Bush Tells of Goals in Patients’ Rights Bill

President Bush offered a list Wednesday of what he could support in a patients’ “bill of rights” while declaring that he could not back a bipartisan bill introduced in Congress earlier this week.

In letters to Republican and Democratic leaders on Capitol Hill, Bush said his goal is to win support for legislation that ensures “doctors are allowed to make medical decisions.”

On the divisive issue of increased liability for health plans, Bush said his chief concern is that any new law does not invite frivolous lawsuits. “Expensive litigation and the resulting rise in health care costs would only make it more difficult for Americans to afford health care coverage in the first place,” Bush wrote.

Still, he indicated he could support a bill that adds some level of liability, as long as damages are capped.

The issue of increasing the rights of patients in disputes with health care plans has been debated on Capitol Hill for four years.

The bipartisan bill unveiled this week includes a significant increase in liability for health plans and would put employers at risk of lawsuits in some cases.

The measure’s backers include Sens. John McCain (R-Ariz.) and Edward M. Kennedy (D-Mass.) and Reps. Greg Ganske (R-Iowa) and John D. Dingell (D-Mich.).

But White House officials earlier this week persuaded Rep. Charlie Norwood of Georgia, in the past the chief House GOP advocate of expanding patients’ rights, to step back from full-fledged support of the new bill. The administration’s intervention demonstrated Bush’s hope to exert control over his party in the patients’ rights debate.

Bush, in his Wednesday letter, said he is mindful of employers’ desire to avoid being targets of lawsuits. “Employers, many of whom are struggling to offer health coverage to their employees, should be shielded” from lawsuits, he said.

Bush endorsed the idea of extending a number of basic guarantees to all patients, such as access to emergency rooms, direct access to obstetrician-gynecologists and to approved clinical trials--a position backed by Democrats and House Republicans.

Most important, perhaps, Bush backed the right to an enforceable independent review of health plan decisions. He said such reviews should be swift and be conducted by doctors with no connection to the health plan.

Bush also said he wants patients to exhaust the appeal process before they go to court. “Slow and costly litigation should be a last resort,” he said.

Leading Democrats avoided commenting on Bush’s differences with them on liability issues and instead said they welcomed his commitment to a solution. “It is long past time to end the abuses by HMOs and managed health care plans,” said Kennedy. “I am hopeful that we can achieve a constructive bipartisan compromise on our remaining differences.”

Bush’s statement received modulated praise from managed health care companies, who said they hoped that it would stop the passage of legislation that would vastly increase their liability in state and federal courts.

“The president’s letters and his principles indicate we’re at the beginning of this process and there will be other alternatives offered in the political middle,” said Karen Ignagni, president of the American Assn. of Health Plans, which represents managed care plans.

Employer groups were more cautious, saying that they are concerned that Bush is willing to entertain any increase in liability.

“I think the employer community is disappointed that the administration would have endorsed any expansion of liability,” said Paul Zurawski, legislative counsel to the Business Roundtable, which represents some of the nation’s largest businesses.