White House Will Discuss Patients’ Bill

With the Senate nearing debate on a patients’ protection bill pushed by Democrats, White House officials are to meet with key lawmakers today in a last-minute bid to head off a potentially damaging political showdown on the health care issue.

The shift in tactics by the administration, which for months had declined to negotiate with sponsors of the bill, reflects how prospects for the measure have improved since Democrats took control of the Senate and made the so-called patients’ bill of rights their priority.

The bill would carve out new rights for members of health maintenance organizations and greatly expand patients’ ability to sue health insurance companies when there is a dispute over care.

In Europe on Wednesday, President Bush renewed his threat to veto the bill, saying it amounts to a boon to trial lawyers. But the White House also faces serious pressure to compromise, experts said, because it could be politically treacherous for Bush to block a measure that, at least in general terms, resonates deeply with the public.

“There are a lot of people out there who want to see a patients’ bill of rights,” said Marilyn Moon, a senior fellow at the nonpartisan Urban Institute in Washington. Bush could conclude that “this is not a fight worth taking to the bitter end,” she said.

The Senate is expected to begin debating the measure Monday, and today’s meeting at the White House is part of a flurry of activity this week by those hoping to undermine the bill’s newfound momentum.

Competing Measure From House GOP

House Republicans are rushing to draft a competing measure before the Senate acts. Meanwhile, the health insurance lobby is running advertisements in the Washington area that describe the measure as “bad for the economy, bad for working people--a bad idea.” The ads may appear in other markets as the Senate’s debate intensifies.

With Bush still in Europe, administration officials at today’s White House meeting will be Tommy G. Thompson, secretary of Health and Human Services; Elaine Chao, secretary of Labor; and Josh Bolten, deputy chief of staff for policy.

At least eight senators are expected to attend, including the bill’s three sponsors: Edward M. Kennedy (D-Mass.), John McCain (R-Ariz.) and John Edwards (D-N.C.). Others include Phil Gramm (R-Texas) and Don Nickles (R-Okla.), staunch opponents of the bill.

Democratic aides scoffed at the belated overtures from the White House. One called the meeting “politics by photo-op,” saying it was designed more to allow Bush to appear to be seeking compromise than to foster meaningful negotiation.

Jim Manley, Kennedy’s press secretary, said: “We’ve been waiting for more than 10 weeks now” to have discussions with the White House.

The bill was introduced in February.

But several senators planning to attend said they hope to make headway. “I don’t think [the White House] would have called [the meeting] if they didn’t think there was some room for progress,” McCain said.

There is already broad agreement on many provisions of the bill, including those to bolster patients’ ability to get emergency room care and to see certain specialists. There is even agreement that patients should be required to seek recourse with independent review panels before they are allowed to sue.

But there are deep divisions over how and where patients can bring suits against HMOs and how much money patients should be allowed to collect if they win. Disagreement over these issues has thwarted reform attempts for four years.

The Democratic-backed bill would allow lawsuits in federal and state courts, while Bush prefers to restrict suits to federal courts. The bill also would allow patients to collect unlimited economic and pain-and-suffering damages, as well as some punitive damages up to $5 million. A rival bill offered by Sens. John B. Breaux (D-La.) and Bill Frist (R-Tenn.), and backed by Bush, would prohibit punitive damages and cap damages for pain and suffering at $500,000.

Current law sets only minimal standards for many employer-provided health plans and all but shields those plans from paying damages in lawsuits for harmful medical decisions.

The Democratic bill gained momentum Wednesday when it picked up the endorsement of Rep. Charlie Norwood (R-Ga.), a dentist who helped write similar legislation that passed the House two years ago. Norwood had withheld his backing this year at Bush’s request and had spent the last few months in a futile effort to negotiate a compromise with the White House.

Debate Over Who Decides, Who Pays

Senate Democrats have said they believe they have the votes to pass their bill. But the odds are less certain in the Republican-controlled House. For his part, Bush reiterated Wednesday that he would like to sign a patients’ bill of rights but said that, because of the liability provisions of the Democratic measure, it “won’t become law.”

The bill’s supporters say exposing insurers to costly verdicts is the only way to force HMOs to base decisions on medicine rather than money. Opponents argue that the measure will drive up health care costs and push more Americans into the ranks of the uninsured.

A leading industry advocacy group, the Health Benefits Coalition, sought to drive home that point in the dozens of television, radio and newspaper ads that started running Sunday.

Such advertising campaigns have proved effective at eroding support for health care legislation in the past, most notably in the early 1990s, when ads featuring the fictional couple “Harry and Louise” helped derail President Clinton’s sweeping health care reform legislation.

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Times staff writer Edwin Chen contributed to this story.