Patients' rights double cross

As Bush heralds a new "deal" on patients' rights, a key Republican coauthor in the House says he was never consulted.

Published August 2, 2001 8:00AM (EDT)

As President Bush strode to the White House podium with Rep. Charlie Norwood, R-Ga., Wednesday evening to announce that a compromise on the patients' bill of rights had been reached, no one was more surprised than Rep. Greg Ganske, R-Iowa. After all, it was Ganske's bill that Norwood was supposedly compromising on.

And it was Ganske -- as well as Ganske's cosponsor, Rep. John Dingell, D-Mich. -- whom Norwood had promised to talk to before making any agreements with the White House. Which he clearly hadn't done.

And it was Ganske, Dingell and key conservative "Blue Dog" Democrat Rep. Marion Berry, D-Ark., with whom Norwood was supposed to be meeting that afternoon at 4:30, though Norwood hadn't shown up for some reason. As the meeting broke up at around 5:30 p.m., suddenly that reason became clearer, as the cable news networks cut from the latest on missing intern Chandra Levy and beamed into the White House where Bush and Norwood were making their momentous announcement.

"The outline of this agreement, which will later tonight be put into language ... protect[s] the patients of this country," Norwood announced. "The stakeholders that have worked for me and with me, in both parties, are going to be very pleased with this because we accomplished the very goals we started out to do."

But as of Wednesday night, not one of the stakeholders sounded pleased.

"Charlie cut his own deal with the White House, and he didn't bother to tell any of us anything," a clearly agitated Ganske told Salon. "It had better be a damn good deal. I'll tell you what, he may have killed the patients' bill of rights," Ganske continued. "Because I think this is such bad faith, heaven knows now what the Senate will ever do."

"I consider this a breach of a bipartisan effort that has been going on for years," Berry said. "That is unfortunate, because it means that we will not pass a patients' bill of rights through the Congress this year. Even if the House passes the compromise, the Senate will certainly kill it.

"There was nothing bipartisan about the White House approach to this issue, which is a shame," Berry added, "because this has always been a bipartisan effort on our side."

An hour after the Bush-Norwood announcement, Ganske still was in the dark as to the details of the agreement between Norwood and Bush. Norwood set up a 7:30 p.m. meeting to brief his three cosponsors, as well as the leaders of the fight in the Senate, Sens. John Edwards, D-N.C., Ted Kennedy, D-Mass., and John McCain, R-Ariz.

"If it's such a good deal, why wouldn't he bother to give his cohorts and colleagues who've worked with him on this for years a heads-up?" Ganske asked before the meeting. "He had told John Dingell -- and he personally told me -- that he would not cut a deal without personally talking to us."

The scene was reminiscent of February when Bush's liaison to the Senate, Sen. Bill Frist, R-Tenn., was dispatched to negotiate a deal on patients' rights with Democrats Edwards and Kennedy as long as McCain was kept out of the deal. "It became clear that this was just an agreement between Norwood and the White House," said Mike Briggs, spokesman for Edwards, after the 7:30 meeting. "And Norwood is pretty fuzzy on the details." Asked what Edwards thinks of the proposal, Briggs said, "He thinks that it doesn't work."

Briggs said that not one of the participants at the 7:30 meeting, save for Norwood, found the deal acceptable.

The deal was a long time coming. Norwood took some heat earlier in the year when he and Ganske were called to the White House and pressured by senior strategist Karl Rove to refrain from introducing their bill until they could come to a compromise. Ganske didn't adhere to Rove's request, but Norwood did. Frustrated after months of getting nowhere, Norwood broke away from the White House and rejoined his original group. In previous incarnations, Norwood had been the original drafter of the bill, "the Norwood-Dingell bill" that Vice President Al Gore continuously, clumsily harangued then-Gov. George W. Bush for not supporting in the third presidential debate. On Wednesday, Norwood flip-flopped again, in what was hailed as a major victory for the White House.

Since the Edwards-Kennedy-McCain bill passed the Senate in late June, the Ganske-Dingell team has worked hard to make sure that their bill shares its details. But Bush promised to veto the Edwards-Kennedy-McCain bill in its current form, and the White House has been supporting a rival House bill, offered by Rep. Ernie Fletcher, R-Ky., and supported by only one known Democrat, Rep. Colin Peterson, D-Minn.

Norwood cited Bush's veto threat as a reason for his compromise. "The bottom line and goal is, we want to change the law," Norwood said. "The last time I looked, that's pretty difficult to do without the presidential signature."

"The White House is confident that the support of Congressman Norwood means that this would pass on the floor of the House," White House spokesman Ari Fleischer told reporters.

Both bills provide patient protections, but the Ganske-Dingell bill, in pre-amended form, allows consumers to sue their HMO or insurance provider in state court, with a $5 million cap on noneconomic damages. The Fletcher bill moves it to federal court, and caps the same damages at $500,000. Despite intense lobbying pressure from the Bush White House and the House GOP leadership, the Fletcher bill was never able to peel off enough Republican supporters of the Ganske-Dingell bill to secure a victory. The GOP has only a six-vote majority in the House, and Ganske-Dingell bill strategists estimated the support of approximately 20 Republicans as well as almost every Democrat. As a result, last week Speaker Dennis Hastert, R-Ill., pulled the bill from its scheduled vote.

Bush said Norwood was "practicing the art of what is possible. It's a spirit we need more of in Washington: people who come to this city with the intent of doing what's right; the intent of having accomplishment; the intent of not playing -- you know, bickering over politics and getting intransigent because you don't get everything you want."

That said, neither Bush nor Norwood detailed in any way the compromise they had hammered out. Before the Wednesday evening meeting, supporters of the patients' bill of rights said that they were under the impression that Norwood and Bush had agreed to let the venue be in state court, but with a higher burden of proof than the Ganske-Dingell bill required. Additionally, the cap on noneconomic damages would be set at $1.5 million.

According to a Ganske-Dingell strategist, Norwood had floated that idea at a meeting last week, and the team -- including Edwards, Kennedy and McCain -- had found it unacceptable.

On Wednesday night, some strategists involved in the fight hypothesized as to what might happen. It's possible, they believe, that Bush thinks this "break" in negotiations will provide his side with momentum, and enough Republicans will break from the Ganske-Dingell ranks to join with the rest of the GOP caucus and pass the bill. Negotiations in the House-Senate conference committee would be tough, but then perhaps some of the blame would be shifted toward Senate Majority Leader Tom Daschle, D-S.D., and the Democrats.

"There are 800 groups that have endorsed our bill," Ganske said. "And without even giving the other coauthors of the bill the benefit of a phone call, Charlie just went and potentially undercut us and these 800 groups."

McCain received official word on the matter from White House Chief of Staff Andrew Card, with whom McCain had a short phone call that one senior aide described as "friendly." "He said, 'OK, we'll take a look at it,'" the aide said, describing the senator's mood as "curious, phlegmatic."

Dingell and Berry sat in the office of Minority Leader Dick Gephardt, D-Mo., and listened to a description of the terms of the agreement.

"We consider this a big bump in the road," said Warwick Sabin, a Berry spokesman. On Tuesday, Bush told reporters about a meeting he'd had that day with Norwood. "He brought some ideas right here in the Oval Office," Bush said. "He felt like he needed to go back and discuss them with some of the bill sponsors -- senators and other members of the House of Representatives. I'm hopeful that he will shake the hand of accommodation that I put out for him." What changed in one day, releasing Norwood from his desire to communicate with his team?

Ganske could only speculate. "Charlie's been freelancing a lot," he said. "Look at the video of him from the press conference. He's gray. His facial features are sagging. He's exhausted."

By Jake Tapper

Jake Tapper is the senior White House correspondent for ABC News.

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