[Congressional Record Volume 140, Number 109 (Tuesday, August 9, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: August 9, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
    DO SOMETHING ABOUT THE COST OF HEALTH CARE IN THE PRIVATE SYSTEM

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
February 11, 1994, and June 10, 1994, the gentleman from Wyoming [Mr. 
Thomas] is recognized for 5 minutes.
  Mr. THOMAS of Wyoming. Mr. Speaker, the Federal Government is too big 
and spends too much. Most people agree with that and, indeed, most 
Members here agree with that when they are home and campaigning, and 
support that concept.
  Yet many of the same Members come here and talk in favor of the 
Clinton-Gephardt solution to health care, which would be a solution 
that would provide for the greatest increase in the size of Government, 
for the greatest increase in the cost of Government, that has ever been 
proposed.
  We talk about benefits to provide universal care, and we need to talk 
about extending care to everyone that can never be lost. And they do 
not talk about what it costs. They do not talk about who is going to 
pay for it. They do not talk about what it means to the size and the 
growth of Government and to the cost of Government.
  Mr. Speaker, we need to talk a little bit about how we can make some 
improvements, how we can do something about providing better health 
care to the families of Wyoming and to the families of this country, 
and do it in a way that will not increase the size of Government, that 
will not increase the cost of Government. And we can do that.
  I would like to talk about just one aspect of it today that I think 
is very important, and that has to do with the cost of health care 
delivery in the private system. And we can do some things about that. 
Most people would agree that we can do some things about that.
  Rather than trying to reinvent, trying to reconstruct, trying to redo 
the whole health care system and put it into a Government delivery 
system, we ought to deal with those things we can do in the private 
delivery system. And we can do some things about health care cost: 
malpractice insurance, for example; tort reform. We can do some things 
there that have a great deal to do with the costs of health care, that 
have a great deal to do with the cost of health care in the private 
delivery system. And it is not so much the matter of insurance premiums 
for health care liability insurance. It has to do with the question of 
defensive medicine.

                              {time}  1110

  That is a significant cost. We can do something about limiting 
attorney's fees. We can do something about capping noneconomic damages 
at $250,000, not limiting the ability for someone to recover from 
losses they have had, but, rather, the noneconomic damages that become 
astronomical. We can do something about tort reform. The trial lawyers, 
however, have been successful in striking any reference to the cap on 
noneconomic damages in the Clinton-Gephardt bill, even though it was in 
the Ways and Means bill as it was passed.
  Wyoming, for example, is severely impacted by high malpractice rates. 
Rawlins, WY, has not recruited an obstetrician because the insurance is 
so high. As a result, women have to travel 100 miles to have delivery 
of a baby.
  Even though we have had only four malpractice suits in Wyoming, 
physicians pay higher rates than they do in California, because 
California does have a cap on noneconomic damages. We can do some 
things about outcome research. That can be done in the private sector 
so that doctors will have an opportunity to know the best procedure to 
be used.
  We can do something about antitrust restrictions. If we are to have a 
delivery system in Wyoming, we have to make some changes in antitrust 
restrictions so that hospitals can work together, so that doctors can 
work together, and we can define a delivery system network so that we 
can have in Wyoming different types of delivery systems that move 
toward a regional center. When you have a low population area, you have 
to do this. We did that in Cheyenne. It allowed two hospitals to come 
together. They can operate more economically. We can do it.
  We can do something about true administrative and paperwork reform, 
by electronic billing, by uniform claim forms. We started doing this 2 
years ago. And we can do some work in that area that has nothing to do 
with more Government and more expenditures through Government but, 
rather, to reform the private sector.
  We can do something about State-mandated benefits that have caused 
insurance policies to have to maintain extensive benefits that are 
included by mandates in State plans. We can change those kinds of 
things.
  We need to work on the areas where there is agreement here, where 
there is agreement for making some changes in the private sector that 
will reduce the cost of health care. And that is one of the areas that 
we can find agreement in this Congress, without the idea of uprooting 
one-seventh of the economy, putting it over into a Government-delivered 
health care system that will increase the size, increase the cost of 
the Federal Government.

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