Winners and Losers

For the moment, everyone claims to be a winner in the patients’ bill of rights debate.

Rep. Charlie Norwood, a Georgia Republican and former dentist who has been a leader in the debate, is a hero to the White House and to the leadership in the House of Representatives for crafting a deal that could win approval by a majority of his colleagues.

Members of the House, who were worried about television ads during the August recess blaming them for dragging their feet, can go home to say they voted for a patients’ rights bill.

President Bush heads for his ranch in Texas confident that he played an important role in shaping a compromise with Dr. Norwood.

Senate Democrats put this issue at the top of their agenda when they recaptured control of the Senate in June and quickly passed a sweeping version of this bill designed to facilitate health care lawsuits.

And most important, the American people are winners because this dangerous piece of legislation still has not become law.

That’s the good news. Now, the rest of the story?

Nothing reveals quite so clearly that Washington is indeed a sausage factory as the bill that ultimately passed the House last week (August 2).

The compromise that Dr. Norwood and Mr. Bush worked out squeezed two different concepts into one sausage skin.

Mr. Bush wanted people to be able to sue their health plans in federal court to provide uniformity. Dr. Norwood and friends wanted them to be able to sue in more accessible state courts.

Voila! The compromise: People will be able to sue in state courts but under a yet-to-be-determined battery of federal guidelines.

There were cries of foul on both sides of the aisle. This new twist will usurp state authority over health care and health insurance, which, by the way, states have a lot more experience in handling.

But that’s only the beginning. Any version of this legislation – new or old – will create a huge new federal regulatory scheme that will control virtually every aspect of private health coverage.

While the bill’s regulatory system doesn’t make the headlines, it may well give Washington the means to put the machinery in place for the health care system envisioned in the Clinton health care bill.

According to a paper published by The Heritage Foundation, the federal government would impose new rules governing the kinds of health plans that people can buy and how utilization review will be conducted. It would govern internal and external appeals processes, grievance procedures, which prescription drugs people will be able to receive, rules for participation in clinical trials, and how plans deal with doctors, including compensation arrangements.

Now the House and Senate bills must go to the grand sausage factory in Congress – a conference committee – to resolve differences. The committee’s job is to come up with a single bill that can again pass both houses and then be sent to the president for his signature.

Don’t hold your breath.

While everyone is saying a bill will become law, the two sides are even further apart now than they were a year ago.

Both sides have to figure out what this new state/federal arrangement is about. And employer liability in the health care lawsuits is a huge factor that deserves national attention, as does the impact on millions of people who are likely to lose their health insurance if the bill passes.

The American people may yet be protected from this politically-driven bill. While everyone is positioned to be a winner right now, soon the finger-pointing will begin over who is responsible for the impasse in getting a bill enacted.

This misguided legislation would be completely unnecessary if Congress were to tackle the real issue at hand – giving people more power and authority to own their own health insurance policies.

If families were selecting their health insurance like they buy auto, home, and life insurance now, they would own the policies and would be able to sue their health plans under existing contract law. Most important, if they are unhappy, their first resort would be to change plans early on, not get entangled in costly and time-consuming lawsuits.

Instead of this misguided and misnamed patients’ bill of rights, the American people need a health care declaration of independence so they, and not private or public sector bureaucrats, are making decisions about their health care arrangements.

But that’s the next political battle, one in which the American people could be the real winners.

Grace-Marie Turner is president of the Galen Institute, a not-for-profit health policy research organization based in Alexandria, VA. She is the editor of Empowering Health Care Consumers through Tax Reform. She can be reached at P.O. Box 19080, Alexandria, VA 22320.

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