The Des Moines Register - My Bill Would Reduce Healthcare Costs, Address Doctor Shortage

Op-Ed

By Steve King

As Congress takes action to repeal and replace Obamacare, it should address Obamacare's failure to rein in the absurd legal costs of practicing medicine. Perhaps the most significant action Congress could take is to pass my legislation, H.R. 1215, the Protecting Access to Care Act (PACA). President Trump has indicated a willingness to sign this bill, and the Senate should follow the House's lead and pass this bill so that he has an opportunity to do so.

I introduced PACA because Iowa faces a problem right now that the entire country is projected to face soon: Iowa has a shortage of doctors.

As reported by the Cedar Rapids Gazette, Iowa "ranks 42nd when it comes to the number of physicians per capita" and "51st for the number of emergency-medicine physicians per capita." The Gazette also reports that Iowa has the "second lowest number of OB-GYNs per 10,000 women."

Meanwhile, the Washington Post has reported that the "United States faces a shortage of as many as 90,000 physicians by 2025."

These shortages have real-world consequences. Shortages mean that health care consumers not only have fewer choices, but also that the costs of healthcare services are artificially high. To make matters worse, as healthcare costs rise, federal spending on healthcare programs also increases, placing even greater demands on American taxpayers.

The Protecting Access to Care Act targets a key factor reducing the supply of doctors: the high cost of practicing medicine created by trial lawyers abusing the system in pursuit of egregiously large non-economic damage awards in medical malpractice cases. Non-economic damages, which are highly speculative and which vary from case to case, are a major driver of costs in our healthcare system. These awards not only increase the cost of malpractice insurance, they contribute to the wasteful practice of "defensive medicine."

This is where my legislation steps in. Among its important reforms, the Protecting Access to Care Act would place a $250,000 cap on noneconomic damages (these are awarded for purely subjective things like "mental anguish" and "punitive damages") while also limiting the amount of contingency fees a trial lawyer can take away from a successful plaintiff. Importantly, PACA would continue to allow injured plaintiffs to receive 100 percent compensation for all of their economic losses, which includes real, measurable costs like medical expenses and lost wages.

The net effects of all of the reforms in my bill are significant. The Congressional Budget Office has projected that enactment of the reforms contained in the Protecting Access to Care Act would result in a savings of at least $50 billion in federal health care dollars. The CBO has also estimated that "premiums for medical malpractice insurance ultimately would be an average of 25 to 30 percent below what they would be under current law," meaning this cost would be significantly reduced. Like farmers, doctors need the ability to engage in risk management, and strengthening their ability to manage exposure to risk will strengthen the medical marketplace.

Enactment of H.R. 1215 would quickly lead to increases in the supply of doctors willing to work in high-risk specialties, while decreasing the number of doctors driven out of practice by abusive lawsuits. Not only does my legislation address an existing problem in Iowa, but it also confronts a problem of significant national concern that experts agree is looming.

Limiting damage awards on noneconomic claims should not be controversial. Politicians from the left, such as Gov. Jerry Brown of California, and politicians from the right, such as former President Ronald Reagan, have both endorsed PACA's common-sense reforms. Gov. Brown signed a version of these reforms into law in 1976, and PACA's proposals were endorsed by President Reagan's Tort Policy Working Group in 1986. In fact, if you spend time on health care policy, it quickly becomes clear that among the people most interested in obstructing this legislation are the trial lawyers' special interest groups and the political beneficiaries of their large and numerous donations.

Americans deserve a healthcare system that allows consumers a greater choice in service providers, that encourages doctors to enter, or remain, in high-risk fields, and that protects their tax dollars from being spent on needlessly excessive healthcare costs. The Protecting Access to Care Act achieves all of these goals. Congress should not hesitate to send my important legislation to President Trump. The House has passed my bill. The Senate should do so, too.

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