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