[Congressional Record (Bound Edition), Volume 150 (2004), Part 7]
[Extensions of Remarks]
[Page 9362]
[From the U.S. Government Publishing Office, www.gpo.gov]




                          PERSONAL EXPLANATION

                                 ______
                                 

                            HON. JEFF FLAKE

                               of arizona

                    in the house of representatives

                        Wednesday, May 12, 2004

  Mr. FLAKE. Mr. Speaker, today I voted ``no'' on final passage of H.R. 
4280, the Help Efficient, Accessible, Low Cost, Timely Healthcare 
(HEALTH) Act of 2004.
  This is not the first time I have had to make this difficult vote. On 
March 13, 2003, I voted against H.R. 5, which contained nearly 
identical language to H.R. 2480. Both in 2003 and today, I have heard 
arguments as to why the Federal Government should act and why this 
proposed reform is badly needed. Hearing these arguments on many 
occasions has not made it any less difficult to vote against this bill, 
but I am not convinced that the Federal Government should preempt State 
law in this area.
  Those supporting this bill have made some compelling arguments as to 
why Congress should step in and institute these reforms. They cite the 
national nature of insurance plans, whereby a doctor in Arizona might 
have to pay more for malpractice insurance due to an over-the-top jury 
award in Florida. They also note that, as doctors close up shop or stop 
providing high-risk care in specialties such as emergency medicine and 
obstetrics and gynecology, patients are forced to cross State lines in 
order to seek out treatment. We have all watched with dismay as 
hospitals have been forced to shut their doors and doctors have opted 
to treat patients without malpractice insurance due to the high costs 
of premiums. Certainly, the trial attorneys who line their pockets with 
egregious fees aren't suffering as a result of the mess they've made 
with unscrupulous lawsuits. These arguments only underscore an already 
evident need for the States to pursue medical malpractice reforms. 
However, as one who believes firmly in federalism, I am wary of 
supporting legislation that would, in effect, preempt other States' 
constitutions.
  For example, California instituted real medical malpractice reform 25 
years ago, which H.R. 4280 seeks to emulate. However, if the final 
version of H.R. 4280 differs from California's reform, then their 
system may ultimately be usurped by the new Federal authority created 
by this legislation. Punishing California's sensible reforms would be a 
terrible outcome.
  The natural evolution of health care delivery suggest that a Federal 
solution such as H.R. 4280 may one day be necessary. But right now it's 
up to the States to begin that process, and I am already a part of 
those efforts in Arizona. The States should follow California's 
example, which has been an undeniable success over the past 25 years.

                          ____________________