Unlikely Leaders Face Off Over Patients' Rights


Each, in his own right, could have found himself an easy target for abuse in the Senate's debate on the patients' bill of rights legislation.

Sen. John Edwards (D-N.C.), after all, made his fortune as a trial lawyer, in some instances winning tens of millions of dollars for clients in medical malpractice cases. Sen. Bill Frist (R-Tenn.), on the other hand, is a surgeon whose family started what has become the world's largest hospital conglomerate, an enterprise in which Frist owns millions of dollars' worth of stock.

But instead of standing in the back while the political battle raged over the health care measure, Frist and Edwards were front and center. And on a subject that attracted many of the Senate's big names, the two relative newcomers have emerged as go-to guys for their respective parties.

In doing so, each managed a neat trick for any politician: converting his background from a potential liability into an asset. And in the process, they've improved their prospects as party leaders, which in Edwards' case includes speculation about a White House run in 2004.

In the last several weeks, though, their focus was on the often mundane task of shepherding legislation to a vote.

Edwards joined Sens. Edward M. Kennedy (D-Mass.) and John McCain (R-Ariz.) in sponsoring the version of the bill that passed the Senate on Friday. He also served as the bill's spokesman, making frequent trips to the Senate press gallery to brief reporters and offer what proved to be accurate predictions of how his side would fare on key amendment votes.

Frist, along with Sens. John B. Breaux (D-La.) and James M. Jeffords (I-Vt.), offered a competing measure that was backed by President Bush. Frist also helped lead the effort to derail the Edwards-Kennedy-McCain bill, which Bush has vowed to veto if the House agrees to it and the measure reaches his desk.

The bill calls for new protections for those Americans covered by health plans, including guaranteed access to specialists and emergency care. While Frist and Edwards believe those rights should be extended, they differ sharply on what recourse should be available to a patient who has been denied care.

Frist, who has performed more than 200 transplant operations, sought to confine suits against HMOs to federal court and impose a $500,000 cap on allowable pain-and-suffering damages. Edwards and his allies successfully argued that such suits should be allowed in state courts--where jury trials could be requested--and that no limit be placed on pain-and-suffering damages.

Asked about the gap, Frist quipped that that's what you get when you have one bill written by a lawyer and one written by a doctor.

It is a difference in the details that points to a wider gulf in political philosophies and personal styles. Which is not to say the two men from neighboring Southern states are without similarities.

Both are multimillionaires who came to politics late after remarkably successful careers in their chosen professions. Neither was very engaged in the political arena before running for the Senate--with Edwards voting only about half the time and Frist not voting until he was 36. They both speak with soft Southern accents, are tall, lean, well-dressed and famously hard-working. They are avid athletes who run marathons. They both touted the fact that they weren't "career politicians" in their Senate victories over incumbents.

But in many matters, both superficial and serious, the 48-year-old Edwards and the 49-year-old Frist diverge.

Edwards is rarely mentioned without the term "boyish" attached. He has long-for-the-Senate hair, with bangs that stay just out of his eyes. He is known for having a constant, easy smile on his face--the same demeanor that made him a legend in front of North Carolina juries.

Frist's most common expression is a furrowed brow. While a surgeon, he also found time to write books and become a licensed pilot. In the Senate, he has continued to do volunteer medical work, often in poor communities in the Capitol's shadow.

"He doesn't have the light touch of some doctors. He comes across like the surgeon that he is," said Stuart Rothenberg, an independent analyst of congressional campaigns. "But I think the fact that he is a doctor is a humongous credential when it comes to the health care debate."

As for Edwards, whom he calls "one of the best candidates I've ever seen," Rothenberg said the "trial lawyer" pejorative has just never stuck.

"I don't think the Democrats went out and said: 'Let's get a trial lawyer for our spokesman,' " said Rothenberg. "But I think that criticism falls apart when you look at what Edwards did as a lawyer. He wasn't an ambulance chaser. He defended little kids and old people who had been horribly hurt by negligent companies."

The first-term senator from North Carolina is already a regular on the Sunday morning talk shows, and has been even more in demand since the patients' bill came to the floor. The measure, which Republicans hadn't planned to take up until later this year, was the Democrats' priority after taking over the Senate reins when Jeffords defected from the GOP in early June. If Republicans had kept control of the Senate, it would have been Frist's bill debated and voted on instead of Edwards'.

In either instance, it is legislation crafted by men long committed to the issue of patients' care, albeit from different perspectives.

Edwards, an unpopular figure among doctors in his own state, made his mark earning millions of dollars in judgments against doctors and hospitals responsible for mistakes that left patients with devastating injuries. He says his strong opposition to caps on damages stems from his knowledge of the high cost of long-term care.

"I would be the first to admit that I see this through the eyes of the patients and not the doctors," he said. "But it is important to note that our bill sees lawsuits only as a last resort. We're trying to set up a series of checks and balances that get patients the care they need without resorting to the courts."

Frist, the Senate's only physician, also talked passionately about patients he has seen and the need to have doctors, not managed care bureaucrats, make medical decisions. Despite his medical credentials, Frist's involvement in health care issues had sparked criticism by some Democrats who charge that his strong ties to Columbia/HCA, the hospital company started by his father and now run by his brother, creates a conflict of interest.


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