News & Reviews

Beltway war of the week: patients' bill of rights Want that super-sized? Give up a Big Mac a month and Teddy Kennedy will give you the right to sue your HMO. Senate rhetoric soared last week as Democrats and Republicans squared off over legislation to regulate managed-care health insurance companies. Democrats served up the super-size burger, fries, and quart-of-Coke version and Republicans suggested the salad. The battle was over the cost. "At the end of five years," contended chief sponsor Sen. Edward Kennedy (D-Mass.), "the average worker's cost would increase by less than $2 a month-less than the cost of a Big Mac." Here's the skinny: The Democratic bill would have made health insurance companies pay for care if it is consistent with generally accepted principles of medical practice. HMOs could not deny claims for care that doctors, as a group, recommend. But Republicans replaced the Democratic "medical necessity" language with their own system allowing patients to appeal if care is denied. Both plans miss the fundamental flaw in American health care: People don't care how much they are charged because it doesn't cost them a dime directly. This leads to inflated costs, which leads to employers dropping coverage. Neither plan includes provisions promoting Medical Savings Accounts, which would let people keep health dollars they don't spend. Supporters of the Democratic plan hauled out the horror stories, like the one about a woman who fell off a cliff, fractured her skull, and was airlifted to the emergency room. But the HMO wouldn't pay because the unconscious woman didn't call first. While Democrats demonized HMOs, Republicans claimed the bill would be a bonanza for trial lawyers. But what about the Big Mac? Sen. Phil Gramm (R-Texas) offered an estimate that, far from costing a couple of bucks a month for the average taxpayer, the Democrat proposal would run up health care costs by $72 billion. That's enough, Sen. Gramm said, to purchase every McDonald's franchise in America. Sen. Kennedy denied that, but Republicans called the Democrats' cost bluff, with a clever amendment that would automatically cancel all the Democratic provisions in the bill if it raises the cost of health insurance more than 1 percent-equivalent to Sen. Kennedy's hypothetical trip to the golden arches. Every Democrat voted no on the amendment. The Republican "patients' bill of rights" legislation must clear the House before going on to the White House, where the plan faces a certain veto from the fast-food loving president. Forbes takes pro-life pledge No stealth nominees Republican presidential hopeful Steve Forbes brought the issue of abortion back to the center of the GOP race last week, pledging that as president he would "not appoint judges to the federal bench if they do not value the precious lives of unborn children." Mr. Forbes made the statement during a week-long trip to 26 counties in Iowa in which the candidate highlighted his views on the Federal Reserve, taxes, and abortion. Does his promise mean that he's committed to nominating people who have well-defined pro-life records or philosophies, as opposed to President George Bush's appointment of David Souter, whose views at the time of his nomination were unclear? "Absolutely yes," Mr. Forbes told WORLD. He said his criteria for all judicial nominees would be "adherence to the Constitution [and] respect for the sanctity of life along the lines of Justices Scalia and Thomas, not only for the Supreme Court but for other federal benches." The No-Comment zone