Health Care Issue Plagues Congress

Monday, September 25th 2000, 12:00 am
By: News On 6

WASHINGTON (AP) — Helping seniors pay for prescription drugs and reining in health maintenance organizations were President Clinton's two biggest health care goals when Congress reconvened nine months ago. As lawmakers rush to return home — to ask voters to let them come back next January — the chances of either happening are minuscule.

Instead, the only major health care measure likely to be signed into law before a new president occupies the White House is in response to threats from hospitals and nursing homes to shut down if Medicaid cuts of three years ago are not restored.

``We're still committed ... but there's some real differences'' in the Republican and Democratic approaches to prescription drugs and managed health care, said House GOP Conference Chairman J.C. Watts.

The curbs on fees from Medicare, the nation's health insurance program for the elderly and disabled, were part of 1997 legislation to balance the federal budget.

After health care providers complained they were being squeezed too tight, Congress voted last year to restore $16 billion to the program. There is broad agreement in both parties that it wasn't enough.

President Clinton has proposed a $21 billion boost in Medicare payments over five years, and several lawmakers have offered proposals of their own. GOP leaders, however, have yet to endorse a specific amount.

A bipartisan group of House and Senate lawmakers also wants to begin allowing the re-importation of prescription drugs. Supporters argue that Americans are paying more for U.S. drugs sold cheaper in other countries.

That measure has been attached to the agriculture spending bill, but with heavy opposition from the pharmaceutical industry — among the biggest corporate givers of campaign funds this year — whether it will survive is uncertain.

Still, the list of accomplishments in an election year full of jockeying over health care issues is a lot smaller than the agendas laid out by either party.

Both sides have proposals pending. On patients' rights, the House has passed a bipartisan bill by Rep. Charles Norwood, R-Ga., and John Dingell, D-Mo., that would let consumers sue HMOs for inadequate health care.

Another House-passed measure by Rep. Tom Campbell, R-Calif., would amend antitrust law to let physicians in private practice form what would effectively be unions to bargain collectively with health insurance plans over fees and treatments.

Neither may get a vote in the Senate, where Republican leaders generally accept the arguments of business and insurance groups that each would raise health care costs and spawn a barrage of new lawsuits.

And the White House has shown no interest in a modest, Senate-passed Republican HMO reform bill that would widen access to emergency room care but permit patient suits only after an independent review, while still disallowing punitive damages and class-action claims.

On prescription drugs, a GOP House-passed measure to provide limited subsidies to the poorest elderly for buying private coverage has been pronounced dead by its sponsors. A Senate Republican proposal to have states run a prescription program has drawn so much opposition from the White House that sponsors there concede its defeat, too. Both parties have ads accusing the other of rather having an issue for the November election rather than a solution.

There's even debate over how health care issues — routinely ranked with education and Social Security at the top of the list — are playing with voters.

An ABC News-Washington Post poll after the summer political conventions gave Gore an 18-point advantage over Bush on the issue of prescription drugs. But Republicans claim they've been successful pointing out how much the Clinton-Gore prescription plan would raise monthly Medicare premiums while still leaving potentially thousands of dollars in yearly out-of-pocket costs.

For Arizona Sen. John McCain, the gridlock is only to be expected.

``The Democrats are in the grip of the trial lawyers who want everybody to sue everybody for anything,'' McCain said last spring during his unsuccessful bid for the GOP presidential nomination.

``And the Republicans are in the grip of the HMOs and the insurance companies and their huge six- and seven-figure donations. We will not move as long as the special interests rule in Washington over the public interests.''


The House-passed Medicare drug coverage bill is H.R. 4680.

Patient rights-HMO bills are H.R. 2723, H.R. 2990 and S. 1344.