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Public Statements

Protecting Access to Healthcare Act

Floor Speech

Location: Washington, DC


Mr. SMITH of Texas. Madam Chairwoman, I yield myself such time as I may consume.

Madam Chairwoman, America's medical liability system is broken and in desperate need of reform.

Frivolous lawsuits drive physicians out of the practice of medicine. Limitless liability discourages others from high-risk medical specialties and substantially increases the cost of health care.

The solutions to this crisis are both well known and time tested, but the President's recent health care legislation did nothing to address the problems in our medical liability system.

We cannot wait any longer to fix the problem. We should pass this bipartisan medical liability reform legislation to cut health care costs, spur medical investment, create jobs, and increase access to health care for all Americans.

H.R. 5, the HEALTH Act, is modeled after California's decades-old and highly successful health care litigation reform. According to the National Association of Insurance Commissioners, the rate of increase in medical professional liability premiums in California since 1976 has been nearly three times lower than the rate of increase experienced in other States.

By incorporating California's time-tested reforms at the Federal level, the HEALTH Act saves taxpayers billions of dollars, encourages health care providers to maintain their practices, and reduces health care costs for patients. It especially helps traditionally underserved rural and inner-city communities and women who seek obstetrics care.

The reforms in H.R. 5 include a $250,000 cap on noneconomic damages and limits on the contingency fees lawyers can charge, and it allows courts to require periodic payments for future damages in order to ensure that injured patients receive all of the damages they are awarded without bankrupting the defendant.

The HEALTH Act also includes provisions that create a fair share rule by which damages are allocated fairly in direct proportion to fault, and it provides reasonable guidelines on the award of punitive damages.

The HEALTH Act allows for the payment of 100 percent of plaintiffs' economic losses. These unlimited economic damages include all their medical costs, their lost wages, their future lost wages, rehabilitation costs, and any other economic out-of-pocket loss suffered as a result of a health care injury.

The HEALTH Act also does not preempt any State law that otherwise caps damages.

This bill is a commonsense and constitutional approach to reducing the cost of health care.

Whereas, the HEALTH Act allows doctors to freely practice nationwide, the ObamaCare individual mandate dictates that all people buy a particular product, whether they want it or not.

Unlike ObamaCare, the HEALTH Act saves the American taxpayers money. The Congressional Budget Office recently determined that the President's health care law will cost almost double its original $900 billion price tag. Another CBO report estimates that premiums for medical malpractice insurance ultimately would be an average of 25 percent to 30 percent below what they would be under current law. These are just a few reasons why organizations like Americans for Tax Reform support this legislation.

The HEALTH Act also reduces the cost of health care as it decreases the waste in our system caused by defensive medicine. This practice occurs when doctors are forced by the threat of lawsuits to conduct tests and prescribe drugs that are not medically required.

According to a Harvard University study, 40 percent of medical malpractice lawsuits filed in the United States lack evidence of medical error or any actual patient injury. That's 40 percent. Many of these suits amount to legalized extortion of doctors and hospitals. But because there are so many lawsuits, doctors are forced to conduct medical tests simply to avoid a lawsuit in which lawyers claim not everything possible was done for the patient. This wasteful defensive medicine adds to our health care costs without improving the quality of patient care.

In his 2011 State of the Union address, President Obama said:

I'm willing to look at other ideas to bring down costs, including one that Republicans suggested last year: medical malpractice reform to rein in frivolous lawsuits.

Let's help the President keep his word and put this legislation on his desk.

Madam Chairwoman, I reserve the balance of my time.


Mr. SMITH of Texas. I yield myself such time as I may consume.

Mr. Chairman, most Americans still oppose ObamaCare yet support medical liability reform of the kind that we are considering tonight. A recent survey found that 83 percent of Americans believe that reforming the legal system needs to be part of any health care reform plan.

As the Associated Press recently reported, most Americans want Congress to deal with malpractice lawsuits driving up the cost of medical care, says an Associated Press poll. Yet Democrats are reluctant to press forward on an issue that would upset a valuable political constituency--trial lawyers--even if President Barack Obama says he's open to changes.

The AP poll found that support for limits on malpractice lawsuits cuts across political lines, with 58 percent of independents and 61 percent of Republicans in favor. Democrats were more divided. But still, 47 percent said they favor making it harder to sue while 37 percent are opposed. The survey was conducted by Stanford University with the nonprofit Robert Wood Johnson Foundation. In the poll, 59 percent said they thought at least half the tests doctors order are unnecessary--ordered only because of fear of lawsuits.

In a poll done by the Health Coalition on Liability and Access in October, 2009, 69 percent of Americans said they wanted medical liability reform included in health care reform legislation. Seventy-two percent said their access to quality medical care is at risk because lawsuit abuse forces good doctors out of the practice of medicine.

Mr. Chairman, let's support a bill that is so strongly endorsed by the American people.

I reserve the balance of my time.


Mr. SMITH of Texas. Mr. Chairman, I yield myself such time as I may consume.

Mr. Chairman, lawsuit abuse drives doctors out of their practices. There's a well-documented record of doctors leaving the practice of medicine and of hospitals shutting down, particularly practices that have high liability exposure. This problem has been particularly acute in the fields of OB/GYN and trauma care as well as in rural areas.

The absence of doctors in vital practice areas is, at best, an inconvenience; at worst, it can have deadly consequences. Hundreds or even thousands of patients may die annually due to a lack of doctors.

According to one State study, 38 percent of physicians have reduced the number of higher-risk procedures they provide, and 28 percent have reduced the number of higher-risk patients they serve, all out of fear of liability.

The American College of Obstetricians and Gynecologists has concluded that:

The current legal environment continues to deprive women of all ages, especially pregnant women, of their most educated and experienced women's health care providers.

A study from Northwestern University School of Medicine polled residents and found that many wished to leave the State to avoid its hostile malpractice environment. The study concluded that:

Approximately one-half of graduating Illinois residents and fellows are leaving the State to practice. The medical malpractice liability environment is a major consideration for those that plan to leave Illinois to practice.

Without a uniform law to control health care costs, many States will continue to suffer under doctor shortages.

Mr. Chairman, I reserve the balance of my time.


Mr. SMITH of Texas. Mr. Chairman, I am pleased to yield such time as he may require to the gentleman from Georgia, Dr. Gingrey, who happens to be the sponsor of the legislation we're considering tonight, the HEALTH Act.


Mr. SMITH of Texas. Mr. Chairman, I yield myself the balance of my time.

Mr. Chairman, I just want to reemphasize again that, under this bill, awards are possible that far exceed the $250,000 cap in noneconomic damages. That's because under the economic damages provision, there is simply no cap. As a result of that, States like California and Texas, which have adopted reforms very similar to the reforms in this particular piece of legislation, there have been numerous awards of multimillion dollars awarded to individuals who have been injured.

So even though we had that $250,000 noneconomic cap, that is not an absolute cap on the awards that have been made.

A minute ago, Dr. Gingrey mentioned that in California, for example, several years ago, I believe it was 2007, there was a $96 million award. And in the last year for which we have records, in 2010, there were awards, I think, for over $6 million, over $10 million, over $14 million. So an individual is able to be reimbursed for the costs and the injuries that that individual may have incurred.

Mr. Chairman, I also want to say that America's medical liability system increases the cost of health care and decreases access to care as doctors abandon their practices and avoid high-risk specialties out of fear of being sued. Medical liability reform, this bill tonight will solve this problem.

According to the Journal of the American College of Surgeons, 5 years after tort reform legislation passed in my home State of Texas, the number of physicians in the State increased by 24 percent. That is twice the rate of growth in population over the same period of time. Other States have seen similar results.

But most States have not enacted meaningful reforms and, as a result, frivolous lawsuits have created a medical liability crisis. This crisis has forced women to drive great distances to deliver their babies because their local hospital doesn't have an OB GYN.

It has resulted in those who need complicated procedures being placed on waiting lists for months because the only available specialist has too many patients who seek care, and it has caused accident victims to lose their lives because their local emergency room no longer has a trauma center. America's broken medical liability system has caused patients to lose access to high-quality health services.

The liability reforms contained in the HEALTH Act will do these things: lead to a significant savings in health care expenses, reduce the practice of defensive medicine, halt the departure of doctors from high-litigation States and medical specialties, improve access to health care, and increase the affordability of health insurance. Also, according to the Congressional Budget Office, this legislation will reduce the Federal deficit by more than $45 billion over the next 10 years. This is a significant savings in a time of escalating deficits and debt.

We've seen the positive effects that similar medical liability reforms have had at the State level. Reforms in States like California and Texas have enhanced patient care, reduced doctor shortages, and decreased cost. It's time for Congress to enact these reforms for the benefit of all Americans.

Mr. Chairman, before I yield back the balance of my time, I'd like to thank the gentleman from Georgia, Dr. Gingrey, who has spoken so well so many times tonight, for introducing this piece of legislation that is going to help so many people across America.

With that, I yield back the balance of my time.


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