Congress primed to revisit patient-protection measures

Patient rights likely to be a higher priority with election of new House speaker.

By Lisa Rabasca
Monitor staff

Patient-protection legislation received a big boost in the 1998midterm elections: Most of the congressional and gubernatorial candidates who supported health-care reform-including two psychologists-were elected to office. In several cases, candidates won tight races by making patient protection a major part of their campaigns.

Patients' rights were further buoyed when Republicans elected Robert Livingston of Louisiana the new Speaker of the House. In the last Congress, Livingston supported a bill that would allow more Americans to sue their managed-care plans for malpractice.

Russ Newman, PhD, JD, APA's executive director for practice, says he is encouraged by the election results.

'Already we're seeing pronouncements in the media around the country that the Clinton administration and the Democrats are going to get patient-protection legislation back on the federal radar screen,' Newman says, but cautions, 'we will still need a bipartisan effort, however.'

Pushing forward

Last year, pre-election bipartisan politics prevented Congress from passing patients' rights legislation. Instead, many lawmakers used health-care reform to clearly define the differences between Republicans and Democrats.

Patient-rights legislation was also hampered by former House Speaker Newt Gingrich (R-Ga.), who had been very responsive to the health-insurance industry, say Practice Directorate officials. In the last Congress, Gingrich appointed a Republican task force to draft a moderate patient-protection bill. The House approved the Republican proposal, which denied consumers the right to sue their managed-care plans.

In comparison, Livingston, the new speaker, co-sponsored the Patient Access to Responsible Care Act, a bill that would have allowed more Americans to sue their health plans for malpractice. In the days after the November election, Democrats and Republicans said they would make patient-protection legislation a priority when Congress reconvenes in January. Rep. Ted Strickland (D-Ohio), a psychologist who won a third term in office, says he expects patient-protection legislation to be introduced early in the legislative session. Strickland will be joined in Congress by another psychologist, newly elected Rep. Brian Baird (D-Wash.).

Tight election races

Strickland's position on health-care reform may have helped to secure his third term. As in many other tight congressional and gubernatorial contests involving candidates supporting patient protection, the Practice Directorate suspects that health-care reform gave Strickland an edge with voters in his close race for a House seat, says Peter Newbould, APA's director of congressional affairs.

For example, Strickland participated in nearly a dozen debates with his opponent, Ohio's lieutenant governor Nancy Hollister, who strongly opposed patient-protection legislation. Moderators and audience members asked about patients' rights legislation in all but one debate, Strickland says.

'My constituents recognize the need for and want the protections that would be made available to them with a patients's rights bill,' he says.

Other congressional and gubernatorial candidates who made patient protection an issue and who won close races include Sen. John Edwards (D-N.C.) Sen. Fritz Hollings (D-S.C.), Rep. Joe Hoeffel (D-Pa.), Sen. Barbara Boxer (D-Calif.), Ohio Gov. Bob Taft (R), Georgia Gov. Roy Barnes (D) and California Gov. Gray Davis (D).

In South Carolina, Hollings ran an ad telling his constituents, 'Something is wrong when the accountants for insurance companies make medical decisions for you instead of your own family doctor.'

Boxer of California ran an ad implying that her challenger 'would retain for health-maintenance-organization executives the same sort of immunity from lawsuits enjoyed by diplomats.'

Continued advocacy

The Practice Directorate is poised to capitalize on the Congress's renewed interest in patient-protection legislation, Newman says. APA supports legislation that would:

 Amend the 1973 Employee Retirement Income Security Act (ERISA) to allow patients in ERISA-regulated plans to sue their managed-care company for inadequate care.

 Prohibit managed-health plans from discriminating against providers based solely on their state licensure or certification-a move that would allow enrollees to access a full range of provider services.

 Allow enrollees to receive care outside the managed-care network of providers.

Health-care advocacy will be bolstered by having two psychologists in the House, says Newman.



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