White House review of patient bill of rights must be expedited, but President needs chance

By U.S. Rep. Charlie Norwood, DDS (R-GA)
March 1, 2001



Five years.

The current fight to enact a real patient bill of rights has been waged in full since the Family Health Care Fairness Act, HR 2400, was introduced in September 1995.

Its successor, the Patient Access to Responsible Care Act (PARCA), HR 1415, gained more than enough support to pass the House in 1998, but was never allowed a vote in any committee or on the floor of the House or Senate.

Last session’s version, the Norwood-Dingell Bipartisan Consensus Managed Care Improvement Act, HR 2723, passed the House by an overwhelming 275‑151 margin, but died in conference with a Senate bill that would have stripped away even the limited patient protections won through the courts in recent years.

Each of those bills dating back to 1995 have a striking similarity. They would all do the same thing. Patients would once again have the uncontestable right to seek damages in court if they suffered injury or death from wrongful decisions by managed care plans. All Americans would have a basic floor of quality standards in their health plan, regardless of where they lived, or what type policy they held. Emergency care standards, the right to choose a provider, continuity of care, access to specialists, and most important, the right to an independent, legally binding medical review process to settle disputes before injury occurs from denied care.

Each successive bill has gone further than its predecessor in adding clarifications to avoid unnecessary health premium increases, frivolous lawsuits, or discouragements to employers who offer health benefits. But the essence of each bill has remained the same, and the patient protection standards have never been watered down in the slightest.

Now we have a new President who has pledged to pass a real patients rights bill, coupled with a substantial House and Senate majority who would vote for one.

We have the latest successor bill in place, the Bipartisan Patient Protection Act of 2001, S.283. This is the legislation I helped develop beginning last August, with the original Norwood-Dingell bill as the foundation. It has been introduced in the Senate by John McCain (R-AZ), John Edwards (D-NC), Lincoln Chafee (R-RI), Bob Graham (D-FL), Arlen Specter (R-PA), and Ted Kennedy (D-MA).

I fully support this legislation. Like our previous proposals, it provides the same full-strength patient protections and legal accountability, simply with more assurances to the business community that it will not negatively impact their ability to continue offering health plans to their employees. The bill is ready to pass right now, with no amendments, in both houses, and by overwhelming numbers.

The best possible scenario for enacting this legislation is for the new Bush Administration to endorse the bill up front, and urge Congress to approve the measure as quickly as possible. It is of course not absolutely necessary for final victory, but it could mean the difference between signing the bill into law by Easter, versus fighting a protracted parliamentary battle with still-reluctant Senate leaders.

However, President Bush has had absolutely no opportunity to participate in the development of any provision of this legislation, nor even adequate time for review of the bill. For this reason, we should grant this new President at least the opportunity to weigh in on the issue within the next several weeks, before pushing for floor action. The last thing we need is to confront delaying actions in the House and Senate that could have been avoided through strong White House advance support.

That White House review must be expeditious and thorough, with clearly defined recommendations for revisions, amendments, or clarifications, if the President feels those to be necessary.

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If review cannot be conducted, Congress must move forward with McCain bill as quickly as possible. A few weeks are well worth the political expenditure; a few months’ delay is not.

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If this type of review cannot be conducted, then Congress must move forward with the existing McCain proposal as quickly as possible. A few weeks of consideration are well worth the political expenditure; a few months delay is not.

When all is said and done, there is very little of substance that can be changed in the McCain bill, while still maintaining bipartisan support. Patients must be able to sue managed care plans for injury from denied care, with no legal hurdles that can deter their case on technicalities. They must be able to receive damage awards that fully compensate the severity of their injury, not awards arbitrarily capped in favor of HMOs.

How that legal procedure is administered, in which courts can be discussed within reason, but not the fact that patients must be able to hold health plans accountable.

The patient protection standards should apply to everyone with health insurance. Whether they are enforced at the state or federal level, or whether a state or federal statute should apply in a particular case, is certainly open for negotiation. But whether the patient should have the protection is off the table. Health care tax cuts, incentives for individuals or businesses to purchase new or better health coverage, ways to hold down premium costs–all these things can be examined by the new Administration, and Congress should make every effort to include those items of great importance to Mr. Bush.

But there is already one agreement between reformers and our new President that should raise the fighting spirit of everyone who has engaged in this war to reform our managed care system: we need not just a bill, but a law on the books, this spring.

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Dentist Charlie Norwood, a veteran House Republican from Georgia, appears to be walking a tightrope this year in promoting a patient bill of rights while simultaneously avoiding a conflict with the new Administration.

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