[Congressional Record Volume 155, Number 44 (Thursday, March 12, 2009)]
[Extensions of Remarks]
[Page E657]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                      TREAT PHYSICIANS FAIRLY ACT

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                             HON. RON PAUL

                                of texas

                    in the house of representatives

                        Thursday, March 12, 2009

  Mr. PAUL. Madam Speaker, I rise today to introduce the Treat 
Physicians Fairly Act, legislation providing tax credits to physicians 
to compensate for the costs of providing uncompensated care. This 
legislation helps compensate medical professionals for the costs 
imposed on them by federal laws forcing doctors to provide 
uncompensated medical care. The legislation also provides a tax 
deduction for hospitals who incur costs related to providing 
uncompensated care.
  Under the Emergency Medical Treatment and Active Labor Act (EMTALA) 
physicians who work in emergency rooms, as well as the hospitals, are 
required to provide care without seeking compensation to anyone who 
comes into an emergency room. Thus, EMTALA forces medical professionals 
and hospitals to bear the entire cost of caring for the indigent. 
According to the June 2/9, 2003 edition of AM News, emergency 
physicians lose an average of $138,000 per year because of EMTALA. 
EMTALA also forces physicians and hospitals to follow costly rules and 
regulations, and can be fined $50,000 for failure to be in technical 
compliance with EMTALA!
  Forcing physicians to offer their services without providing any form 
of compensation is a blatant violation of the takings clause of the 
Fifth Amendment. After all, the professional skills with which one 
earns a living are a form of property. Therefore, legislation, such as 
EMTALA, which forces individuals to use their professional skills 
without compensation is a taking of private property. Regardless of 
whether the federal government has the constitutional authority to 
establish programs providing free-or-reduced health care for the 
indignant, the clear language of the takings clause prevents Congress 
from placing the entire burden of these programs on the medical 
profession.
  Ironically, the perceived need to force doctors to provide medical 
care is itself the result of prior government interventions into the 
health care market. When I began practicing, it was common for doctors 
to provide uncompensated care as a matter of charity. However, 
government laws and regulations inflating the cost of medical services 
and imposing unreasonable liability standards on medical professionals 
even when they where acting in a volunteer capacity made offering free 
care cost prohibitive. At the same time, the increased health care 
costs associated with the government-facilitated over-reliance in third 
party payments priced more and more people out of the health care 
market. Thus, the government responded to problems created by their 
interventions by imposing EMTALA mandate on physicians, in effect 
making the health care profession scapegoats for the unintended 
consequences of failed government health care policies.
  EMTALA itself is having unintended consequences that could result in 
less care availability for low-income Americans at emergency rooms. 
This is because EMTALA provides a disincentive for physicians from 
offering any emergency care. Many physicians have told me in my 
district that they are considering curtailing their practices, in part 
because of the costs associated with the EMTALA mandates. Many other 
physicians are even counseling younger people against entering the 
medical profession because of the way the federal government treats 
medical professionals! The tax credit of the Treat Physicians Fairly 
Act will help mitigate some of these unintended consequences.
  The Treat Physicians Fairly Act does not remove any of EMTALA's 
mandates; it simply provides that physicians can receive a tax credit 
for the costs of providing uncompensated care. This is a small step 
toward restoring fairness to the physicians. Furthermore, by providing 
some compensation in the form of tax credits, the Treat Physicians 
Fairly Act helps remove the disincentives to remaining active in the 
medical profession built into the current EMTALA law. I hope my 
colleagues will take the first step toward removing the 
unconstitutional burden of providing uncompensated care by cosponsoring 
the Treat Physicians Fairly Act.

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