The related actions last week of Sen. John McCain seeking compromise with Democrats over a patients’ bill of rights and President George Bush responding with a set of principles to guide the debate suggest that the three-year fight to protect patients soon could be resolved. Both leaders have shown a willingness to negotiate on the two remaining issues of contention – the scope of the bill and the right of patients to sue.

The states have not waited for the federal government to act on patient rights: more than 40, including Maine, have enacted their own versions. The question of scope relates to whether federal provisions would supercede the state laws. On much of the federal proposals and state laws, there already is agreement or near agreement, such as access to emergency rooms, preventing health plans from offering incentives to deny care and giving women the ability to see a gynecologist without a referral. Other issues, such as privacy rules for genetic information, are sometimes in state laws but are better set at the federal level.

The right to sue is more contentious, but Congress and the White House should be able to resolve this issue, also. One area that that Sen. McCain could help on is whether patients could sue their employer as well as their insurer if they are denied coverage.

President Bush is right when he concludes that “only employers who retain responsibility for and make final medical decisions should be subject to suit.” Some Democrats already accept this position, but Sen. McCain could increase bipartisan support for it, reassuring business lobbies and removing one more item from the list of disputed topics.

Almost everyone believes that independent review should be necessary before bringing suit; Republicans, who rejected the idea earlier, are now more often seeing some benefits in allowing a limited ability to sue at all. For help, they could turn to President Bush, who was governor when Texas became the first state to allow the courts into the process. The lawsuits in Texas have been rare and have not resulted in the increased cost of insurance some feared when they were debated.

One of the reasons earlier versions of a patients bill of rights was not successful was that each party had its own version and was unwilling to treat the other as leading legislation. This time around, there should be a single bill, open to amendment and modification, that both sides contribute to and both sides work on until they have reached agreement. With an interested president and bipartisan support on most of the issues, an agreement could be reached over the next few weeks.