Patients' rights talks continue, bill still has life

WASHINGTON (CNN) -- The White House and key operatives in the House of Representatives continued Friday to try to find common ground on the chamber's long-pending patients' bill of rights, with President Bush keeping close contact with Georgia Republican Charlie Norwood, who has emerged as the issue's most influential figure in recent days.

Bush spoke Friday morning with Norwood, who is a co-sponsor of a bill opposed by the White House and the House Republican leadership. The two held a face-to-face meeting on Thursday, and it is presumed that if an agreement is to be reached on disputed issues of liability, Bush and Norwood will have to be the ones to see eye-to-eye before any legislation moves forward.

Norwood was to travel to the White House on Friday afternoon for more negotiations.

VIDEO CNN's Judy Woodruff talks with Reps. Dingell and Fletcher about the proposed patients' bill of rights (July 27) Play video (QuickTime, Real or Windows Media)   EXTRA INFORMATION Comparison: Patients' Bill of Rights   Big Picture: The issues in the House debate     RESOURCES CNN ACCESS: Patients' bill of rights   Message Board: Health care

Speaking Thursday, Norwood expressed optimism that all gaps would somehow be narrowed.

"We're basically really close in how to solve it," he said. "The people, I think, in this fight are people with pretty good will, and if they want to solve it … then (they'll) keep talking through it until they get an agreement. I feel better about it than I have in a little while."

Norwood's bill is supported by almost all House Democrats and a significant enough number of Republicans to make the White House mindful that the rival bill it supports -- drafted by Rep. Ernie Fletcher, R-Kentucky -- stands little to no chance of success.

"There's room for flexibility on both sides of Pennsylvania Avenue," said White House press secretary Ari Fleischer, referring to Bush's position vs. the Norwood camp.

"The president continues to be encouraged by the progress on the patients' bill of rights," Fleischer said, interjecting: "It's going to take some time."

According to aides close to the Bush-Norwood discussions, the White House has offered a compromise that includes a proposal that would allow more lawsuits against health maintenance organizations and insurance companies to be filed in state courts. Many Republicans wanted such suits limited to federal court, arguing that state courts are too generous when they dole out cash awards.

Under the suggested compromise, however, suits in state court would still be subjected to federally mandated limits on cash awards.

Some in Congress looked over the proposal Thursday night and asked for clarification.

"I think we have some serious questions about this proposal," said Sen. John Edwards, D-North Carolina, who co-sponsored the patients' rights bill that passed the Senate a few weeks ago. "But I think it's a very positive sign that the White House has shown some interest in getting legislation that can pass the Congress and the president can sign."

The dueling bills, which are intended to broaden the legal and treatment options granted to medical patients who are covered by health maintenance organizations, are similar in many respects. Each would guarantee more access to specialists, such as obstetricians, when needed, and would make admittance to emergency rooms much easier.

And, if an HMO disallows a doctor's treatment recommendation because of cost concerns, patients will be able to appeal that decision to an independent review board in the hopes of getting it reversed, or of receiving compensation for any damage they may have suffered as a result of the HMO ruling.

But, as in the protracted Senate debate last month, there are major differences between the bills over how HMOs should be made to make restitution for coverage decisions found to have caused harm, or even death.

Under the Fletcher bill, injured parties would only be allowed to file suit in state court if their provider outrightly ignores the decision of a review panel. And, the Fletcher bill would cap pain and suffering damages awarded by federal courts at $500,000, while the Norwood bbillwould include no such award limits.

The Norwood bill would also allow punitive, or "civil" damages, of up to $5 million. There are no such provisions in the Fletcher bill.

Fletcher supporters argue that the Norwood bill would bring about an explosion in lawsuits, which could result in higher premiums for those covered, or worse, in small businesses jettisoning their health coverage because it has become too expensive to maintain.

Democrats, on the other hand, argue that lawsuit filings will be few and far between under their legislation, saying HMOs will be more conscientious of the coverage decisions they render, should their bill become law.

The Associated Press reported Friday that Bush has told a small group of lawmakers that he might consider higher damage awards, but did not mention any figures. Bush also said he would be willing to drop the Fletcher bill if he can reach an accord with Norwood and his co-sponsors, Rep. Greg Ganske of Iowa, another Republican, and Rep. John Dingell, D-Michigan.

CNN's Kate Snow, Major Garrett and Ian Christopher McCaleb contributed to this report.