Patients' Rights Battle Promises to Be Bloody

Could this be the real Clinton legacy — fiddling while Congress self-immolates? The debate over patients’ rights hit the Hill with a fury Wednesday as three separate bills — each allowing patients to sue their HMOs for uncovered medical costs, but in varying degrees — added to the general legislative tangle that has been the story of Capitol Hill this summer and fall. Things got complicated Tuesday when House GOP leaders did an about-face, gun-control-style, and sought to undercut a popular right-to-sue bill with a watered-down version of their own. That bill had Democratic backing and enough Republicans aboard to pass the House; now it’s mired in what the Dems say is GOP trickery. And as the debate slogged on, Clinton hit the Rose Garden to declare yet another noble defeat for the side of the angels.

"The American people deserve more than partisan posturing and legislative gamesmanship on an issue this vital," he said in a speech practically interchangeable with various proclamations on everything from the budget to campaign finance reform. "A bipartisan majority is poised to pass this bill, but now they are being blocked by legislative tactics." For Republican leaders, who insist it’s the Democrats, not them, who’ve tied cement blocks to the bill, the goal is to position HMO reform as close as possible to the business interests that support them most fervently. That means limiting lawsuits and capping damage awards. Democrats tend to prick their ears to the trial lawyers, who see HMOs as the most lucrative enemy since Big Tobacco, and, most important, the angry patients on whose behalf the suits would be filed. Both sides have a point, even if they’re not above using "gamesmanship" to make it. But as it usually goes when Clinton and the House GOP brain trust square off, it ain’t hard to pick a winner.

"This is a familiar dance," says TIME congressional correspondent John Dickerson. "And Clinton, like so many times before, is backing a viewpoint that’s very easy for him to demagogue." Not to mention that it’s pre-election maneuvering time — and voters are hopping mad at the HMOs. Will Clinton’s tune soothe the savage congressional beast? It might –- after all, it was fear of getting outmaneuvered again by Clinton that pushed Speaker Hastert into his compromise effort. But Denny really can’t win either way. Give in, and it’s the leadership left holding the bag while Democrats declare victory. Push though the weaker bill, and Clinton and the Democrats blame the majority and ride the populist patients-rights sentiment all the way to the 2000 polls. Either way, expect somethingto be ready for the Senate’s consideration by the close of debate on Thursday. After the summer he’s had, the last thing Hastert can afford to do is nothing.