Press Briefing by Secretary of Health and Human Services Donna Shalala

The Briefing Room

1:25 P.M. EDT

MR. TOIV: Good afternoon, everybody. As you know, Senate Republicans today released their proposal for a Patient's Bill of Rights, and of course the President will be doing an event on this issue later. But we thought that you might like the administration response to that proposal, and here to give that is Secretary of Health and Human Services Donna Shalala.

Q: Doesn't the President plan to make a response, Barry?

MR. TOIV: He'll speak to the issue.

SECRETARY SHALALA: He'll speak to the issue. I think this is a more detailed briefing on our first read of what the Republican press releases and the materials they've given us say. I think I would describe this as too little and too late. The Republican proposal does not provide 70 million Americans all the patient protections they need. What they've done is -- we've been talking about 125 million Americans who have no patient protections, and what they've done is taken care of some of them but not all of them. And those they've taken care of, it's a very light proposal.

Let me give you some specific examples. We have insisted that people should get access to specialists, particularly those who have chronic illnesses and are disabled. In the Republican bill they allow access to specialists only in two cases: in the case of women getting access to gynecologists, and in the case of families getting access to pediatricians. We have insisted that people get access to oncologists. If they have cancer, they ought to be able directly to their oncologists. If they have a heart disease, they ought to be able to go directly to their heart specialists. So the Republican plan denies access to specialists for those who need that access.

Second, their plan does not limit or require disclosure of financial incentives for doctors. We ought to know when we go into a health plan what the financial arrangements are. Does that physician get more money if he provides less care? And everyone ought to know what the special kinds of incentives are -- economic incentives are -- that may influence the decisions that a physician makes.

The Republican plan also does not provide for enforceability. We have said consistently that if you give people rights, they ought to have a remedy. If I am injured as a result of a decision that a plan made, my doctor and I agree on the treatment, the plan turns down the doctor's recommendation, I'm injured as a result, I ought to be able to get compensation. There ought to be enforceability in these plans, and the Republican plan leaves that out.

And so, on the fundamental issues of specialists, of financial incentives for doctors, of enforceability, the Republican simply leaves out those proposals.

Most Americans who work in small businesses will not be protected under the Senate Republican proposal. The plan explicitly excludes these Americans from these protections and holds them hostage with the hope that every state will pass a comprehensive bill. And so among those left out of the Republican plan are those who work in small businesses and get their health insurance through that small business.

The Republican plan also is inconsistent with the Kennedy-Kassebaum bill. It rejects that approach that guarantees insurance protections are extended to all Americans. There's no reason that the Patient Bill of Rights shouldn't follow the same structure. And that's the point: they leave out a certain number of people -- our projection is 70 million -- and leave them at the mercy of whatever their states are going to do in this area.

We have recommended that this be a national bill that covers everyone -- whether or not the state has jurisdiction or whether or not the federal government has jurisdiction. The Patient Bill of Rights is for all patients, for all Americans. So on the fundamentals the Republican bill falls far short.

The President still has hopes that we're going to be able to produce a bipartisan bill. And we hope that they'll see the light as they see the shortcomings of the bill that they've put out. They actually haven't put out a bill, they put out some language; and we hope in the process of discussions to point out both the shortcomings of the bill and the President's commitment to try to produce a bipartisan bill in the relatively short period of time that we have.

I'd be happy to answer any questions you may have.

Q: Do you really think the Republicans are denying patients access, as you say, to heart and cancer doctors?

SECRETARY SHALALA: That's what their bill says. Their bill does not require, under their bill of rights, that people with chronic illnesses or who have that disease can have direct access. It would leave them to go through whoever the gatekeeper is in their health plan.

Q: You don't have to make them perhaps see the light, just feel the heat. Is there enough heat, do you think, that Congress is going to have to do this?

SECRETARY SHALALA: I think the average American gets it -- that if you have cancer and you can't go directly to your oncologist, that if something happens to you and you and your doctor have agreed on a treatment and some accountant turns down your doctor and you get injured as a result, you can't get compensation.

And I think this is pretty straightforward for the average American. They want the playing field to be even. They want to know what's in the plans.

I also think that most of us would like to know if there are some special financial arrangements in these plans that in fact offer more compensation if less care is given. I think we want that disclosed. And that ought to be very much part of the Patient Bill of Rights.

Look, nine months ago the President laid out very clearly what he thought the fundamental rights ought to be for everyone, no matter where we purchased our health care or where we lived in the country. And we have endorsed a number of bills. The Republicans have now finally come back with their response, and it is quite short in terms of what Americans want from their health plans.

Q: Is this a good place to begin negotiations?

SECRETARY SHALALA: Look, we were prepared to begin discussions long before this. Our position has been quite clear over the last year. And in fact when the President appointed the commission that I chaired with Secretary Herman, we made it very clear that we thought this was a nonpartisan issue that applied to everyone's health insurance, whether they were Republicans or Democrats. So we're always prepared to talk.

Q: But it --

SECRETARY SHALALA: But we're not -- go ahead.

Q: Is it too late? I mean --

SECRETARY SHALALA: It's never too late. Who set the arbitrary rules about how many days we have left before the end of the legislative session. I mean --

Q: They've got to go home and get re-elected.

SECRETARY SHALALA: This can be done. There are bills before Congress and this could be done. There are amendments being readied.

Q: Is the President going to veto bills in this form when it reaches the President's desk -- if it reaches the President's desk?

SECRETARY SHALALA: Well, I don't want to use that language yet, because what we've just done is seen their -- what I hope is simply an opening offer. And we're going to say to them very clearly that this is inadequate and let's get into the conversation.

Q: On a different topic, the chairman of the House Ways and Means Committee today has called on the White House to abandon an appeal of the suit involving you and other Cabinet secretaries, dealing with the Health Care Task Force. It's now going to appeal today. Do you think that case should be appealed or they should they stick with it?

SECRETARY SHALALA: I don't -- I think the Justice Department and the White will have to answer that. It doesn't involve me. I'm not a party to it.

Q: You're one of the Cabinet Secretaries on the suit.

SECRETARY SHALALA: I think it's a White House decision. We'll have someone come out. We'll have someone come out and answer that question.

Q: Good luck. (Laughter.)

Q: We have four or five other questions we'd like you to have come out and answered. (Laughter.)

SECRETARY SHALALA: Ask them.

Q: You don't know anything about those.

SECRETARY SHALALA: I don't know anything about this one either. (Laughter.) Any other questions about the Bill of Rights. If not, we'll see you at the event at 2:00 p.m.

END 1:37 P.M. EDT