This is not  specifically on PD, but it affects all of us anyway. The
following from Families USA - a consumer health advocacy organization and
gives an interesting perspective on  the just passed House version of the
Patient's Bill of Rights.

--------- Forwarded message ----------
From: [log in to unmask]
To: Undisclosed-recipients:;
Date: Fri, 3 Aug 2001 15:14:46 -0400 (EDT)
Subject: From_Families_USA: Patients' Bill of Rights Update
Message-ID: <[log in to unmask]>

Friends

This memo reports on what happened on patients' rights in the House of
Representatives last night. The short version is this: The bill the House
passed was essentially the bill passed by the Senate in June. It has
virtually all of the patient protections for which we've been fighting
for years EXCEPT that there were amendments added that undercut the
provisions to hold health plans accountable and that essentially
eliminate a meaningful right to sue (and may make this aspect of patient
protections worse than it is now).

BACKGROUND: In June, the Senate passed a very strong bipartisan patient's
rights bill. Our consumer-provider coalition strongly supported the
Senate bill. However, President Bush argued vehemently against it (mainly
the right-to-sue provisions) and clearly and repeatedly threatened to
veto the bill.

As the action shifted to the House of Representatives, our chief allies
were Reps. Charlie Norwood (R-GA), Greg Ganske (R-IA), and John Dingell
(D-MI), who had championed the excellent bill passed in 1999 with the
support of 68 Republicans. They decided to adopt the Senate-passed bill
(with minor changes), and we thought we had a solid chance at passing it.
However, the Republican leadership pushed an alternative bill put forward
by Rep. Ernie Fletcher (R-KY), which was weaker in all aspects (not just
the right-to-sue). A vote was scheduled, but the Republican leadership
had to delay because the Norwood-Ganske-Dingell forces had the votes to
win.

The Administration saw controlling the Republican majority in the House
as a major test of their strength, and they were concerned about Bush's
prominent veto threat. On the one hand, they didn't want to veto a
popular patients' rights bill; on the other hand, they needed to show
that their veto threat meant something so they could use it effectively
in the future.

So the President and Vice President stepped up their involvement big
time. They lobbied vigorously, putting pressure on all the wavering
Republicans but saving their strongest fire for Charlie Norwood. There
were numerous White House sessions, lots of meetings, and the President
and Vice President both went to the Capitol to lobby (which we're told
has never been done before). As a result of all this pressure, and
despite his promise to other key patients' rights champions in the House
and Senate that he would accept no deal unless they agreed, Norwood
caved. He worked out a deal with Bush that significantly changed the
right-to-sue and the external review provisions.

THE RESULTS: The House voted last night. The base bill was the
Norwood-Ganske-Dingell bill (the Senate-passed bill), which contained all
of our patient protections. However, there were several amendments put
forward that we opposed.

The most important was the Norwood-Bush deal. This amendment passed
218-213, with 6 Republicans voting against and 3 Democrats voting for.
This amendment significantly changed the right-to-sue provision.  It
allows suits in state court after an external appeal. However, it creates
a strong presumption for the court that the result of the appeal is
correct. This creates quite a hurdle for a consumer to overcome in court
(in legal parlance, it's called a *rebuttable presumption*). In addition,
there were *caps* placed on court awards for non-economic and punitive
damages of $1.5 million, unless the state has a lower cap (our position
is that there should be no caps). The view of our coalition is that this
is tantamount to no right-to-sue. There is also some concern that this
result may be worse than nothing, in that the courts have been moving
towards recognizing some right-to-sue under current law.

The Norwood-Bush deal also changes the external appeals process by
creating a federal external appeals provision, thereby wiping out good
provisions won by advocates in the states. The rules for the appeals seem
to be fine, but the plans would choose (and pay for) the entity that
would hear the appeal, thus raising conflict-of-interest concerns.

Another amendment added some perennial Republican favorites: Association
Health Plans and Medical Savings Accounts. Sponsors argue that these will
increase consumers' access to affordable health insurance, but we don't
think that will happen. We believe they will actually hurt the insurance
market. (For an explanation of AHPs and MSAs, see our fact sheets on our
Web site at
(http://www.familiesusa.org/html/uninsured/uninsured_proposal.htm).

The final bill, with the amendments, passed 226-203. All the Republicans
voted for it, and five Democrats crossed party lines to join them.

THE PROGNOSIS: President Bush and the Republican House are getting a lot
of credit for compromising and passing this bill. The press coverage has
been gigantic, and the public will think that we've passed a good
patients' rights bill.

Democrats in the House and Senate lambasted the House-passed bill in the
strongest terms. They feel sold out by Charlie Norwood (who is now the
new darling of the Republican party * they even chanted his name on the
House floor when they passed the bill!).

The legislation now has to go to a House-Senate conference committee.
We've been there before: In 1999 the House passed a strong bill, the
Senate passed a very weak bill, and nothing ever came out of that
conference committee. With feelings so hot right now, it's hard to see
how a compromise can be reached. The House Republicans probably see no
reason to compromise (they will argue that they have already compromised
and, in any case, they have the President with them). The Senate
Democrats feel the right-to-sue is critical and can't see themselves
supporting a bill without it.

It won't be easy, but we still hope that some way can be found to enact a
strong patients' bill of rights this Congress.

=============================================
This message was generated by the Families USA Listserv.

Replies to any message from this Listserv SHOULD NOT be sent to the
Listserv address, but to Ingrid VanTuinen at  [log in to unmask],
or to another party, if so indicated in the message.

You may unsubscribe from this list by sending a message to
[log in to unmask] NOT TO THE LIST NAME with the following
command in the message field of your e-mail memo:

unsubscribe familiesusa

If you have trouble unsubscribing, or have questions about any of the
Families USA Listservs, send email to Ingrid VanTuinen at
[log in to unmask]

Ingrid VanTuinen, Writer/Editor
Families USA
1334 G St., NW
Washington, DC 20005
PH: 202/628-3030
FAX: 202/347-2417

Web: www.familiesusa.org
Email: [log in to unmask]

----------------------------------------------------------------------
To sign-off Parkinsn send a message to: mailto:[log in to unmask]
In the body of the message put: signoff parkinsn