[Congressional Record (Bound Edition), Volume 152 (2006), Part 5]
[Senate]
[Pages 7092-7093]
[From the U.S. Government Publishing Office, www.gpo.gov]




                   MEDICAL CARE ACCESS PROTECTION ACT

  Mr. ENSIGN. Mr. President, yesterday, I introduced the Medical Care 
Access Protection Act to address our Nation's medical liability crisis.
  High medical liability insurance premiums are threatening the 
stability of our Nation's health care delivery system. These rates are 
forcing many doctors, hospitals, and other health care providers to 
move out of high-liability States, limit the scope of their practices, 
and even close their doors permanently.
  The crisis is affecting more and more patients and is threatening 
access to reliable quality health care services in many States across 
our country.
  Because of unaffordable medical liability insurance premiums, it is 
now common for obstetricians to no longer deliver babies, and for other 
specialists to no longer provide emergency calls or provide certain 
high-risk procedures.
  Ask yourself this question: What if you were in need of an emergency 
procedure? What if you were the woman who had a high-risk pregnancy and 
could not find a specialist to provide you with the care you needed? 
The medical liability crisis is threatening access to reliable quality 
health care services this is happening to patients all over America.
  Additionally, some emergency departments have been forced to 
temporarily shut down in recent years. In my home State of Nevada, our 
level I trauma center closed for 10 days in 2002. This closure left 
every patient within a 10,000 square mile area unserved by a level I 
trauma center.
  Jim Lawson, unfortunately, was one of those in need of the trauma 
unit at that time. Jim lived in Las Vegas, and was just one month shy 
of his 60th birthday. He had recently returned from visiting his 
daughter in California. When he returned, he was injured in a severe 
car accident.
  Jim should have been taken to University Medical Center's level I 
trauma center, but it was closed. Instead, Jim was taken to another 
emergency room, where he was to be stabilized and then transferred to 
Salt Lake City's trauma center. Tragically, Jim never made it that far. 
He died that day due to cardiac arrest caused by blunt force from 
physical trauma.
  Why was Nevada's only level I trauma center closed? A simple fact: 
Medical liability premiums could not be afforded by the doctors, and 
there were not enough doctors to provide care. The State had to 
actually step in and take over the liability to reopen the trauma 
center.
  More than 35 percent of neurosurgeons have altered their emergency or 
trauma call coverage because of the medical liability crisis. This 
means that patients with head injuries or in need of neurosurgical 
services must be transferred to other facilities, delaying much needed 
care.
  An example of this problem was brought to my attention by Dr. Alamo 
of Henderson, Nevada. Dr. Alamo was presented with a teenager suffering 
from myasthenia gravis. She was in a crisis and in need of immediate 
medical treatment. Because of the medical liability situation, there 
was no emergency neurologist on call to assist this young woman. Dr. 
Alamo called several in the area, and none of them wanted to take her 
case because of the medical liability situation. So Dr. Alamo had the 
young woman transported to California by helicopter to receive the 
medical care she needed.

[[Page 7093]]

  These kinds of situations should not happen and should not be forced 
to happen because of the medical liability crisis we have in America 
today. Stories such as these are becoming all too common across our 
country.
  I recently heard of seven patients who died in Chester County, 
Pennsylvania, because they did not have access to neurosurgical care. 
These patients were transported to neighboring counties instead of 
being treated locally where there was no available neurosurgeon. Some 
of these patients died during transport, and others died while on the 
operating table. This is unacceptable.
  Women's health care is also in serious jeopardy. In Pennsylvania, the 
legal climate caused nine maternity wards to close over the past 
several years. And hundreds of OB/GYNs have left the State, retired, or 
limited their services. This story is being repeated all over America.
  The bottom line is that patients cannot get the health care they need 
when they need it most. By definition, I believe this is a medical 
crisis. This crisis is affecting more and more patients, and it is 
threatening access to care.
  To address the growing medical liability crisis in my State of 
Nevada, legislation was enacted that includes a cap on noneconomic 
damages and a cap on total damages for trauma care.
  In order to control health care costs and make health care more 
readily available, we must extend similar protections to other States.
  Our entire Nation needs serious medical liability reform now.
  Without Federal legislation, the exodus of these providers from the 
practice of medicine will continue, and patients will find it 
increasingly difficult to obtain needed care. This is not a Republican 
or Democratic issue; this is a patient issue. Simply put, patients 
cannot find access to care when they need it most in many areas.
  I introduced the Medical Care Access Protection Act to address the 
national crisis our doctors, hospitals, and those needing health care 
face today. My legislation is a comprehensive medical liability reform 
measure. The bill sets reasonable limits on noneconomic damages, while 
also providing for unlimited economic damages.
  The Medical Care Access Protection Act is a responsible reform 
measure that includes joint liability and collateral source 
improvements, and limits on attorney fees according to a sliding award 
scale.
  My legislation also includes an expert witness provision to ensure 
that relevant medical experts serve as trial witnesses instead of so-
called ``professional witnesses'' who are used to further abuse the 
system and further drive up medical costs.
  My bill also preserves States' rights by keeping the State medical 
liability statutes in place and by allowing States that enact medical 
liability reform bills in the future to supersede the Federal limits on 
damages.
  The Medical Care Access Protection Act uses the Texas style of caps 
on noneconomic damages which has brought real reform to the Texas 
liability system. This provides a cap of $250,000 for a judgment 
against a physician or a health care professional. In addition, the 
patient can be awarded up to $250,000 for a judgment against one health 
care institution. Judgments against two or more health care 
institutions cannot exceed $500,000, with each institution liable for 
not more than $250,000. Thus the noneconomic damages can total 
$750,000.
  The Texas style of caps on noneconomic damages is working. Patients 
are experiencing better access to health care, and Texas communities 
are finding it easier to recruit new doctors. At least 3,000 new 
doctors have established practices in Texas since the law's passage in 
2003. Many of these doctors are serving in medically underserved areas 
of the State. Some counties, such as Cameron County along the Texas-
Mexico border, are experiencing unprecedented success in physician 
recruitment--the opposite of what is happening in Pennsylvania.
  The number of medical specialists in Texas is also growing. Patients 
have access to more specialists and emergency room physicians. Since 
2003, Texas has gained a total of 93 orthopedic surgeons and more than 
80 OB/GYNs.
  Insurance costs have decreased significantly for doctors and 
hospitals. Medical liability rates, which had been out of control, have 
been going down. Physicians' insurance rates had risen by as much as 54 
percent in the last few years. But with medical liability reform, 
physicians in Texas have seen their rates drop by a significant amount. 
More than 4,000 Texas physicians have opened new professional liability 
policies. Some of these doctors are new to the State.
  The medical liability structure in Texas is working. These types of 
outcomes should be shared by every State and ultimately every patient 
in America. The American Medical Association has removed Texas from its 
list of States experiencing a medical liability crisis. It should be 
our goal that every State in America be removed from the crisis list.
  Let's put an end to this crisis once and for all. Let's enact 
meaningful medical liability reform today.
  The Medical Care Access Protection Act is not a battle of right 
versus left; it is a battle of right versus wrong. This bill is the 
right prescription for patients. We need to secure patient access to 
quality health care services when they need it most.
  Let's make sure expectant mothers have access to OB/GYNs and trauma 
care victims have access to necessary services in their hour of most 
critical need. And let's make sure we continue to provide patients with 
the opportunity to receive affordable, accessible, and available health 
care for years to come.
  The Medical Care Access Protection Act is substantially different 
from legislation we have brought to the Senate floor in previous years, 
and it warrants serious consideration.
  We are going to have a vote on whether to even debate this bill next 
week. The American people need to contact their Senators. They need to 
say: Let's bring the bill to the floor and have an open and honest 
debate on this measure. Are you going to stand with the trial lawyers, 
or are you going to stand with the patients in America? That is the 
question we have to ask ourselves. It is time for us to stand with the 
patients. If the people of America want change, they will have to 
contact their legislators. This has to be a grassroots effort that 
rises up from across the country.
  I believe the time for action is now. As we consider this bill, I 
hope Senators will put aside partisan differences and political 
alliances and will put the patients of America first.
  I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Vitter). The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mrs. MURRAY. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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