Re: The Bushwhacking of America

To: President Bush:

Re: The Bushwhacking of America

Your actions this week, to undermine a bi-partisan compromise for a patients’ bill of rights, contradict your campaign pledges to the American public about HMO reform.

“If I’m the president, we’re going to have emergency room

care, we’re going have gag orders, we’re going to have direct access to OB/GYN. People will be able to take their HMO insurance company to court. That’s what I’ve done in Texas and that’s the kind of leadership style I’ll bring to Washington.” You made these declarations during the third debate with Vice President Gore and every item is covered in the compromise proposed today by Senators McCain and Kennedy.

The Texas legislation, which became law without your signature, included in it no caps on damages applicable specifically to HMO patients — an issue you raised for the first time today for Americans. During the campaign, you held the Texas law out as a national model. The compromise crafted by Senators McCain and Kennedy meets all the qualifications you laid out for a national patient’s bill of rights in the third debate.

“I do support a national patient’s bill of rights,” you declared.” As a matter of fact, I brought Republicans and Democrats together to do just that in the State of Texas to get a patient’s bill of rights through….And this particular bill,”

1) “it allows patients to choose a doctor, their own doctor if they want to.” So does McCain-Kennedy.

2) “But we did something else that was interesting. We’re one of the first states that said you can sue an HMO for denying you proper coverage.” As does McCain-Kennedy.

3) “Now there’s what’s called an Independent Review Organization that you have to go through first. It says you have a complaint with your insurance company, you can take your complaint to an objective body. If the objective body rules on your behalf, the insurance company must follow those rules. However, if the insurance company doesn’t follow the findings of the IRO, then that becomes a cause of action in a court of law.” McCain-Kennedy mirrors Texas law in this regard.

Maybe most importantly, you stated emphatically during the third debate, “You know, I support a national patient’s bill of rights, Mr. Vice President, and I want all people covered. I don’t want the law to supersede good law like we’ve got in Texas.” Veering from the careful anatomy of the compromise measure would indeed either preclude patients from being covered or supercede Texas law. The compromise allows patients in states who currently have state court claims to pursue them, while creating new remedies for those subject to the federal Employee Retirement Income Security Act or ERISA. Under the compromise, for ERISA-covered patients, coverage disputes are dealt with in federal court and negligence claims in state court. Your comments today that you would like all claims in federal court would undermine the Texas law you championed, which is meant to apply to both ERISA and non-ERISA patients and allows a state court claim for negligence.

There is no substantive modification you can make to the proposed compromise that does not renege on a campaign pledge. Proceed carefully. Any substantive changes to the compromise proposed would be nothing less than a Bushwhacking of the American public.