Clinton Puts the Focus on Patients’ Protections

Scrambling to salvage a White House proposal to expand protection of managed care participants, President Clinton on Saturday assailed the Republican Congress for pushing legislation that would limit patients’ ability to sue health insurers.

Clinton devoted his weekly radio address, delivered during a celebrity-studded weekend retreat in New York’s tony Hamptons, to the dim prospects for congressional passage of a comprehensive “bill of rights” for the 160 million Americans enrolled in managed care health plans.

Legislation favored by Republican leaders represents an “empty promise,” Clinton said, because it would exclude many health insurance plans, restrict access to specialists and narrow the rights of patients to appeal coverage decisions by health maintenance organizations and collect damages.

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“It simply will not protect the American public or ensure the quality health care they deserve,” said Clinton, who made his remarks at a fire station in the Long Island community of Amagansett. “Now Congress should rise to its responsibilities and guarantee a patients’ bill of rights, and they should reject proposals that are more loophole than law.”

Hoping to pressure Congress to act, Clinton said his administration will continue to expand protection unilaterally for federal employees who participate in managed care plans. He announced that the Defense Department has issued a directive implementing a “bill of rights” for its 8.3 million beneficiaries--members of the military, civilian employees and their families.

Clinton’s remarks came as Congress appeared increasingly likely to adjourn for the year without enacting the kind of sweeping legislation the White House contends is needed to balance the scales between individual consumers and the huge HMOs that provide medical care for most Americans.

Although polls show that managed care regulation is a potentially potent election-year issue, Congress has only a few weeks left in which to act, and lawmakers appear deeply divided over the proper course to take.

Sen. Susan Collins (R-Maine), who delivered the Republican response to Clinton’s address, said the GOP approach would expand protection of managed care patients without opening the door to costly lawsuits that could cause health care expenses to rise and leave some consumers without coverage. Under the Republican measure advocated by Collins and other GOP senators, disputed coverage decisions would be reviewed by independent physicians.

“Our plan differs from the Democrats’ bill in a fundamental respect: It places treatment decisions in the hands of doctors, not lawyers,” Collins said.

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The competing bills under consideration by Congress all seek to expand the rights of managed care patients, but they differ in scope and specifics.

One of the biggest flash points involves the financial liability of HMOs. The broad legislation favored by Clinton and his allies would allow patients to sue and collect large damage awards if a health maintenance organization’s denial of coverage led to serious harm or death. Under existing law, damage awards are limited to the cost of the denied service or procedure, and not to its consequences.

A GOP-sponsored bill recently approved by the House, for example, does not apply to Americans who buy individual health plans. A competing Senate bill covers employers who “self-insure,” but not those who purchase coverage from insurance companies.

Clinton has threatened to veto the House bill, and has criticized the pending Senate measure.

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Clinton’s broadside was delivered as the president and his wife, Hillary Rodham Clinton, spent a second day relaxing far from the scandal-obsessed environs of Washington.

Later Saturday, Clinton was the featured guest at two Democratic fund-raising events. The first was a $5,000-per-guest cocktail party at the East Hampton home of conductor Jonathan Sheffer.

The second fund-raiser, held at the $1.7-million farmhouse of actors Alec Baldwin and Kim Basinger, attracted more than 1,000 people who paid a minimum of $5,000 apiece to dine on cold corn soup, duck and lobster salads, shrimp and smoked salmon, or as much as $1,000 each for a seat on the lawn.

Times Staff Writer Alissa J. Rubin in Washington contributed to this report.