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Lawmakers Clash over Patient Bill of Rights.

The White House and Senate Republicans clashed Sunday over legislation intended to protect patients from cost-conscious health care plans, setting up what could become one of the more politically charged debates of the remaining days of Congress.

President Clinton and congressional Democrats have pushed aggressively for a "patient bill of rights" intended to help consumers deal with HMOs' efforts to save money.

Democrats charge that Senate Republicans, who have kept the Democrats' measure from reaching the floor, began crafting their own version only after they realized their failure to take up the matter could cost votes in this fall's congressional elections.

"Not until their pollsters and their political advisers said there was political damage did they find any inkling of interest," Clinton adviser Rahm Emanuel said on CBS' "Face the Nation."

Democrats call the GOP plan a weak alternative offering more protection for insurance companies than for patients. Republicans counter that the Clinton plan would lead to increased federal regulation and higher health care costs.

"As usual the Democrats have an answer, and it's a government takeover, just like we had the Clinton health care government takeover program," Senate Majority Trent Lott said. "That's what they would like to do here. Their ultimate goal is for the government to control and run everything in our life and health care. They want HCFA (Health Care Financing Administration) federal bureaucrats in the room with you and your doctors."

Clinton's patient "bill of rights" would place curbs on health plans that limit patient choices to save money. Proposed protections include an outside review when care is denied, better access to specialists and coverage of emergency-room care even if reasonable fears of a medical crisis are unfounded.

A key provision opposed by Republicans, however, is one that would expand the rights of patients to file lawsuits against HMOs.

"You can't sue your way to better quality in health care," Sen. Bill Frist, R-Tenn., said on ABC's "This Week." "What you need to do is build accountability into the system."

However, Health and Human Services Secretary Donna Shalala, appearing on the same show, said the administration plan has the support of the American Medical Association. She also disputed reports that the plan would drive up health care costs, saying several independent analysts estimate prices would increase "anywhere between a $1 and $5 for a family a month."

"Most Americans are prepared to pay that for the security of knowing that their health care plan will be there when they need it," she said.

In addition to being targeted by Congress, HMOs also have taken a pounding on Wall Street. A new study found the stock of HMOs took a downturn in 1995 after nine years of growth because increases in premiums did not keep up with higher costs.

The average annual return for HMOs grew 32 percent from 1987 to 1995 but fell an average of 7 percent from 1995 to 1997, according to this week's issue of Health Affairs, released Monday.

Likewise, health services companies saw annual average returns of 21 percent during the earlier period but just 3 percent in the later years.

The study's authors warned that lower profits could translate into trouble for HMOs as they try to grow.

"If Wall Street loses interest in health care companies, it could greatly affect the amount of capital that these companies can generate in the market, and subsequently, changes in the overall health care system," said co-author Srija Srinivasan, a consultant for the Kaiser Family Foundation.  
 

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