American Family Voices | Title: "Circus"

Republican National Committee ^ | July 24, 2004

[RWR8189]

Rhetoric

ANNOUNCER: “Step right up, step right up. Watch the amazing George Bush take three sides of an issue. Gasp as he takes credit for bills he opposed. Gawk in amazement as you listen to George Bush flip-flop on the Patients Bill of Rights.”

PRESIDENT BUSH:  “That’s not true, I do support a national Patients’ Bill of Rights. As a matter of fact, I brought Republicans and Democrats together to do just that in the state of Texas, to get a Patients’ Bill of Rights through.”

ANNOUNCER:  “The amazing George Bush actually vetoed the Patients’ Bill of Rights. Then it became law over his objections. Now he takes credit for it. But wait, there’s more.”

PRESIDENT BUSH:  “If I’m the President, people will be able to take their HMO insurance company to court.”

ANNOUNCER:  “Another ghastly flip-flop. When Bush became President, he asked the Supreme Court to block patients’ rights under the very Texas law he touted. George Bush – three faces on one issue. The first vetoes the Patients’ Bill of Rights, the second takes credit for it, and the third creeps out and asks the Supreme Court to kill it.”

PRESIDENT BUSH:  “That’s the kind of leadership style I’ll bring to Washington.”

“Paid for by American Family Voices.”

The Facts

President Bush Has Consistently Supported Patients’ Bill Of Rights

In 1997, Then-Governor Bush Said Texas’ Patients Rights Law Would Do “Something To Address A Significant Problem,” But Voiced Concern About Higher Health Care Costs And Excessive Litigation.  “Texas will be the first state to allow patients to sue managed care organizations for medical malpractice if decisions to deny or delay treatment cause injury. Gov. George W. Bush said … that despite concerns that the measure could increase lawsuits and drive up health care costs, he will allow it to become law without his signature. ‘Given the choice between doing nothing and doing something to address a significant problem that impacts the health of thousands of Texans, I have concluded the potential for good outweighs the potential for harm,’ Bush said.”  (Peggy Fikac, “Texas First To Allow Medical Malpractice Lawsuits Against HMOs,” The Associated Press, 5/22/97)

ü      Bush Said He Could Not Support 1995 Bill Because It Provided “Too Little Protection For Patients,” But He Directed State Agencies To Institute Rules Ensuring Patient And Doctor Protections.  “Bush called the [1995 Patient Protection Act] a well-intentioned effort gone bad. ‘The result was too little protection for patients and much too much protection for special interests, combined with too little competition and too much cost,’ he said in the veto message. Acknowledging ‘legitimate concerns’ about managed care, Bush instructed the state health and insurance departments to develop rules to guarantee fair treatment of consumers and doctors.”  (Ken Herman, “Cigarette Machine Bill One Of 23 To Get Bush’s Veto,” Austin American-Statesman, 6/17/95)

In Early Days Of His Administration, President Bush Submitted To Congress His Principles For Patients’ Bill Of Rights And Reached Out To Democrat Leadership.  “President Bush told Congress … he would support popular new patients’ rights, but only if HMOs and other health insurance companies are protected against ‘unnecessary and frivolous lawsuits.’ … ‘Americans want meaningful remedies, not a windfall for trial lawyers resulting in expensive health care premiums and unaffordable health coverage,’ Bush wrote in a document billed as his principles for a ‘Bipartisan Patients’ Bill of Rights.’ His message was received warmly by a key Democrat pushing the counter proposal. ‘To protect patients’ rights without encouraging excessive litigation, damages should be subject to reasonable caps,’ he said. Bush, who also wrote separate letters to Democratic and Republican congressional leaders, has said big jury awards would drive up the cost of health care and force employers to drop or reduce coverage for workers.”  (Ron Fournier, “Bush Says Bar On ‘Frivolous Lawsuits’ Essential In Patients Bill,” The Associated Press, 2/7/01)

In His First Address To Congress, President Bush Asked Congress To “Find Common Ground” On Patients’ Bill Of Rights That Would “Promote Quality Health Care, Not Frivolous Lawsuits.” “Together, this Congress and this president will find common ground to make sure doctors make medical decisions and patients get the health care they deserve with a patients’ bill of rights. When it comes to their health, people want to get the medical care they need, not be forced to go to court because they didn’t get it. We will ensure access to the courts for those with legitimate claims. But first, let’s put in place a strong, independent review so we promote quality health care, not frivolous lawsuits.”  (President George W. Bush, Remarks To Joint Session Of Congress, 2/27/01)

President Bush Called Patients’ Bill Of Rights One Of His Top Priorities For July 2001.  “President Bush implored Congress today to pass and send him a patients’ bill of rights that addresses his concern for limiting lawsuits, portraying himself as a proponent of – and not an obstacle to – legislation that most Americans support. The president said such legislation, which would put new regulations on health insurers and give people in health maintenance organizations more control over their care, was one of his three priorities between now and early August, when Congress begins a month long recess. ‘The Congress must act on a patients’ bill of rights – a good patients’ bill of rights, one that recognizes patients are important, not lawyers,’ Mr. Bush said in a morning appearance in the Rose Garden. He added that he wanted a bill that ‘encourages quality health care without encouraging frivolous and junk lawsuits that will threaten the very existence of an important health care policy in America.’”  (Frank Bruni, “Bush Strikes A Positive Tone On A Patients' Bill Of Rights,” The New York Times, 7/10/01)

ü      President Wanted Bill To Discourage Frivolous Lawsuits; Congressional Budget Office Said Bill Without Such Measures Would Cause Greater Increase In Premiums For Employer-Sponsored Health Insurance.  “Mr. Bush and the Democrats agree that any new federal law should guarantee patients’ access to emergency care, medical specialists and an independent medical review of decisions denying claims for benefits. But they diverge over the question of what happens if a patient is dissatisfied with the outcome of a review. … Under Mr. McCain’s [and the Democrats’] bill, patients could sue H.M.O.’s in state court for injuries resulting from poor care, and they could recover damages to the extent allowed by state law. Patients could also sue in federal court if an H.M.O. or its agents did not exercise ‘ordinary care’ in making decisions about coverage, eligibility, co-payments or similar matters. Democrats would not set any limits on damages for economic loss or pain and suffering in these federal cases. A patient could win up to $5 million in a ‘civil assessment,’ similar to punitive damages, for flagrant violations of rights. Republicans would expand the right to sue in limited circumstances, if a patient successfully pursues an administrative appeal and a health plan does not comply with the decision of an independent reviewer. Senator Frist’s bill would prohibit punitive damages and would set a $500,000 limit on damages for pain and suffering. … In fact, the Congressional Budget Office estimates that the McCain bill would increase premiums for employer-sponsored health insurance by 4.2 percent, while the Frist bill would increase costs by 2.9 percent.”  (Alison Mitchell and Robert Pear, “Senate Considers Patients’ Rights In Test With Bush,” The New York Times, 6/18/01)

President Supported Compromise That Allowed Patients To Sue Health Plans In State Courts But Protected Large Employers Who Provide Health Benefits.  CBS’ BOB SCHIEFFER: “The Patients’ Bill of Rights which was all but dead last week has suddenly come to life. And now, behind the scenes, key members of Congress and at the White House, they’re trying to come up with a compromise version that the president could sign maybe this week. …” PRESIDENT GEORGE W. BUSH: “We’re working on a Patients’ Bill of Rights that will benefit patients, not necessarily trial lawyers.” SCHIEFFER: “In fact, the compromise being worked on isn’t that different from the bill the president dislikes. Patients in nearly all health plans would retain the right to sue their HMOs in state courts. But the compromise protects large companies like Caterpillar, who operate their own health plans, from such lawsuits, which the companies claim could bankrupt them. Complaints against them would be settled in federal court, where damages would be capped.”  (CBS’ “Morning News,” 8/1/01)

Democrats Derailed Compromise On Patients’ Bill Of Rights

On July 24, 2002, Senate Democrat Leader Tom Daschle Cut Off Negotiations With Administration, Which Was Still Seeking Compromise Between Senate And House Bills. “Senate Democrats broke off talks with the White House on patients’ rights with a letter dated July 24. … Senate Majority Leader Tom Daschle, D-S.D., said Aug. 1 that he would appoint conferees to negotiate with the House, but that, too, was a formality. Some said it allowed Daschle to change the subject after the Senate’s failure to pass a Medicare drug bill, but it is unlikely to do anything to resolve the standoff over patients’ rights. … The White House, which says it still wants to strike a deal on patients’ rights, favors the House bill.”  (Mary Agnes Carey and Samuel Goldreich, “Patients’ Rights: Doomed?” CQ Weekly, 8/3/02)

Unanimous Supreme Court Decision Upheld Patients’ Ability To Challenge

Decisions By Their Health Plans Within Boundaries Of Existing Law

Supreme Court Unanimously Determined That Federal Law Governs Patient Lawsuits Against Insurers. “The Supreme Court unanimously ruled yesterday that patients cannot use state courts to sue most health insurance plans for refusing to cover medical treatments … The court ruled that patients can only sue insurers in federal court under a 30-year-old federal law. Under the Employee Retirement Income Security Act, patients are unlikely to receive large jury awards because they can only sue for the cost of the benefits that were denied, not for their pain and suffering or to punish the insurer.”  (Charlie Savage and Liz Kowalczyk, “Court Limits Patient Suits Vs. Insurers,” The Boston Globe, 6/22/04)

ü      U.S. Chamber Of Commerce, National Association Of Manufacturers And Other Organizations Told Court That Unlimited Lawsuits Hurt Consumers By Increasing Health Care Costs And Forcing Restrictions On Benefits.  “In a separate friend-of-the-court brief, the American Association of Health Plans, the U.S. Chamber of Commerce, the National Association of Manufacturers and the American Benefits Council warn that, if insurers must contend with the cost of more lawsuits, consumers will face ‘higher co-payments, deductibles and premiums, while being subject to restricted benefits and drug selection.’”  (Charles Lane, “Court To Hear Insurance Case,” The Washington Post, 11/4/03)

ü      Urban Institute President Robert D. Reischauer Said Adequate Care By Health Insurers Can Be Ensured Without Threat Of Lawsuits At State Level.  Q. “Aren’t health insurers gradually losing their exemption from state regulation, even without a federal patients’ rights law?”  ROBERT D. REISCHAUER: “There has been a very gradual erosion, but we haven’t gotten to the point where the erosion has become a slippery slope for the law. Personally, I’m a supporter of the Erisa exemptions. There are other avenues to insure adequate care besides the threat of lawsuits: competitive forces, oversight by employers or purchasers of the quality of care that they are offering employees.”  (Milt Freudenheim, “Five Questions For Robert D. Reischauer,” The New York Times, 6/30/02)

Senators Kerry And Edwards Have Played Politics With Patients’ Bill Of Rights For Years

Kerry Promises Patients’ Bill Of Rights That Would Guarantee Patients: The Ability To Sue Their HMOs, Access To Specialists And Emergency Room Care, And External Appeals Process To Challenge HMO Decisions.  “As president, John Kerry will push Congress to finally pass a real Patients’ Bill of Rights – one that allows Americans to hold HMOs accountable for decisions that harm patients by denying necessary medical care. Critical patient protections John Kerry will support include: A right to see the specialists they need; A right to real emergency protections; A real external appeals process that allows patients to appeal a HMO decision; A right to hold health plans accountable; Whistleblower protections that allow health care workers to report quality problems without fear of retaliation.”  (John Kerry For President, “John Kerry’s Plan To Make Quality Health Coverage Affordable For America,” Fact Sheet, 6/23/04)

But Kerry And Edwards Have Voted At Least Three Times Against Patients’ Bill Of Rights Legislation Containing Most Of The Provisions Their Campaign Is Now Proposing: 

ü      In 2001, Kerry And Edwards Voted Against Bipartisan Substitute Legislation For Patients’ Bill Of Rights.  The bill, sponsored by Senators Bill Frist (R-TN) and John Breaux (D-LA), “would provide federal protections, such as access to specialty and emergency room care, and allow patients to appeal a health plan organization’s decision on coverage and treatment. It also would allow patients to sue at the federal level, with non-economic damages capped at $750,000. Economic damages would be unlimited and punitive damages would be prohibited. It also would require the administrative appeals process to be exhausted for patients before a cause of action is brought in connection with a denial of claim for benefits.”  (S. 1052, CQ Vote #219: Rejected 36-59: R 34-10; D 1-49; I 1-0, 6/29/01, Kerry And Edwards Voted Nay)

ü      In 2000, Kerry And Edwards Voted Against Amendment That Contained 1999 Patients’ Bill Of Rights Act Modified With Many Of Conference Committee’s Compromises.  It would provide a range of federal protections – such as access to internal and external appeals, emergency care, specialists and out-of-network doctors – mainly for the 56 million Americans in self-insured health plans. It would give patients in self-insured and employer plans the right to sue in federal court for harm caused by either failure to comply with the external medical review or delay in providing care. It would prohibit managed care plans from denying patients based on predictive genetic information.  (H.R. 4577, CQ Vote #166: Adopted 51-47: R 51-4; D 0-43, 6/29/00, Kerry And Edwards Voted Nay; Senate Republican Policy Committee, “Labor-HHS Appropriations/Patients’ Bill Of Rights,” 6/29/00)

ü      In 1999, Kerry And Edwards Voted Against Patients’ Bill Of Rights Legislation That Passed And Went To Conference.  The bill provided federal protections – such as access to emergency care, continuing care and approved clinical trials for cancer treatment – primarily for the 48 million Americans covered by self-insured health plans. It also established an internal and external appeals process, and prohibited insurers from denying patients based on predictive genetic information.  (S. 1344, CQ Vote #210: Passed 53-47: R 52-2; D 0-45; I 1-0, 7/15/99, Kerry And Edwards Voted Nay)

Kerry And Edwards Support Personal Injury Trial Lawyers Over Patients And Employers

Kerry And Edwards Opposed Requirement That At Least 85 Percent Of Large Monetary Awards From Actions Brought Under Patients’ Bill Of Rights Be Awarded To Patients, Not Personal Injury Trial Lawyers.  The vote was to table “the Bond, R-Mo., amendment [to S. 1052] that would require that a patient beneficiary who receives an award from any cause of action brought under the [2001 Patients’ Bill of Rights] receive at least 85 percent of that award if it exceeds $100,000. Attorney fees in state and federal courts would be capped at 15 percent.”  (S. 1052, CQ Vote #204: Motion Agreed To 62-38: R 11-38; D 50-0; I 1-0, 6/28/01, Kerry And Edwards Voted Yea)

Kerry And Edwards Voted Against Exempting Employers Who Provide Health Benefits From Lawsuits Brought Under Patients’ Bill Of Rights.  “The Gramm amendment would strike the bill [S. 1052, Patients’ Bill of Rights] provisions that will allow suits to be filed in State and Federal courts against employers who voluntarily provide health insurance to their employees, and in lieu thereof would insert provisions modeled on Texas’ patient protection law that exempts employers from health care lawsuits.” (S. 1052, CQ Vote #197: Rejected 43-57: R 43-6; D 0-50; I 0-1, 6/26/01, Kerry And Edwards Voted Nay; Senate Republican Policy Committee, “Health Insurance/Legal Protection For Employers Who Provide Insurance,” 6/26/01)

Kerry And Edwards Twice Voted Against Exempting Small Businesses That Provide Health Benefits From Lawsuits Brought Under Patients’ Bill Of Rights.  (S. 1052, CQ Vote #199: Rejected 45-53: R 44-5; D 1-47; I 0-1, 6/27/01, Kerry And Edwards Voted Nay; S. 1052, CQ Vote #215: Motion Agreed To 55-43: R 5-42; D 49-1; I 1-0, 6/29/01, Kerry And Edwards Voted Yea)

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[walden]

Didn't read it-- is there a point here?

[phxaz]

didnt read your post. any question there?

[upchuck]

They sure as hell don't represent MY American Family's Voice!