PARTISAN PASSING

July 14, 1999
		A very partisan debate continues over a patients' rights bill in the Senate. Tom Bearden reports. The Health Unit is a partnership with the Henry J. Kaiser Family Foundation.

A Health Spotlight Report: Patients' Bill of Rights July 13, 1999: Should patient's be able to sue HMO's? July 8, 1999: An Alzheimer's vaccine? Remaking Medicare June 24, 1999: Should doctors unionize? June 7, 1999: Mental Health Conference July 20, 1998: Three patients' rights bills. July 1998: Forum: Should the government manage care? July 9, 1998: Debating managed care The NewsHour's Health Spotlight. Browse the NewsHour's coverage of Health   Health Insurance Association of America Texas Medical Association The Democrats' 'Patients' Bill of Rights Families USA The Business Roundtable	TOM BEARDEN: This morning Maine Republican Olympia Snowe introduced an amendment with provisions most members of the United States Senate probably would agree with. SEN. OLYMPIA SNOWE: Mr. President, I rise today to introduce an amendment to the patients bill of rights that will ensure that appropriate medical care, and not a bureaucrat's bottom line will dictate how long a woman stays in the hospital after undergoing a mastectomy. TOM BEARDEN: The amendment would give women enrolled in managed care plans confidence that breast cancer treatment decisions would be made by medical professionals, and not by managed care accountants. SEN. OLYMPIA SNOWE: The last question a woman should have to worry about at a time like this is whether or not their health insurance plan will pay for appropriate care after a mastectomy. A woman diagnosed with breast cancer in many ways already feels as though she has lost control of her life. She should not feel as though she has also lost control of her own treatment. Yet in many instances, because of the decisions made by accountants and insurance actuaries, none of whom have ever witnessed such an operation, let alone go to medical school, that same woman cannot afford to follow her doctor's advice. TOM BEARDEN: Washington State Democrat Patty Murray stood to say the amendment was well intended and, in fact, was very similar to an amendment proposed by Virginia Democrat Charles Robb that Republicans defeated just last night. SEN. PATTY MURRAY: We would have been delighted to work with our colleagues if they wanted to talk to us about a word or two that they were concerned about. We were not given that opportunity. The amendment was simply defeated.
	Frustrated Democrats
	TOM BEARDEN: What frustrated Democrats even further was the fact that Senator Snowe's amendment, if approved, would knock out an amendment by Connecticut Democrat Chris Dodd. That would require managed care plans provide coverage for patients involved in clinical trials. SEN. CHRISTOPHER DODD: It sounds to me like what the Senator of Maine has offered is something that I could certainly agree with. I would add it to my amendment. There's no reason why we ought to ask people to make a choice between a proposal dealing with breast cancer and a proposal that deals with clinical trials and prescription drugs. And so I would make a request that this be added to the clinical trials amendment so we can achieve the goals of both dealing with the clinical trial issue and the issue the Senator from Maine has raised. SEN. HARRY REID: But I understand you're saying, why don't we take that, which is in keeping with the Senator from Maine's amendment today, and agree that we should do that. Is that what you're saying? SEN. CHRISTOPHER DODD: I'd take the Senator from Maine's amendment. I'd take her amendment. SEN. HARRY REID: But they're both basically the same. SEN. CHRISTOPHER DODD: Basically the same. We all agree on the clinical trials. Put them together, and in two minutes we move on to the next issue around here. TOM BEARDEN: But Vermont Republican Jim Jeffords objected. SEN. JIM JEFFORDS: I want to explain where we are right now. This monstrosity or whatever you want to call it, the procedure which was set up by the leaders in negotiating back and forth leads us into these kind of situations. We're trying to end up with the best bill on the Republican side, and we are intending to do that. What we are doing now is taking care of the issue raised with respect to women's health and mastectomies. We have a good provision; it's recognized by the other side as a fine position. Everybody ought to adopt it. Well, we hope you do. And I would hope that we get 100 votes on this amendment. We are going to take up, and the other side will have an opportunity to reinstitute clinical trials at some point, but that's just the process as it's been set up. TOM BEARDEN: The partisan split over the patients' bill of rights was reflected in a series of votes the Senate took yesterday evening and last night. A Democratic proposal in which health plans would be required to pay for treatment doctors say is medically necessary was defeated. A Democrat proposal giving patients access to the nearest emergency room, whether or not it was in their health plan's network, was defeated. The two sides said they agreed on the basic idea, but disagreed over what kind of care should be covered once a patient has been stabilized in the ER. SEN. BOB GRAHAM: Medicare and Medicaid beneficiaries get the benefit of post-stabilization care. Our amendment would make that benefit available to all 190 million non-Medicare and Medicaid Americans. The Republican bill would not. It does not say that you're entitled to medically necessary services to continue you in a stabilized condition after you had contacted your HMO and received authorization to do so. SEN. TIM HUTCHINSON: The Graham amendment is flawed, and it is seriously flawed, because it uses language that is confusing for patients, confusing for plans and providers; it's vague and ambiguous, and it does not ensure that post- stabilization services are related to the emergency condition.
	Republican amendments pass
	TOM BEARDEN: And a Democrat proposal to extend the provisions of the patients bill of rights to cover all 161 million managed care plan enrollees was defeated. None of the Democratic amendments ever attracted more than three Republican votes. Meanwhile, Republicans were able to pass an amendment limiting the reach of the patient bill of rights to the 48 million people in self-insured plans; pass an amendment that would cancel the provisions of the patients' rights bill if it raised annual health care costs by 1 percent or more; and pass tax deductions for the self-employed who buy their own health insurance. SEN. RICHARD DURBIN: Yesterday was banner day for the insurance industry on the floor of the United States Senate. Three different amendments were considered, amendments which the insurance industry of America opposed. They may be dancing in the boardrooms and the canyons of K Street, but I can tell you that the people of America understand this debate, and they know that they lost on the floor of the United States Senate yesterday. SEN. LARRY CRAIG: While Republicans are talking about giving all Americans access to health care insurance, and letting them control their medical health care, our Democrat friends are talking about driving up costs, canceling health care coverage for millions of Americans, and putting American health care under the control of more federal government. TOM BEARDEN: And the partisan split was evident again today during the debate over breast cancer treatment and clinical trials. SEN. BARBARA BOXER: So here we have the Snowe amendment, which takes a giant step forward in the treatment of women with mastectomies, but at the same time, strikes the opportunity for women to get into clinical trials to get the drugs that they need that are necessary to give them their health. This is a sad day. And what's the response from the Senator from Maine? Gee, I'm sorry about this. It's parliamentary. I am very sad. I have never seen the Senate be as partisan as it is on this issue. This is a sad, sad day. SEN. PHIL GRAMM: With all of these cries of partisanship, not one Democrat voted for any amendment offered by any Republican yesterday or Monday. Now, I don't understand bipartisanship as existing when Republicans vote to let the government take over the health care system and to bring lawyers into the system rather than doctors, but it is not bipartisan, it is somehow not bipartisan when Democrats refuse to vote for our proposals. I mean, you can't have it both ways. TOM BEARDEN: The amendment by Senator Snowe to improve access to breast cancer treatment eventually was put to a vote, and like the earlier votes, the amendment passed with all Republicans voting in favor, and all Democrats voting against. The Dodd amendment on clinical trials was thereby eliminated.