health maintenance organizations (HMO) and other managed care plans. The GOP leadership arranged for the Democratic bill to be the starting point for this week's debate. This approach allows Republicans to talk about what they dislike about the Democrats' approach, while making it more difficult for Democrats to criticize the GOP proposal. But Senate Minority Leader Tom Daschle of South Dakota introduced the Republican version of the bill as a substitute to the Democratic bill in a move that, if approved by the chamber, would allow the Republican bill to be amended.
Daschle said Senate Majority Leader Trent Lott has been candid about his plans to substitute an unamended Republican bill for the Democratic bill when the debate ends on Thursday. But by offering the Republican plan as the Democrats' first amendment, Daschle said the Republican plan can be amended. "Both are subject to amendments, both are subject to consideration, both are subject to the debate that we had anticipated when we had reached this agreement," he said. Democrats plan to offer as many as 20 amendments -- each targeting a different piece of the legislation -- that they hope will force GOP senators to support their plan or risk looking like they don't want to protect patients. Both parties held dueling rallies on Monday on the issue. Democrats brought out patients to talk about about their negative experience with HMOs, while Republicans featured small business owners who said the Democratic bill would put them out of business. Lobbying organizations also have focused the issue. The insurance industry has been running advertising campaigns against both proposals while the American Medical Association has launched a lobbying campaign on behalf of the Democrats' bill. The Health Benefits Coalition, a group of business and insurance groups that oppose new laws, set up a headquarters of sorts at nearby lobbyists' offices, complete with a phone bank and set of television sets to monitor debate. Democrats set up a headquarters named the Intensive Communications Unit, or ICU, where senators could do radio and TV interviews with hometown stations. The proposals from both sides address some common complaints about HMOs by expanding access to specialists and allowing patients to appeal when an HMO denies treatment. But there are also significant differences. For one, the Democrats' bill covers the more than 150 million Americans in managed care. The Republicans' would primarily cover the 48 million currently in employee-funded health plans. The Democrats also would allow patients to sue HMOs for punitive damages when denied treatment. Republicans would resolve such disputes through outside arbitration. Republicans say the Democratic bill is too expensive and will force employers to drop health insurance coverage. Sen. Bill Frist (R-Tennessee), a doctor by profession, said the Democratic plan could drive some insured workers into the ranks of the uninsured: "Let's not go so far and too far in all the anger against managed care that it drives up the ranks of uninsured."
Sen. Phil Gramm compared the Democratic bill to the failed 1993 health care plan offered by President Bill Clinton, noting that "this is not the first time Bill Clinton and Ted Kennedy have wanted to rewrite health care system of this country." "The bill before us is step one toward government running the health care system so that when my momma needs to go see a doctor, she first has to talk to a government bureaucrat," the Texas Republican said. "We defeated that in 1993 and we're going to defeat it this week in the United States Senate." Daschle says the Democratic bill would add costs of only about $2 per-covered party, per-month, citing estimates by the Congressional Budget Office (CBO). The CBO estimates the Democratic measure would increase premiums by about 4.8 percent -- actually would cost about $9 per month for an individual plan and $22 per month for a family plan -- but Democrats assume employers will pick up a large portion of the cost. "The Republican program is the profit-protection program for the insurance industry It's a bill of goods, it's a bill of wrongs," said Sen. Ted Kennedy (D-Massachusetts), the main sponsor of the Democratic package. "Ours is a patients' bill of rights." Vice President Al Gore said Monday on CNN's "Early Edition" that the Republican plan doesn't give patients the ability to see the specialist of their own choosing or the right to emergency care.
"It's not a real patients' bill of rights. They've tried to steal the name but they haven't incorporated the ideas that make up the real health care patient's bill of rights," said Gore. Gore also countered the argument that the Democratic bill is too expensive, saying less than adequate health care drives up business costs because employees don't get treatment they need, leading to more absenteeism and lost work hours. Republicans also say higher costs will result from any new lawsuits allowed under the Democrats' proposal. "I simply do not believe that you can sue your way to quality health care," said Sen. Susan Collins (R-Maine). Democrats also want to force health insurance companies to cover care that doctors believe is "medically necessary." Republicans would allow insurers to make those decisions. Gore said the Democratic proposal gives "justice" to Americans. "By providing rights to American citizens to appeal the decision by an HMO, that's not costing taxpayers money, that's giving you justice," he said. The debate is as much about politics as patients. Democrats and their allies say they're in a win-win situation. "Republicans have to decide: Do we create an issue in 2000 or do we provide what people want: real patient protection," said Ron Pollack of the lobbying organization Families USA. CNN's Jonathan Karl and The Associated Press contributed to this report. |
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MORE STORIES:Monday, July 12, 1999
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