Editorial: End delays on worthy HMO bill

Monday, Sept. 20, 1999 | 8:46 a.m.

The Republican leadership in the House and the Senate have tried every avenue available to thwart a patient's bill of rights. The Senate has been especially hostile, passing legislation in August that essentially maintains the status quo, which is the preference of the insurance industry, a big Republican campaign contributor. While the leadership in the House has been adamant in its opposition, the dynamics there are much different, creating momentum for a patient's bill of rights.

A number of former and current physicians are Republican members of the House who know firsthand what it's like to deal with the insurance industry's insistence on profits over patient care. They have relentlessly pushed their leadership to allow legislation to be considered that would give a patient more freedom to choose his doctor and, if care was denied by an HMO, have the right to appeal to an independent review panel. In addition, these dissident Republicans believe that a patient should have the right to sue his HMO if he is harmed by a denial of care. The right to sue is the most contentious and divisive among Republicans; Democrats almost universally support this right.

Those Republicans supporting a patient's bill of rights, including Rep. Charles Norwood, R-Ga., tried to work with the Republican leadership and forge an amenable compromise, but these efforts broke down. So Norwood, a former dentist, announced in August that he and other Republicans had struck a deal with Democrats on a patient's bill of rights, which included the right to sue. Faced with a mutiny, House Speaker Dennis Hastert, R-Ill., said shortly before Congress adjourned for its summer recess that he was asking some of the dissidents -- Reps. John Shadegg, R-Ariz., and Tom Coburn, R-Okla. -- to come up with a compromise containing the right to sue that would be acceptable to the leadership. Hastert also pledged to hold a vote on HMO reform legislation sometime in September.

Now that Congress is back in session, what's the status of the legislation? For starters, most of the leadership has denounced the bill drafted by Coburn, a family doctor, even though Coburn's legislation puts more restrictions on lawsuits than does Norwood's bill. Hastert, who said in August that the House would vote on the bill in September, on Friday announced that a patient's bill of rights wouldn't be considered until at least the week of October 4.

A delay of a week or two might not seem like much, but every day that passes without a vote means it is that much more likely that HMO reform will be defeated. This is the same obstructionist tactic used last year on campaign finance reform. Although the House passed an overhaul of campaign finance laws, because it came so late in the calendar year it doomed its chances in the Senate, where Republicans used parliamentary maneuvers to kill the legislation. Hastert should reconsider his decision to allow a vote in October and instead permit one much sooner. Otherwise, Americans will place the blame for failing to pass a patient's bill of right squarely on the shoulders of the Republican leadership in Congress.