Patients' rights bill takes sharp setback

Talks between senators, White House can't reach accord on suing HMOs


WASHINGTON - Talks between the White House and the Senate on a bill to define patients' rights collapsed yesterday, significantly reducing the chances that the government will impose new standards on health insurance companies and health maintenance organizations this year.

Ultimately, senators said, they could not reach agreement with the White House on creation of a federal right for patients to sue for injuries caused by the decisions of a health maintenance organization.

In June 2001, the Senate passed by 59-36 a bill that would establish a wide range of patients' rights for more than 200 million Americans.

Patients could file suit, in federal or state court, to enforce their rights and could win damages for certain injuries.

President Bush had threatened to veto the Senate measure, but he supported a bill passed by the House last August. The House bill would provide patients with a much more limited right to sue.

The authors of the Senate bill - Democrats Edward M. Kennedy of Massachusetts and John Edwards of North Carolina and Republican John McCain of Arizona - began quiet negotiations with the White House in November. Yesterday, they abandoned those efforts, saying they saw no chance of an agreement.

In a letter to Bush last week, the three senators said, "We have made significant progress, but require your personal intervention to resolve the final difficult issues dividing us." They requested a meeting with the president but could not get one.

The White House had floated the idea of setting different limits on damages for different types of injuries. Under one suggestion, a person with a serious injury could have recovered up to $4 million for pain and suffering and other noneconomic damages, while a person with a less serious injury could have won up to $1.5 million.

A Bush administration official said the White House was "willing to work within that framework." But a Senate aide said Kennedy believed that it was "totally inappropriate" to set a limit on damages for the most serious injuries, such as brain damage, blindness or loss of a limb. The three senators said a court should be able to consider the effects of such injuries on each individual victim.

McCain and Edwards said the White House had made a good-faith effort to reach agreement.

"For too long," McCain said, "this vital reform has been frustrated by political gridlock - principally by trial lawyers, who insist on the ability to sue everyone for everything, and by the insurance companies, who want to protect their bottom line. Caught in the middle are average citizens who are members of HMOs."

Scott McClellan, a White House spokesman, said Bush still wanted to "get strong patient protections this year." But, in an apparent reference to the Democrats, McClellan added, "It appears that some are unable to pull loose from the grip of powerful personal-injury trial lawyers."

A Senate Republican aide said the Democrats' complaints were "political theater for the fall campaign."

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