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Office of the Press Secretary

For Immediate Release August 10, 1998
                      PRESIDENT CLINTON ANNOUNCES 
                       PATIENTS' BILL OF RIGHTS
                            August 10, 1998

Today, the President will outline the inadequacies of the Gingrich/Lott patients' bills of rights, showing that they have more loopholes than protections. He will announce that if Congress sends him such flawed legislation, he will veto it. While the Republican Leadership stalls on passing a real patients' bill of rights, the President continues to implement patient protections for the 85 million Americans in federal health plans. The Office of Personnel Management is releasing today a new regulation to prohibit gag rules, as part of its efforts to meet the President's directive to bring all Federal health plans into compliance with the patients' bill of rights. Today, the President will:


Contain Empty Promises. Many of the provisions in the Republican plans are symbolic gestures rather than real patient protections. As the American Nurses Association says: "Republican leaders who promise protection from managed care abuses for patients only deliver slogans for the patients and protections for the managed care industry." For example these bills:

Let HMOs, not health professionals, define medical necessity. The

     Republican Leadership proposals provide for an external appeals
     process, but make this process meaningless by allowing HMOs
     themselves, rather than independent health professionals, to 
     define what services are medically necessary.  This loophole will 
     make it very difficult for patients to prevail on an appeal to 
     get the treatment their doctors believe they need.

Allow financial incentives to threaten critical patient care. The

     Republican legislation purports to protect patients from financial
     incentives to limit care, but applies this protection in only a 
     very narrow set of circumstances. The bills thus leave most 
     patients, in most health care settings, vulnerable to financial 
     incentives that limit patient care.  By pretending remove those 
     incentives, while allowing them to go forward, the Republican 
     Leadership bills mislead patients as to the risks of improper 

Leave Out Essential Protections For Patients. The Republican Leadership proposals fail to include several critical patient protections. The National Breast Cancer Coalition, raising concerns about the absence of important protections, says that "if these bills are enacted, it could be devastating for the thousands of women who undergo breast cancer treatment every year." The Republican Leadership proposals:

Fail to guarantee direct access to specialists. The Republican Leadership proposals fail to ensure that patients with serious health problems have direct access to the specialists they need. For example, patients with cancer or heart disease may be denied access to the doctors they need to treat their conditions.

Fail to protect patients from abrupt health care changes. The

     Republican Leadership bills fail to assure continuity of care when 
     an employer changes health plans.  This deficiency means that 
     pregnant women or individuals undergoing care for a chronic 
     illness may have their care suddenly altered mid course, 
     potentially causing adverse health consequences.

Fail to compensate patients who have suffered harm as a result of a

     wrongful health plan action.  The proposed per day penalties in 
     the Republican Leadership plans fail to compensate patients who 
     suffer serious harm or even death because of a health plans' 
     wrongful action.  For example, if a health plan improperly deny 
     a lifesaving cancer treatment to a child, it will only incur a 
     penalty for the number of days it takes to reverse its decision 
     but will not have to pay the family for all the damages it will 
     suffer as the result of having a child with a now untreatable 
     disease. And because the plan will not have to pay for all the 
     harm it causes, it will have insufficient incentives to change 
     health care practices for the future.

Reverse Course on Some Critical Protections. In some areas, the Republican Leadership bills undermine current patient protections that are law today. The American Medical Association says that these bills "would roll back vital patient protections enacted in the states." Similarly, the Kentucky Chapter of the American College of Physicians says that "the Republican bills basically gutted the 'prudent layperson standard'" that assure real emergency room protections. The Republican bills:

Undermine existing medical privacy protections. The House Republican

     Leadership bill would preempt some existing medical privacy
     protections guaranteed by state law, without putting any 
     protections in their place.  As a result, the bills would 
     increase the number of individuals who can review and give out 
     health records without a patient's knowledge or consent.

Reverse course on emergency room protections. The Republican

     Leadership proposals back away from the emergency room protections 
     that Congress implemented for Medicare and Medicaid beneficiaries 
     in the Balanced Budget Act of 1997.  The Republican bills include 
     a watered-down provision that does not require health plans to 
     cover patients who go to an emergency room outside their network 
     and does not ensure coverage for any treatment beyond an initial 
     screening.  These provisions put patients at risk for the huge 
     costs associated with critical emergency treatment.

Leave Millions of Americans Out in the Cold. The Republican Leadership bills do not apply to all health plans and therefore leave out millions of Americans. As the American Nurses Association says: "we will not agree to leave a large segment of the population unprotected." The bills:

Do not cover all health plans. Both Republican Leadership bills leave

     millions of Americans unprotected.  The Lott proposal, for example,
     covers only self-insured plans, thus leaving out 100 million
     Americans, including millions of Americans in small businesses.  
     These Americans are held hostage to the hope that states will 
     provide them with every patient protections that the Republicans 
     in Congress will not.

ANNOUNCE A NEW "ANTI GAG" REGULATION FOR FEDERAL EMPLOYEES. While the Republican Leadership delays passing strong patient protections, the Clinton Administration is implementing the patients' bill of rights for the 85 million Americans in Federal health plans. The President will:

Announce release of anti-gag regulation. Today, the President will

     announce that the Office of Personnel Management (OPM) is 
     releasing a new regulation prohibiting plans participating in the 
     Federal Employees Health Benefits Program (FEHBP) from using gag 
     clauses.  This regulation will ensure that health professionals 
     can discuss all medical treatment options with their patients.  
     Earlier this year, OPM notified all participating health plans 
     that they must provide other new patient protections --  including 
     assuring access to specialists, continuity of care, and access to 
     emergency room services -- to their enrollees.  FEHBP has 350 
     participating health plans that serve 9 million federal employees 
     and their families, including over 100,000 people in Kentucky.

Build on efforts to extend patients' bill of rights to all Federal

     health plans.  In June, the Department of Health and Human 
     Services extended the patients' bill of rights to the 40 million 
     Americans who receive Medicare.  Last month, the Department of 
     Veterans' Affairs began to put in place a new, rapid appeals 
     process for the 3 million veterans who receive health care.  Last 
     week, the Department of Defense issued a directive to all 
     military bases throughout the world, extending patient protections 
     to 8 million servicemen and women and their families at nearly 600 
     hospitals and clinics around the world.