Patients' Rights Rise in Senate ; the Democrat-Controlled Chamber Will Debate a Patients' Bill of Rights Tomorrow

Article excerpt

It's being called a test case for the new balance of power in the nation's capital.

How the White House and the Senate work together - or don't - on a patients' bill of rights will speak volumes about the unfolding relationship between the new Republican president and a Senate suddenly controlled by the opposition.

Although managed-care reform was on candidate Bush's list of campaign promises, it wasn't high on his list, and it didn't make the first cut of priorities on President Bush's agenda either. But it is of keen interest to the new Democratic Senate majority leader, Tom Daschle, who has made it his top priority and is bringing it to the floor for debate tomorrow.

The very move by the Senate to take up patients' rights, as opposed to the president's preferred agenda, is itself an illustration of a shift in power here - with the White House reacting to, instead of leading on, the issues.

"Instead of having the energy bill on the floor right now, or trade promotion authority on the floor right now, we're going to have the patients' bill of rights," says a senior administration official, acknowledging that Democratic control of the agenda is an "important" change from the "old regime."

"The Democrats can not only take an issue which Bush did not want to bring up at the moment, and bring it up, they can bring it up on their terms," says Norman Ornstein, a political analyst at the American Enterprise Institute here.

"It means that the White House and Republicans are on the defensive," he adds.

What makes this issue especially interesting - and the reason it is a test for both ends of Pennsylvania Avenue - is its contentious nature, even though the key players support the overall concept.

Both parties agree, for instance, that patients covered by the much-maligned health-maintenance organizations (HMOs) should have access to emergency care and medical specialists, as well as have recourse for disputes by seeking independent medical review of their cases.

How much can patients sue?

But one issue separates Senator Daschle from Mr. Bush, and it plays to the worst stereotypes of Democrats and Republicans. Judged by the rhetoric, this issue comes down to the party of the trial lawyers versus the party of big business, as the two sides take unflinching positions over the right of patients to sue their HMOs.

The bill that Daschle and Democrats are pushing - a bipartisan effort led by Democratic Sens. …