With the Senate poised to finally grapple with patients' bill of rights legislation today, President Bush on Wednesday urged the Democrat-controlled chamber to send him a bill he could sign this year.
"This issue is reaching an hour of decision, and before this year is out, I want to sign into law a patients' bill of rights," Bush said in a speech.
Bush reiterated his concern that the bill backed by Democratic leaders goes too far in encouraging costly litigation against health insurers.
But on Capitol Hill, Senate Majority Leader Tom Daschle (D-S.D.) said he believes that Bush's remarks signal potential progress.
"Obviously, many of the principles the president articulated today are exactly the principles incorporated in this legislation," Daschle said. "There is a lot of common ground here, and I think by restating his principles, we are again restating our belief that that common ground can produce a good result."
In another sign of possible movement toward compromise, House Republicans are expected to unveil a bill soon that in certain circumstances would allow patients to file suits against HMOs in state courts. Allowing such suits in state courts--rather than limiting them to federal courts, where damage awards would be capped--is a key point of contention in the debate.
House leadership aides stress that the GOP bill would allow state court suits only in cases in which HMOs have failed to abide by rulings of independent review panels. But in creating such an opening, House Republicans are moving away from a Senate GOP bill endorsed by Bush that would not allow any suits against HMOs in state courts.
Bush, calling patients' rights "an urgent issue," laid out the key elements that he would support--and those he would not.
He said the measure must ensure the right to emergency treatment at the nearest emergency room, the right to see a specialist and the right of a woman to see a gynecologist without going through a gatekeeper.
He added: "In any bill that receives my signature, patients will have the right to a fair and immediate review when medical care is denied. If a health care plan denies care, you should be able to appeal immediately to an independent, impartial review panel of medical doctors; and if they say you need the care, your health care plan must provide it--period."
Under such a "strong, independent review process," the president said, "most disagreements will not wind up in court."
Bush has threatened to veto the Democrat-backed Senate bill because it would allow HMOs to be sued in state courts. That provision, he has charged, would be a boon for trial lawyers while driving up health care costs.
On Wednesday, Bush praised as a "good bill" the GOP Senate alternative measure that would prohibit HMOs from being sued in state courts and would, while allowing unlimited economic damages in federal cases, cap pain-and-suffering damages at $500,000.
Bush also referred to unnamed "bad bills," which presumably included the Democrat-backed measure.
After delays caused by partisan skirmishes earlier this week, the Senate is expected to formally take up the patients' rights bill today, with votes on amendments expected to stretch through next week.
Daschle said he will push for a final vote on the measure before the Fourth of July recess. Otherwise, he said, the Senate would work through the holiday week.