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a NewsHour with Jim Lehrer Transcript
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A BILL OF HEALTH?

July 16, 1999
Patients Rights

 

Following a week of partisan debate, Senate Republicans have passed a bill they say will expand patients' rights. Following a report by Kwame Holman on the debate, Elizabeth Farnsworth leads a discussion with health care providers.

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NewsHour Links

A Health Spotlight Report: Patients' Bill of Rights

July 15, 1999:
Senate votes against HMO suits.

July 14, 1999:
A partisan debate.

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

 

Outside Links

Health Insurance Association of America

Texas Medical Association

The Democrats' 'Patients' Bill of Rights

The Republican Patients' Bill of Rights Plus

Families USA

American Association Of Health Plans

The Business Roundtable

 

ELIZABETH FARNSWORTH: Kwame Holman begins our coverage of the patients rights debate.

KWAME HOLMAN: As last night's final vote on the Patients' Bill of Rights approached, weary Senate Democrats knew they would fail to stop the Republicans' version of the measure. In a week-long, often contentious debate over whether and how to regulate managed care plans, they had failed to pass even a single Democratic amendment. And though two Republicans joined all Democrats to oppose the final bill, the Republican majority prevailed.

SPOKESMAN: The votes are 53 ayes, the no's are 47. The bill is amended.

KWAME HOLMAN: Minority Leader Tom Daschle derided the Republican plan.

SEN. TOM DASCHLE (D-SD): What I believe the Republican bill truly stands for when it calls itself HMO reform, HMO stands in my view, for "Half Measures Only." That's all we've gotten are half measures. And to those who say well, isn't this a little bit better? My answer is no. In all sincerity, I believe we've actually lowered the standard when we passed this bill tonight -- lowered the standard. We haven't made progress, we've moved back from progress. The President will veto this bill because he and we know we can do better than this; that we shouldn't move down the quotient. We shouldn't lower the standard. We should do far more in ensuring that we cover all patients, all 160 million. Ultimately, I believe, as Senator Kennedy noted, we will pass a comprehensive Patients' Bill of Rights.

 
Debate remains far from over

KWAME HOLMAN: Majority Leader Trent Lott agreed the issue is far from decided; he called on both parties to work together as the debate moves to the House of Representatives, and not to let HMO reform simply become a campaign issue.

SEN. TRENT LOTT (R-MS): To the President and to those of you that haven't supported the Republican position on this Patients' Bill of Rights, please, work with us. You want to get something done, let's make it happen . If you want an issue, you've got enough votes. You'll have some issues, and so will we. And then what? Is America going to be better off? No. Let's get results. We've done that in the past on other issues related to health. And so I challenge our Democratic friends to join us in this effort.

KWAME HOLMAN: The Senate Republican plan would create a process under which people in employer-sponsored health plans could appeal medical decisions made by their managed care companies.

SEN. BILL FRIST (R-TN): We've heard a lot of people say it's not independent. It's pretty independent if you have got a managed care company and you have an entity that's government regulated here, that is unbiased, the words are actually in the plan, appointing an independent reviewer who is a doctor.

KWAME HOLMAN: But Democrat John Edwards of North Carolina said the Republicans' right to appeal essentially is hollow.

SEN. JOHN EDWARDS (D-NC): The lawyers will write the plans, and under every single thing that we have passed during the course of this week, the plan controls, the insurance company controls. And if you think for a minute that the lawyers who are hired by the insurance companies are not going to write the plans in a way that protects the plan and the HMO's and never protects the patient, you are living in Never-Never Land.

 
The Republican plan  

KWAME HOLMAN: Other main features of the Republican plan include increasing patient access to emergency room treatment, including ER's outside a plan's network; guaranteeing timely access to specialists within a plan's network, including obstetricians and gynecologists; letting HMO's retain final say on what treatments are medically necessary; and guaranteeing coverage of overnight hospitalization after mastectomies. But Democrats complained too many of the bill's provisions do not apply to all of the more than 160 million people enrolled in health insurance plans, and fails to give unhappy patients the right to sue their health plans for punitive damages. California's Barbara Boxer.

SEN. BARBARA BOXER (D-CA): It's a bill supported by the insurance industry, it's a bill supported by the HMO's, and here's what it leaves out: The right to a clinical trial for every fatal disease, the right for all Americans to be covered; 70 percent of Americans are not covered in the Republican bill. It leaves out the right to hold HMO's accountable, if they kill you, if they maim you, if they hurt you or your family.

KWAME HOLMAN: But New Mexico Republican Pete Domenici said the states can address many of those concerns.

SEN. PETE DOMENICI (R-NM): From that side of the aisle they don't trust the states. Even if the states have protection by way of a bill of rights, they want to take over nationally; 42 American states have protections for some or all of the very same things that are in the Democrat bill.

KWAME HOLMAN: The next stop for HMO reform is the House of Representatives, where GOP leaders say they plan to take up a bill before the August Congressional recess.


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