Will the Real John Ashcroft Please Stand Up?

Missouri's junior senator says he is a pro-consumer health-care reformist. But the insurance companies, HMOs and big business, which give him millions, think he's on their side.

In 1999, says Public Citizen, Schering-Plough spent $9 million lobbying Congress, more than any other pharmaceutical company would spend that year.

"The drug companies simply want to extend their monopoly," says Schulder of the National Council of Senior Citizens. "The federal government theoretically gives a patent to inventors, because those companies say, 'We need some guarantee that our expenses in developing the product will pay off.'

"But the pharmaceutical sector is the most profitable on Wall Street by far. They are doing quite well with their current 17-year patent, but they want to extend it. We oppose that extension. Once Ashcroft and others get that approved, the gates will be opened to extend all patents."

Ken Vuylsteke, chairman of the medical legal committee of the Missouri Bar Association, says Ashcroft's amendment "is another roadblock on the way to getting needed care.... It's really illusory and, in fact, would reduce the rights consumers already have."
Greg Lahann/Newsmakers Photos
Ken Vuylsteke, chairman of the medical legal committee of the Missouri Bar Association, says Ashcroft's amendment "is another roadblock on the way to getting needed care.... It's really illusory and, in fact, would reduce the rights consumers already have."
John Ashcroft, who from 1994-98 accepted more than $600,000 in campaign contributions from the Business Roundtable and about $250,000 from the health-insurance industry, became a zealous supporter of a patients' bill of rights that the American Medical Association called "a sham."
Richard Ellis/Newsmakers Photos
John Ashcroft, who from 1994-98 accepted more than $600,000 in campaign contributions from the Business Roundtable and about $250,000 from the health-insurance industry, became a zealous supporter of a patients' bill of rights that the American Medical Association called "a sham."

One week after Ashcroft signed onto the bill (July 27, 1999), it was funneled to a subcommittee of the Judiciary Committee, which hears patent issues.

Ashcroft chaired the committee.

The next month, Schering-Plough contributed $50,000 to the Ashcroft Victory Committee. In December, it contributed an additional $1,000 to the senator's main campaign committee.

Ashcroft's critics immediately charged him with playing a pivotal role in promoting corporate welfare. "Our view is that Sen. Ashcroft is a key player in this thing," says Brad Cameron of the Campaign for Fair Pharmaceutical Competition, a coalition of generic-drug makers and consumer groups. "He has supported this from the beginning, and he refuses to do anything to stop this kind of monkey business.

"This bill is nothing more than a private relief bill for a wealthy corporation. There is no constituency anywhere in America, and certainly no constituency in Missouri, for this bill," Cameron says. "We believe that Sen. Ashcroft is -- well, let me put it more diplomatically -- that he is the one senator in America who can stop this."

And by June 22, after the Kansas City Star reported Schering-Plough's $50,000 campaign contribution to Ashcroft, the news was fully out.

On June 22, the AMA made good on its promise by placing an ad in several newspapers, including the Post-Dispatch -- albeit a diplomatically worded one: "With the shift of just one vote, Senator John Ashcroft's vote, the U.S. Senate could pass the real Patients' Bill of Rights that the people of Missouri want."

That night, Ashcroft announced that he would support a patients' bill of rights that held insurers responsible for misconduct. Ashcroft issued a press release saying he "commended the American Medical Association for helping focus public attention to the need for such legislation" and adding that he supported laws that "put doctors and patients in charge of their health care."

The AMA was thrilled. "The senator last night affirmed his support of the AMA's efforts to pass a bipartisan Patients' Bill of Rights," the AMA announced the next morning. But two weeks later, when Democrats tried to amend the Patients' Bill of Rights to the Labor, Health and Human Services and Education appropriations bill, Ashcroft switched back. He again offered amendments that allowed managed-care plans to hire and pay an "independent external reviewer" to adjudicate consumer appeals -- similar to the amendment he offered before with the backing of the insurance and business lobbies.

This time, however, Ashcroft's amendment allowed the patient to sue the managed-care plan in federal court for unlimited economic damages and no more than $350,000 in punitive damages. But there was a catch: Patients could sue only if the insurance company didn't comply with a finding of negligence on the part of the "independent external reviewer," which it hired anyway.

Ashcroft's new amendment, says Vuylsteke of the Missouri Association of Trial Attorneys, is deceptive. Although it allows patients to sue in federal court, it sets an incredible burden of proof on them. "It's another roadblock on the way to getting needed care," he says. "Once you go to federal court, your rights are still severely curtailed, because you have to bear the standard of proof that the HMO acted recklessly in denying care as opposed to negligently. Well, that's a pretty heavy burden for anybody to meet. So it's really illusory and, in fact, would reduce the rights consumers already have."

But once again, Ashcroft's amendment and the entire business-backed version of the Patients' Bill of Rights was approved, 51-47, by the Senate.

The AMA called the Republican measure a "sham" and a "transparent attempt to subvert the will of the American people for a real Patients' Bill of Rights." Meanwhile, over in the House, Norwood and 20 other Republicans held a press conference saying they would never support the Senate version of the bill.

However, Ashcroft's press releases continued citing the AMA's support of his amendments. After listing the vague terms of his measure -- "ensuring that patients get care when they need it," "medical decisions that are made by independent physicians, not by insurance claims adjusters" and mandates that "HMOs abide by strict timetables and face penalties for non-compliance with findings by independent physician reviewers" -- one press release stated that "Ashcroft drafted these provisions at the request of the American Medical Association."

Then, on July 5, the full-page "Thanks, Senator Ashcroft" ad appeared in the St. Louis Post-Dispatch. In addition to praising Ashcroft for supporting the "right" Patients' Bill of Rights, it thanked him for "making sure doctors make the medical decisions," for "watching costs" and for "working to ensure that family premiums are kept affordable." At the bottom of the ad were the names of the 15 groups that paid for it -- the Business Roundtable, the National Federation of Independent Business, the National Association of Manufacturers, the National Restaurant Association, Associated Builders and Contractors and others who had spent millions to kill the AMA's bill. Since then, the same groups have paid for TV ads that also thanked Ashcroft for supporting the "right" Patients' Bill of Rights.

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