WASHINGTON (AP) _ President Bush is turning to House Republicans to counter the patients' rights bill that Democrats and his chief GOP nemesis, Sen. John McCain, pushed through the Senate before taking a weeklong July Fourth holiday.
Bush said he would work with House to develop a bill that ``discourages runaway litigation costs.'' He said he could not sign the Senate version because ``it puts the interest of trial lawyers before the interest of patients.''
He may have an uphill fight. In 1999, 68 House Republicans voted for a bill similar to the one the Senate passed Friday night. Of the 60 of them still in office, fewer than a dozen have indicated a willingness to support Bush's views.
The Senate bill is ``the product of consensus and compromise,'' said Rep. Marge Roukema, R-N.J. ``This bill can and should be signed into law.''
Patients' rights is only one of the year's most contentious issues that GOP leaders in the House have promised to act on after Congress returns July 10 and before it breaks again. House Speaker Dennis Hastert, R-Ill., also has promised to do a campaign finance bill in the four weeks before lawmakers take a monthlong vacation in August.
``Doctors and patients should be in control of health care, not trial lawyers and the courts,'' Hastert said last week as the final touches were put on a bill supported by Bush and Republican leaders in the House.
As with patients' rights, Bush again finds himself on the opposite side of McCain, the campaign finance reformer who mounted a stiff early primary challenge to Bush last year for the GOP presidential nomination.
``We couldn't have done this without John McCain,'' said Massachusetts Sen. Edward M. Kennedy, who managed passage of the patients' rights bill for Democrats.
The Senate vote capped a five-year struggle that dated to the Clinton administration _ a delay McCain attributed to the power of special interests. ``Trial lawyers have controlled this for the Democratic side and HMOs and insurance companies on the other side gridlocked us,'' said McCain, R-Ariz.
Covering private and federal health programs, all of the patients' rights proposals would require health plans to pay for needed visits to specialists such as pediatricians, minimum hospital stays after mastectomies and access to clinical trials.
Differences emerged over the court remedies available to aggrieved patients and their families. Plans can be sued if those services are denied or delayed, and the actions result in permanent injury or death.
But the Democratic-McCain plan passed by the Senate would have federal courts hearing only contract disputes; state courts would judge medical malpractice and related cases.
In the first test of their new leadership, the Senate Democrats fended off challenges to the suits allowed in consumer-friendly state courts. Bush threatened to veto the bill for that reason _ saying federal courts were sufficient to handle patient cases _ and reiterated his opposition after the Senate passed it.
The president is now putting his weight behind a new House bill written by Reps. Ernie Fletcher, R-Ky., Nancy Johnson, R-Conn., and Collin Peterson, D-Minn., as a compromise.
Unlike the Senate-passed version, the GOP alternative only allows state court lawsuits if a patient's insurer ignores a reviewer who recommend needed medical care. The Senate allows punitive damages meant to send insurers a lesson up to $5 million; the House GOP would allow none.
The Senate bill says there are no limits to pain and suffering awards; the House GOP caps such awards by a judge or jury to $500,000.
The range of jury awards sets up a potentially the most contentious negotiation with the White House.
Still, many issues that were contested only a year ago are now essentially givens.
Democrats have won the most basic question: whether there should be new federal regulations at all for health insurance companies, which are traditionally regulated by states.
As the Senate deliberated, White House aides debated throughout the day about whether to re-issue a veto threat or adopt softer language to leave Bush room to maneuver. They settled on a statement that rules out a Bush signature on the Senate bill _ though the word ``veto'' in not used _ hoping to change the measure when House and Senate negotiators sit down to merge their two versions.