Bush Strikes Patients' Rights Deal

The patients' rights bill will probably sail through the House before the end of the week, Vice President Dick Cheney said.

The White House and GOP leaders raced Thursday to put the finishing touches on the legislation, based on an 11th-hour compromise between President Bush and the lead Republican author of a version Bush had threatened to veto.

Cheney appeared at the rally on the front steps of the Capitol just moments after Bush met with House and Senate Republicans in the Capitol basement, where he thanked the broker of the deal, Rep. Charlie Norwood, R-Ga., "for being realistic and reasonable."

Aides scrambled to put together the appropriate legislative language from a single page outline, with House leaders expressing optimism that the bill could be voted on by Thursday night. The terms governing the debate were finished at 8 a.m. Thursday.

Bush, standing beside Norwood, a former dentist who has worked closely with Democrats but finally made a deal with the president, announced the deal Wednesday.

"After a lot of labor and a lot of discussion, we shook hands in the Oval Office about 10 minutes ago," the president said.

"It does protect the patients of this country," said Norwood, who followed Bush to the White House podium for the late-afternoon announcement. "We have accomplished the very goals we set out."

According to a one-page statement released by the administration, Bush agreed to open the door a little more to more lawsuits and Norwood agreed to close it a little.

The Norwood-Bush deal would put limits on court awards for successful patients. Compensation for pain and suffering would be limited to $1.5 million, three times the $500,000 Bush originally favored. Democrats and Norwood sought to make such awards unlimited.

Punitive damages would be $1.5 million under the deal — and they would come only in cases where health plans ignore medical advice from independent reviewers. Democrats and Norwood had supported a $5 million limit. Bush supported plans that would have barred punitive damages.

The deal also would allow insurance plans that were self-funded and self-administered by employers to go to federal court, but not state court. Democrats said they offered that compromise to the president earlier this week, but got no response.

Bush and Norwood agreed to a compromise on the thorny issue of where patients may sue their health plans — in consumer-friendly state courts or the uniform system of federal court.

The HMOs could be sued in state courts, but the cases would be governed by rules used in the federal court system that would require patients to exhaust all of their appeals to outside reviewers before going into court.

Prominent Democrats were mixed in their criticism.

"The president has finally agreed to accept the patient protections" the bill's supporters have long sought, said Sen. Edward M. Kennedy, D-Mass., including access to emergency room care and medical specialists. At the same time, he said, the proposal "continues to make these rights unenforceable and protect HMOs more than patients."

Even as Democrats and some moderate House Republicans scrambled to keep supporters from defecting to the Bush-Norwood compromise, Norwood said the Bush seal of approval was critical.

"The bottom line and goal is, we want to change the law," he said. "The last time I looked, that's pretty difficult to do without the presidential signature."

Notwithstanding a flurry of activity that stretched into the wee hours Thursday, it remained unclear whether a package could be finalized in time for a vote before the House adjourns Friday for an August recess.

Plans were being made for Bush to visit the Capitol on Thursday to speak to Republicans in the House and Senate. Even some from his own party were skeptical of the compromise.

"I have to have more of an explanation. I have to see it in writing," said Rep. Marge Roukema, R-N.J., as news of the deal spread among lawmakers Wednesday evening.

Roukema is a GOP supporter of the patients' rights plan Bush opposes.

Senate Democrats who have been Norwood allies said they were disappointed in the deal, but were somewhat muted, and it was unclear how hard they might fight it.

Some House Democrats said applying federal court rules in state lawsuits would be too cumbersome.

"The rumor is that the intent here is to kill the bill," said Rep. Louise Slaughter, D-N.Y., a member of the House Rules Committee, which met late Wednesday.

Norwood admitted the details would be difficult for lawmakers to write into specific legislative language — and agree on — in a single day. He also said he made the deal with the White House in the interest of getting a plan Bush would sign.

"The deal had to be cut by somebody and I was that somebody that was elected to do it," he said. "I felt it was the right thing to do."

But Rep. Greg Ganske, R-Iowa, and Sen. John McCain, R-Ariz., expressed reservations about signing on to a compromise without knowing all the details.

The Associated Press contributed to this report.