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Healthy Mothers and Healthy Babies Access to Care Act of 2003-Motion to Proceed-Continued

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Date:
Location: Washington, DC

HEALTHY MOTHERS AND HEALTHY BABIES ACCESS TO CARE ACT OF 2003-MOTION TO PROCEED-CONTINUED

Mr. CRAIG. Mr. President, first, I am here to speak on S. 2061 and ask our colleagues to support it. Many of my colleagues have already spoken of the pressing need for this legislation, so I will not repeat their words now. What I will speak about is how the medical liability crisis has played out in my region of the country, the Pacific Northwest. I believe the situation as it exists there provides clear evidence of the need for national reform.

My story is the tale of two States, my home State of Idaho and our neighbor to the west, Oregon. Idaho enacted its original tort reform legislation in 1987. This legislation limited the award of noneconomic damages in personal injury cases to $400,000. This limit was indexed to inflation. Oregon also enacted tort reform legislation in 1987. Like the Idaho law, the Oregon law limited the award of noneconomic damages in personal injury cases. Oregon's law placed this limit at $500,000.

Unlike Idaho however, where the tort reform measure withstood judicial scrutiny, and has since been strengthened by the Idaho State Legislature in 2003, Oregon's law was struck down by the State supreme court in 1999. Since the cap was removed, there have been 20 settlements and jury awards of more than $1 million.

As expected, the costs of these awards have been passed on to medical professionals in the form of higher medical malpractice insurance premiums. The Eugene Oregon Register Guard reported on March 19, 2003, that obstetricians who have base coverage ($1 million per claim, $3 million aggregate per year) through Northwest Physicians Mutual, a doctor-owned insurance company, have seen their premiums increase nearly threefold, from $21,895 in 1999 to $61,203 in 2003. The same article referred to a statewide survey conducted by researchers at Oregon Health and Science University which found that since 1999, 125 doctors have quit delivering babies in Oregon-representing about 25 percent of doctors providing obstetric care. Nearly half of these physicians, 48 percent, cited insurance costs and 41 percent said they feared lawsuits.

The article goes on to tell the story of an Oregon physician who is abandoning his practice in Eugene, in order to establish a new practice in Coeur d'Alene, ID. The physician stated that he was attracted to Idaho because the State has safeguards in place for doctors. These safeguards have helped keep malpractice premiums down in Idaho. Indeed, the Idaho Medical association reports that physicians in Idaho for some high-risk specialities, such as obstetrics and gynecology, pay about half of what their counterparts in Oregon pay.

While I welcome any healthcare providers who wish to practice in Idaho, I do not wish to see women of a neighboring State, or any State, suffer from lack of available health care because medical providers cannot afford to purchase malpractice insurance in their home State.

Now as a firm proponent of our Federal system, I have always believed that it is preferable to solve problems at the level of government closest to the people. And my preference here would have been for State governments to address this issue, as indeed many have. However, many other States have either not enacted reform legislation, or as in the case of Oregon, have found their efforts at reform sidetracked by overzealous judges. And, as the medical liability crisis in the 19 States identified by the AMA now threatens to overwhelm the entire Nation's medical liability system, I feel that now is the time to address this issue at the national level.

A Federal law is required to ensure that reforms will be effected in all States. Furthermore, the language of S. 2061 will protect States with existing caps. At the same time it will protect health care providers by establishing a Federal standard for noneconomic damages limits, even if such caps are barred by a State constitution, such as in Oregon. By allowing State autonomy in the setting of liability limits, this bill respects our tradition of federalism.

Since this body refused to vote for cloture on a related bill last July, the general accounting Office has issued a report assessing the effects that rising malpractice insurance premiums have had on the public's access to health care. This report, released in August of last year, confirmed instances in the five "crisis" States studied where actions taken by physicians in response to malpractice pressures have reduced access to services affecting emergency surgery and newborn deliveries. No instances of reduced access to heath care were identified in the four "non-crisis" States studied.

The August report follows an earlier GAO report that examined the causes of the dramatic increase in malpractice insurance rates. That earlier report found that "losses on medical malpractice claims-which make up the largest part of insurer's costs-appear to be the primary driver of rate increased in the long run."

Together these two studies provide strong evidence that: (1) Rising claims costs are driving up the cost of malpractice insurance; (2) the rising cost of insurance is causing medical service providers to take actions which have limited access to health care; and (3) the imposition of noneconomic damages caps, as well as the other reform measures included in this bill, are effective in constraining the rise of insurance premiums.

From the Pacific Northwest to the Florida Keys, the problem is clear and the solution is clear. The only question awaiting clarification is whether this body possesses the resolve to pass this much-needed legislation.

Mr. President, to reiterate, I want to tell the story of two States as it relates to this issue and the bill, Healthy Mothers and Healthy Babies Access to Care Act, addressing that problem. The States are Idaho and Oregon. In 1987, Idaho and Oregon passed identical laws-or relatively identical laws. In the State of Idaho, we capped our personal injury cases at $400,000. Oregon capped them at $500,000. Unlike Idaho, the Oregon Supreme Court, in a period of time immediately following that, struck down the Oregon action. Idaho did not.

Idaho not only held its law but then strengthened that law in 2003. Here is the rest of the story. Idaho strengthened its law in 2003. Oregon struck down its law in 1999. But they both started in the same place. Since the cap was removed in Oregon, there have been 20 settlements for injury awards of well over a million dollars.

As expected, the cost of these awards has been passed on to the medical professional in the form of higher medical malpractice insurance premiums. The Eugene, Oregon Register Guard reported on March 19, 2003, that obstetricians who have base coverage-that is, $1 million per claim, $3 million per aggregate per year-through Northwest Physician Mutual, a doctor-owned insurance company, have seen their premiums increase nearly threefold, from $21,895 in 1999, to 61,203 in 2003. The same article referred to a statewide survey conducted by researchers at Oregon Health and Science University, which found that since 1999, 125 doctors have quit delivering babies in Oregon-representing about 25 percent of the doctors providing obstetric care. Nearly half of these physicians, 48 percent, cited insurance costs, and 41 percent said they feared lawsuits.

The article went on to talk about one Eugene, OR, physician who moved to Coeur d'Alene, ID. The reason he moved to Idaho is because in our State of Idaho, their insurance premiums are substantially less because the cap we placed in the law has held the test of the courts.

The reality is that we are trying to set the stage nationwide. We are all aware-and many colleagues have come to the floor of the Senate to talk about it-of the studies done, the GAO report, the high-cost States, and the OB/GYN doctors fleeing from those States, and as a result making it very difficult in some instances for pregnant women to receive the kind of health services they need and, in fact, upon time of delivery, to know they have a doctor waiting at their side to help them.

As medical liability crises in these 19 identified States loom, it is time we speak with uniformity across the Nation. That is exactly what this bill does. I hope that our colleagues can support cloture and we can move to a final vote on this bill. Clearly, the American people are now expecting us to speak out.

Last week, I held a health care conference in Boise. One of the primary concerns was the rapidly rising cost of health care. One of the components of that escalation in cost is the very thing we are attempting to address today. So I hope the Senate can stand with reasonable unity. Myself and others understand the politics of the trial bar. When is enough enough?

If we don't, by this action, deny access to the courts by those who are truly injured-and we don't-then why are we allowing a certain segment of our society, in the litigious manner they have chosen, to line their pockets. Who is the beneficiary? The patient? In many instances, they are not. Yet costs go up simply because of the risk involved.

We ought to be protecting the patient and, in this case, the average citizen of this country on both sides of that equation by making sure they can gain true access to the courts when true injury results and, at the same time, making sure we are wise enough to hold down the increasing costs of health care, assisted by the dramatic increase in premium costs to our physician. This is a step toward that kind of a solution.

I yield the floor.

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