PATIENTS' RIGHTS: LET'S SEE SOME BIPARTISANSHIP
February 8, 2001
There has been a lot of talk on Capitol Hill lately about bipartisanship and finding common ground on issues of great importance for the American people. It is time to turn such talk into action. It is time for Congress to pass a meaningful patients' bill of rights. The American people have told us they want it. It was part of the campaign promises of nearly every candidate for federal office. Now it is time to act.
For too long, some of us in Congress have struggled to come up with a way to create rights for patients who have disputes with health maintenance organizations. We have worked to put life-or- death decisions back into the hands of doctors and their patients.
While we applaud the success of managed-care companies in reining in what were skyrocketing health care costs, we think quality of care and patients' control over their own medical decisions were sometimes sacrificed in the name of short-term cost savings.
By now, the litany of abuses is familiar: clerks at HMOs overruling highly trained doctors, women kept from seeing their gynecologists, patients with life-threatening diseases denied access to specialists. While many states have passed genuine patient- protection legislation in recent years, Congress still needs to do its part to help restore a balance between providing health care and cutting costs.
While Ted Kennedy was putting together the essential framework for a patients' bill of rights in the Senate, the House, led by Reps. Charles Norwood and John Dingell, made significant progress in the last session. Their bipartisan bill would: guarantee that patients can go to the nearest emergency room; give women the right to go to their ob-gyn without a referral; provide everyone appropriate access to needed specialists; and limit the ability of health plans to give financial incentives to deny care. When insurance companies deny coverage, the bill would let patients appeal to an independent review panel that would make fast, impartial decisions. Finally, and only after exhausting appeals, patients would have the right to sue their HMOs in state court. That would end a system that now grants virtual legal immunity to HMOs.
The House passed the Norwood-Dingell bill, but it was narrowly rejected by the Senate. Some senators were concerned about making the power to sue too broad, while some were concerned about putting too many hurdles in the way of injured patients.
The good news is that we are not that far apart. We all agree that patients deserve basic rights. We all agree that we should give patients the ability to enforce those rights without promoting frivolous lawsuits or unfairly holding employers liable. Working with our colleagues in the House and on both sides of the aisle in the Senate, we think we have a solution.
We have introduced in the Senate the Bipartisan Patient Protection Act, which would assign cases involving disputed medical judgments to state courts to be decided according to each state's laws. For example, a cancer patient whose insurance company refused to pay for a lifesaving bone-marrow transplant because it is deemed "experimental" could take the HMO to state court. State laws would govern what if any limits there would be on how much juries could award injured patients. Federal courts would have jurisdiction over what are essentially contract disputes over the terms of insurance policies. Fines of as much as $5 million could be imposed by federal courts on insurance companies that cause the death or injury of a patient through bad faith and flagrant disregard for the terms of the patient's policy.
Our legislation would complement reforms that many states already have enacted. One of the first states to provide patients an independent review of decisions by HMOs was Texas, where patients also can take their HMO to court. The governor of Texas when that law took effect was George W. Bush, who said last year that he favors a national law. We look forward to working with President Bush, and we applaud his recent assurances of cooperation. To show the nation that we mean it when we talk about reaching consensus and finding common ground, we hope Congress shares his enthusiasm and works together to put our bill on the president's desk.
John McCain is a Republican senator from Arizona. John Edwards is a Democratic senator from North Carolina.