[Congressional Record (Bound Edition), Volume 149 (2003), Part 13]
[Senate]
[Pages 17279-17280]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           PATIENTS FIRST ACT

  Mr. BUNNING. Mr. President, I am disappointed the Senate did not vote 
to move to full consideration of S. 11, the Patients First Act of 2003, 
to address the national crisis our doctors, hospitals and those needing 
healthcare face today.
  One of the top issues we all hear about from doctors in our States is 
how they are being squeezed financially by skyrocketing medical 
liability premiums. The Senate had a real opportunity to help remedy 
this problem by passing the Patients First Act, but unfortunately, we 
didn't even get a chance to fully consider and vote on this bill.
  Not only is medical liability hurting doctors, but it is now starting 
to affect the quality and availability of care for patients. First, let 
me give a little background on the situation in Kentucky. I know many 
other States face the same situation.
  In March of this year, Kentucky joined 17 other States on the 
American Medical Association's list of ``crisis States.'' This means 
that the current liability system is affecting patient care.
  Physicians across my State are facing some hard choices trying to 
figure out how to pay their rising premiums. Some are choosing to close 
their offices or retire early. Others are packing up and moving to 
other States with more sensible insurance regulations. Most concerning 
are reports of physicians no longer delivering babies because they 
cannot afford the liability insurance. This leaves expectant mothers in 
the lurch and creates huge, frightening gaps in critical medical 
coverage. In Kentucky, for example, Knox County hospital has stopped 
delivering babies which is forcing expectant mothers to travel to 
neighboring counties for care.

[[Page 17280]]

  The Kentucky Medical Association conducted a survey last year on the 
effects of rising medical malpractice premiums. They found that 70 
percent of the physicians in Kentucky saw their premiums go up. In the 
worst example, there was a $476,000 increase for a six-physician 
orthopedic office that didn't have any settlements or judgements 
against it.
  Recently, I received a letter from Catholic Healthcare Partners, a 
hospital system with about 30 hospitals and 8,900 affiliated physicians 
across the country. In Kentucky, they own several hospitals, including 
Lourdes Hospital in Paducah and Marcum & Wallace Memorial Hospital in 
Irvine.
  According to Catholic Healthcare Partners, the hospital system's 
liability insurance premiums increased by 50 percent in 2001 and 70 
percent in 2002. In fact, in the past 3 years, their premiums have 
increased by almost $25 million. Unfortunately, Catholic Healthcare 
Partners is the rule instead of the exception.
  In May, the Joint Economic Committee published a study on the impact 
of medical liability litigation. The report said the total premiums for 
medical liability insurance more than doubled from 1991 to 2001 to 
reach $21 billion. Hospitals and doctors simply cannot continue keeping 
their doors open and treating patients if their premiums continue to 
rise this rapidly.
  For example, Appalachian Regional Healthcare is one of the largest 
rural health systems in the country and employs 150 physicians in its 
nine hospitals and other healthcare outlets. ARH provides services in 
both Kentucky and West Virginia, and employs most of the obstetricians 
and pediatricians in eastern Kentucky.
  In January of this year, ARH made a decision to become completely 
self-insured. In 2001, the hospital system's key carrier for medical 
liability coverage dropped the hospital, and ARH couldn't find any 
other affordable coverage. For 2002, the bids for coverage the hospital 
received were $12 million to $13 million--which was more than the 
hospital system's net revenue and almost triple what they had paid the 
year before.
  The hospital system is now building an insurance reserve in case 
there are any malpractice settlements against it. However, according to 
ARH representatives, they realize that even one single case could 
cripple the system and its physicians.
  There is no doubt the system is broken. And for many Kentuckians, 
especially in our rural areas, there is no doubt skyrocketing insurance 
rates are making it harder for patients to get the quality care they 
need. The rising premiums not only take a toll on physicians and 
hospitals, but it means you, me, and everyone in this country is paying 
more for medical care. Very simply, individuals pay more for medical 
care because of the increases in premiums doctors face.
  Although all of us are paying more, some people are making out like 
bandits--usually the trial attorneys. It hardly seems that you can turn 
on your television these days without seeing a commercial by one trial 
attorney or another looking for ``injured'' people. Some of these 
lawyers specialize in certain kinds of injuries while others aren't as 
picky and will take anyone involved in an accident. Most give a toll-
free number, and many promise that ``we won't get paid unless you get 
paid.''
  In a report by the Department of Health and Human Services released 
last year, it said the number of ``mega-verdicts is increasing 
rapidly,'' particularly within specialty areas of medicine. The report 
goes on to say lawyers have an ``interest in finding the most 
attractive cases'' and they have ``an incentive to gamble on a big 
`win.''' Finally, the report says ``lawyers have few incentives to take 
on the more difficult cases or those of less attractive patients.''
  Is this really the way we want our legal system to work? Are we 
really getting the best results with this type of legal system? The 
answer to both of these questions is no.
  It seems like I have been voting for changes to our medical liability 
system since I have been in Congress, but we always seem to come up a 
few votes short. The Patients First Act places some commonsense 
controls on lawsuits against doctors. This will help bring some control 
over the rising medical liability premiums, and doctors in my State 
will be able to provide healthcare services.
  For example, the bill places limits on noneconomic and punitive 
damages, but does not limit economic damages. The bill also limits the 
amount attorney's can collect from their clients depending on the size 
of the settlement. The bill requires lawsuits to be filed within 3 
years of the injury, although this time limit is extended to children 
under the age of 6 who are injured.
  Finally, the bill makes defendants liable for only their share of the 
injury that occurred and allows periodic payment of future damages. 
These changes could make a big difference in the availability and cost 
of healthcare in the United States and Kentucky. These changes could 
mean physicians in Kentucky thinking about leaving the state will be 
able to stay, and doctors thinking about leaving the profession will be 
able to continue practicing.
  I am disappointed we did not have enough votes to proceed and fully 
consider the Patients First Act, however, I am hopeful we can come back 
and revisit this important issue soon, and give our doctors, hospitals, 
and especially those needing healthcare a more affordable system with 
better access.

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