Patients' Rights Compromise Sought

WASHINGTON – A key Republican lawmaker is taking the latest White House plea for compromise on patients' rights to supporters of his bipartisan bill, but House GOP leaders doubt Democrats will agree to deal on a Democrat-backed bill that's already passed the Senate.

One GOP source, speaking on condition of anonymity, said President Bush told Georgia Rep. Charlie Norwood that as a Republican, he should align himself with the White House on the issue and not with the Democrats.

"We are very close to a deal," Norwood spokesman John Stone said Monday.

He refused comment on Bush's telephone call to Norwood but said the congressman is "committed to staying with ... all of the bipartisan supporters" of the bill, meaning Democrats who have shied away from compromises suggested by the White House.

Bush has promised to veto the current version of protections for patients in HMOs and other health plans. Its sponsors include Rep. John Dingell, D-Mich., and Sens. Edward M. Kennedy, D-Mass., and John McCain, R-Ariz.

The showdown on patients' rights legislation loomed Tuesday as House Majority Leader Dick Armey prepared to go on the offensive against the plan, which is overwhelmingly backed by Democrats.

In a speech to the Cato Institute, a libertarian think tank, Armey, a Texas Republican, was to criticize the version as too costly because it encourages wronged patients to sue health plans instead of finding other ways to get insurers to pay for needed care.

House Speaker Dennis Hastert, who talked with Norwood on Monday, said the congressman asked him for a specific date when the issue would come up for a vote. Hastert, R-Ill., said he told Norwood he was ready to bring the bill up quickly if an agreement could be reached with the president. "I said if he's ready to go this week, I'll go this week," Hastert said.

Rep. James Saxton, R-N.J., was among those who met Monday at the White House in the latest round of talks. Saxton said possible additional federal health payments to New Jersey hospitals with high caseloads of low-income patients did not come up but may be part of final negotiations on the legislation.

Republican sources familiar with Bush's call to Norwood, speaking on condition of anonymity, said the president pressed the congressman in highly personal terms to support the White House's bid to rewrite the legislation so Republicans could support it.

Stone would not discuss negotiation details but said Norwood is seeking a bill that everyone can agree on and that Bush will sign.

"We feel we're closer to that than any time before, thanks to the good-faith efforts of the president," he said.

The measure is designed to provide patients new rights in dealing with HMOs and other insurance companies, including better access to emergency room care and treatment by medical specialists. While broad agreement exists on types of patient protections to be included, disagreements come in over the extent to which patients should be permitted to sue HMOs and the size of damages for which insurers should be liable.

Norwood and most Democrats favor a bill with broader access to courts, including state courts, where trial lawyers feel such cases are more likely to prevail. They say the right to sue is essential if the new protections are to be meaningful.

Bush and most Republicans prefer to send most suits to federal courts and to limit damages. They say patients worry more about getting treatment than filing suits. And because the Democratic bill would make insurance more costly, they say, some people would lose coverage.

Norwood has been discussing possible compromise with the White House in recent days, including a potential hybrid system in which some suits could be filed in state courts under federal rules.

Last Friday, Norwood and Democrats drew up a point-by-point critique that said, "We believe that when HMOs and health insurers make medical decisions that were traditionally made by physicians and other health care providers, they should be subject to the same standard of accountability as physicians and other providers."

The two-page paper identified the plan as a "White House proposal," a characterization that administration officials disputed. One source said Bush himself made that point in his conversation with Norwood.