WASHINGTON (CNN) -- The Senate killed off a Republican move Tuesday to shield employers from lawsuits over health coverage, but behind-the-scenes dealing could yield a compromise on patients’ rights within the next few days. The chamber spent the early portion of Tuesday debating a vital change to the bill championed by the majority Democrats – a bill the GOP would like to defang before the House of Representatives gets its say on the issue later in the summer. The amendment -- similar to provisions of a patients’ bill of rights enacted in the state of Texas -- would have blocked lawsuits against employers when the treatment decisions of insurance providers and health maintenance organizations are challenged by patients in court. The amendment, presented by Texas’ two Republican senators, Phil Gramm and Kay Bailey Hutchison, failed on a 43-56 vote just after noon. Gramm and many of his Republican colleagues have argued employers should not be held liable if the insurance organization or health provider in their employee benefits package denies an employee a needed medical procedure. Democrats said the number of employers that would be exposed to suits under their bill would be small because very few employers take an active role in deciding the treatments their employees receive. Republicans countered that the Democratic bill – presented by Sens. John Edwards of North Carolina and Edward Kennedy of Massachusetts, with assistance from Republican John McCain of Arizona – contains page after page of provisions opening all employers to the risk of legal action. "There is indeed extreme exposure as far as employers are concerned," said Sen. Fred Thompson, R-Tennessee. "By definition of applicable law, employers are supposed to have control over these health plans." Added Sen. Don Nickles, R-Oklahoma. "If you read their bill, employers beware -- you’re going to be sued." Republicans argued that could drive up premiums for individual beneficiaries and result in some small businesses dropping insurance benefits altogether -- adding another 1.2 million to the number of uninsured U.S. workers, Thompson said. Kennedy returned fire, saying employers establish a trust with their employees when they set up insurance plans for them. Democrats, including the bill's sponsors, have provided many examples of employers cutting off health coverage if their employee suffers some sort of costly, catastrophic injury. "This is in place for those occasions when an employer or HMO [doesn’t] live up to the commitment to that patient when they sign up and start paying the premiums," Kennedy said. With the Gramm amendment dispatched, the door is now open for a compromise, under development by Republican moderate Olympia Snowe of Maine, that would block lawsuits against employers if the employer specifically waives all rights to participate in medical decisions made for its employees. Snowe has approached the White House about the compromise language and has received a favorable response, although she pointed out Tuesday that talks are only in their preliminary stages. President Bush has threatened to veto the bill if it reaches the Oval Office in its current form. Several moderate senators, including Snowe, said Tuesday they have received calls from Bush encouraging them to keep trying to find a compromise on the issue of how vulnerable employers should be. Sens. Ben Nelson, D-Nebraska, and Mike DeWine, R-Ohio, both said they have spoken to the president. "He encouraged me to continue to work with others to try to improve this bill, and I told him I intend to do it," DeWine said, adding Bush encouraged him to try to find a compromise on other contentious areas of the bill. The congressional debate threatens to stay contentious, even if the bill emerges from the Senate intact. The House may soon produce its own bill that would allow patients to sue their health providers in state courts – a venue generally thought to favor higher awards than federal courts. The Democratic bill in the Senate has similar provisions. Republicans in the Senate are supporting a rival bill that would only allow suits to be heard in federal courts and would set a ceiling for cash awards. That bill, produced by Republican Bill Frist of Tennessee, Democrat John Breaux of Louisiana, and independent Jim Jeffords of Vermont, is favored by the Bush White House. Also Tuesday, the Senate defeated an attempt by GOP Sen. Charles Grassley of Iowa to have the Edwards-Kennedy-McCain bill sent back to the Senate Health, Education, Labor and Pensions Committee for further revisions. Grassley’s move fell on a 39-61 vote. I can understand the need for compromise here: an employer shouldn't be held responsible very time an HMO or insurance agency screws up. At the same time, shouldn't the employer be held accountable for partnering with "bad" HMO's? If a company does its homework in advance, much of this could be avoided. And if a company has input... shouldn't it be responsible if such input results in harm? I don't understand why 43 Senators would oppose ANY employer accountability. I'm not well versed in employer-health care coverage, so maybe I'm missing something... but this sounds like more corporate-sell out by the GOP. ------------------ Newbiehad... coming to a bbs near you, October 31st.
Actually, if I was an employer, I would probably just not offer health insurance at all rather than risk a lawsuit. Even if the employer wins the suit, there are costs involved in defending oneself from such suits. And if you lose, that can often mean possible layoffs, potentially even enough to run the company out of business, or even loss of personal assets for many business owners. Better to just avoid that possibility and not offer health benefits at all as often as possible. Given today's legal system, the employer would likely face significant costs defending himself (or even losses in court) even if the employer had no active role beyond picking an HMO. I don't understand how so many Democrats can be for a plan that will likely result in fewer people having access to health insurance and potentially cause there to be fewer jobs available for workers. ------------------
Also, I would maintain that it is a bit harder to select an HMO that would make you lawsuit-proof. For one thing, a good HMO now is not necessarily a good HMO five years from now. You'd have to stay on top of any development with the HMO to be completely shielded. But if the HMO that was once good started to falter, you'd run the risk of lawsuits by changing HMOs because people that were covered under the previous plan might not be covered if the insurance company is switched (they would sometimes become preexisting conditions under the new plan). So, you're risking a lawsuit by changing, and risking a lawsuit by not changing. Also, one of the things that keeps popping up as a reason to allow people to sue their HMOs has been HMOs' refusal to pay for experimental treatments. It's hard to know what your HMO will or won't do in regards to treatments that don't yet exist. But if you can't tell the future, you run the risk of a lawsuit. And let's not forget costs, a small businessman might opt for the best plan he can afford for his workers, but he risks a lawsuit by doing that because the less expensive plan (even though it may look fine at the time) may not end up offering the best possible care and cause an amployee to sue. So, under this law, the only way an employer could guarantee to avoid a lawsuit would be to not offer health insurance at all. Even just giving the money that he would be spending on health care to the employees in bigger pay would be far safer than offering health insurance and risking losing the business and one's personal assets. And even if there are some limits imposed as to when an employee can sure the employer, the risk for lawsuits is still high and even if the employer wins, it still costs a not insignificant amount of money to defend one's self from a lawsuit. I think adding the ability to sue one's HMO is enough. Putting the employers in the crosshairs is a bad idea that will likely reap many unintended consequences. ------------------
or socialize medicine I know the rudiments of socialized medicine. I, by no means have all the answers, but could it not truly be another alternative? But then again, would I really want our government being responsible for taking care of my health needs? “shudder” ------------------ Everything you do, effects everything that is.
