WASHINGTON (AP) _ President Bush urged Congress on Wednesday to pass a patients' rights bill before the end of the year, but said he will fight proposals that open the door to unnecessary lawsuits against HMOs.
``The idea is to serve more patients, not to create more lawsuits in America,'' he said.
Bush praised a bill sponsored by Sens. John Breaux, D-La., Bill Frist, R-Tenn., and James Jeffords, an independent from Vermont, that is an alternative to a Democratic health care proposal.
The Democratic plan, which senators will begin to debate later this week, would rewrite 27 years of rules that now protect HMOs and insurers from patient complaints and lawsuits. Republicans, who have vowed to scuttle the legislation, contend it would open the gates for numerous lawsuits that would threaten small businesses.
``Before this year is out, I want to sign into law a patients' bill of rights,'' Bush said at a work force conference, outlining his hopes to establish a board that would review complaints against HMOs. The president said that with that kind of review process, ``most disagreements will not wind up in court.''
Many small-business owners are worried about the Democratic plan.
``I don't want to stop offering benefits,'' says Philip Tredway, the owner of an Erie, Pa., plastics company that has 55 employees. But, he worries, if the Democratic bill becomes law ``I'll have to deal with out-of-control costs and the potential that my company will be hit with a business-killing lawsuit.''
The bill's sponsors disagree, saying the legislation would shield employers from lawsuits unless they directly helped make a decision against a patient's interest.
``We're very specific in the bill,'' said Sen. John Edwards, D-N.C., a co-sponsor with Sens. Edward M. Kennedy, D-Mass., and John McCain, R-Ariz. ``There's actually a sentence in the bill that says employers may not be held liable under this bill with that one exception.''
The bill, which has been pushed to the top of the Senate's legislative priority list by the new Democratic majority, would provide a slate of guarantees for patients, including emergency care, access to obstetricians and gynecologists and payment for costs associated with clinical trials.
Against the Senate GOP leaders' wishes, the Democrats would let patients sue insurance companies in either federal or state courts for a range of damages, including punitive ones.
Now patients generally cannot sue over health care or other employee benefits because of a 1974 law, the Employee Retirement Income Security Act, or ERISA, which creates a federal standard for pensions and health care benefits and pre-empts state courts considering lawsuits. While a suit may be filed in federal courts, the benefits covered are extremely limited.
Breaux, who has signed on to the rival plan favored by the Bush administration, said the legislation should make clear that employers can be sued only if they agree in advance and in writing to serve as the health plan's ``designated decision maker.''
While a bill must include a clearer declaration on when an employer can be sued, Breaux said Republicans would be making a mistake if they kept trying to block patients' rights legislation,
The worries will likely grow with evidence that some longtime GOP opponents of state lawsuits could partially embrace them, all in the name of giving the president and the public a finished patients' bill of rights.
Senate Majority Leader Tom Daschle, D-S.D., said he is determined to get a patients' rights bill through the Senate, despite the Democrats' slim majority, and threatened to hold lawmakers in Washington through the July Fourth recess if necessary. Formal debate on the issue should begin Thursday.
Meanwhile, some Republicans are looking for a compromise.
House Speaker Dennis Hastert of Illinois said he might favor approval of lawsuits in state courts, part of an attempt to create a viable alternative to the Senate Democrats' bill. Hastert's plan would allow state lawsuits only in cases in which companies ignored rulings by outside experts who rule in favor of patients.
Paul Dennett, a lobbyist for the American Benefits Council, which handles benefits issues for Fortune 500 companies, said employers could easily be caught in the net of lawsuits under the changes being considered.
For instance, he said, employers could be liable for ``exercise of control'' if they tell an insurer to follow certain medical standards when deciding which treatments to cover. If a patient is injured because the health plan followed those standards, the employer could be liable for dictating the standards in the first place, Dennett said.
``They continue to insist employers have no liability when they actually do,'' he said.