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THE WHITE HOUSE

Office of the Press Secretary

For Immediate Release July 15, 1998

        PRESIDENT CLINTON ANNOUNCES FEDERAL HEALTH PLANS LEAD 
        THE WAY AT AN AMA PATIENTS' BILL OF RIGHTS ROUNDTABLE 
          UNDERSCORING NEED FOR PASSING STRONG LEGISLATION

                              July 15, 1998

Today, at the American Medical Association (AMA), the President met with doctors, nurses, and families from around the nation who highlighted the critical need for Congress to pass a strong enforceable patients' bill of rights this year. The President of the AMA, Nancy Dickey, praised President Clinton's leadership and pledged the AMA's continuing efforts to pass a meaningful patients' bill of rights before Congress adjourns. The President also announced that the Federal government is leading the way by implementing the patients' bill of rights for the 85 million Americans in Federal health plans. Today, the Department of Veterans' Affairs announced that it is beginning its implementation of an external appeals process for the 3 million veterans served by the DVA.

Doctors, nurses, families of patients, and benefits managers from around the country strongly urged Congress to pass a patients' bill of rights. The individuals who met with the President in today's round table discussion with the AMA included: (1) a man from Chicago whose wife died after her HMO forced her to travel from Hawaii to Chicago in an emergency to be treated at an in-network hospital; (2) a woman from Kansas whose husband died because he was delayed and denied access to a specialist for heart surgery until it was too late; (3) a man from Seattle whose sister died after her health plan reversed a treatment decision for which it should have provided coverage in the first place, after it was too late for the treatment to be effective; (4) a Massachusetts oncologist who has witnessed numerous patients denied access to the specialists they need; (5) the President of the American Nurses Association, who spoke on behalf of thousands of nurses around the country who see every day the devastating health consequences for patients who have been denied access to specialists, or have an abrupt transition in care; and (6) a woman who reviews claims in an oncologists' office and has witnessed, again and again, health plans deny patients access to the care they need.

While Congress delays passing legislation, the Clinton Administration is implementing the patients' bill of rights for Americans in Federal health plans, including a new external appeals process for veterans. Today, the Department of Veterans' Affairs is announcing that it is beginning the implementation of an external appeals process for the three million veterans served by DVA. This new external appeals process builds on the other protections already in place at DVA, including ensuring patients full participation in treatment decisions, access to specialists, access to women's health services, preventing anti-gag clauses, preventing financial incentives to limit care, and one of the most extensive internal appeals processes in the country. In February, the President signed an Executive Memorandum to bring all Federal health plans, which serve 85 million Americans, in compliance with the patients' bill of rights.

President Clinton reiterated his call on Congress to pass an enforceable patients' bill of rights before they adjourn. For nine months, the President has been calling on Congress to pass a patients' bill of rights that includes: guaranteed access to needed health care specialists; access to emergency room services when and where the need arises; continuity of care protections to ensure patient care will not abruptly change if their provider is dropped; access to a timely internal and independent external appeals process for consumers to resolve their differences with their health plans; a limit on financial incentives to doctors; ensuring that doctors and patients can openly discuss treatment options; ensuring that women have direct access to an OB-GYN. Any bill of rights should include an enforcement mechanism that ensures recourse for patients who have been maimed or who have died as a result of health plan actions. A right without a meaningful remedy is simply not a right.

The Senate Republican patients' bill of rights proposal announced today is closer to an insurers' bill of rights than a patients' bill of rights. After nine months of ignoring the President's call for a strong enforceable, bipartisan patients' bill of rights, the Senate Republicans have responded with a rhetoric-laced, partisan proposal that places the interests of insurers above the needs of patients. The proposal, for which there continues to be no legislative language, falls far short of what patients need to ensure that their health plans are held accountable for their basic health care needs. Specifically, it does not include access to specialists, ensuring that patients are not put at risk through unknown destructive financial incentives to limit patient care; and a strong, workable enforcement provision which is essential to ensure that these protections are real. Moreover, the Republican proposal, however inadequate, applies only to Americans in self-insured plans thus excluding the majority of Americans who are in fully-insured plans. Therefore, those tens of million of Americans excluded from these protections would have the rights they need only if every state passed every protection into law.

The President remains committed to passing a strong enforceable patients' bill of rights in this Congress. Notwithstanding his concerns about the Republican bill, the President will work to pass a strong enforceable patients' bill of rights this year. The patients' bill of rights has been a longstanding priority for the President. In 1996, he called for the establishment of a bipartisan Quality Commission to examine the changing health care system. In March of 1997, he appointed the Commission and instructed them to develop a patients' bill of rights as their first order of business. In November, he endorsed the patients' bill of rights and called on the Congress to make it the law of the land. In his State of Union address, he focused the nation on this issue and reiterated his call on Congress to pass this legislation. One month later, he issued an Executive Memorandum directing the Federal health plans, which cover 85 million Americans, to implement the patients' bill of rights. Since that time, he has been ensuring that the Federal agencies are implementing these protections and reiterating his call on Congress to pass legislation this year.