NOT WHAT THE DOCTOR ORDERED

Timing, politics stymied Patients' Bill of Rights

8/27/2008

Seven years ago, President Bush invited Rep. Charles Norwood to the White House to discuss the Georgia congressman's long-lived efforts to pass a Patients' Bill of Rights.

For much of the late 1990s and early 2000s, lawmakers on Capitol Hill haggled over proposals to protect patients from intrusions by insurers.

Mr. Norwood, a Republican, along with Rep. John Dingell, a Michigan Democrat, championed a sweeping proposal which guaranteed patients they would have recourse when a health plan denied coverage.

But on that August day in 2001, Mr. Norwood left the Oval Office with a handshake and a compromise. And the Patients' Bill of Rights, at least as Mr. Dingell envisioned it, began its slow fade into the vast banks of failed health-care legislation.

"The White House took him down there and they brain-washed him and he turned around and left us," Mr. Dingell, the chairman of the House Committee on Energy and Commerce, told The Blade recently. "They turned him around on us and we never pushed the bill because it just couldn't be done."

READ THE SERIES: Not What The Doctor Ordered

Mr. Norwood, a dentist, died last year, but Rodney Whitlock, his legislative director during the deliberations over the Patients' Bill of Rights, remembers a different story.

"The people who want to say we were brainwashed, they were bitter at the outcome," said Mr. Whitlock, who now works for the Senate Finance Committee.

One day after the White House meeting, the GOP-controlled House along partisan lines passed a rendition of the Patients' Bill of Rights mandating minimum requirements for what must be covered by health plans and giving patients an avenue for having disputes with their insurance companies heard by impartial reviewers.

Those were two key elements of the Norwood-Dingell bill and a proposal sponsored in the Senate by John McCain of Arizona, Edward Kennedy of Massachusetts, and John Edwards of North Carolina.

But Mr. Norwood's compromise with the President limited liability for insurance companies sued by patients who are injured because of insurance decisions - a political sticking point that Republicans and Democrats could never overcome.

Mr. Whitlock said the Patients' Bill of Rights failed not only because of politics, but also because of bad timing.

In the summer of 1998, with the proposals gaining momentum, a gunmen opened fire in the U.S. Capitol, killing two police officers. And on the morning of Sept. 11, 2001, aides to Mr. Norwood, Mr. Dingell, and Sens. McCain, Kennedy, and Edwards convened to deliberate over the Patients' Bill of Rights.

"At pivotal moments, other things blew it off the screen," Mr. Whitlock said.

Mr. Dingell's recollection is that the Patients' Bill of Rights died at the hands of insurance lobbyists - the "masters," as he put it.

"They killed it," he said. "It was the doing of the insurance companies."

Insurance companies and doctor organizations have long been among the most active lobbyists in Washington.

During the past decade, the insurance industry has spent nearly $1.1 billion lobbying the federal government - with more than $412 million coming from the health and accident insurance sector, according to data from The Center for Responsive Politics, a Washington-based nonprofit that tracks political spending.

Doctors have ponied up, too.

Physician, psychologist, and optometrist groups spent more than $489 million on lobbying in the past decade, according to the center.

In 2001, the insurers spent about $7 million lobbying on the Patients' Bill of Rights, the center reported. That same year, the American Medical Association poured $7 million into its Washington lobbying efforts, Senate records show.

Did insurers tilt the system against the Patients' Bill of Rights?

"There's no question they tried, but they failed," Mr. Whitlock said. "Look how little they got in exchange for Norwood's vote."

But to Democrats, the insurers won big because no version of the Patients' Bill of Rights passed.

Contact Steve Eder at:

seder@theblade.com

or 419-304-1680