    [Public Papers of the Presidents of the United States: George W. Bush (2002, Book II)]
    [July 25, 2002]
    [Pages 1287-1293]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks at High Point University in High Point, North Carolina
    July 25, 2002

        Thanks for that warm welcome, and thanks for coming out today. I
    want to thank you all for fighting through the rain. It's part of my
    drought relief program. [Laughter] I do want to thank you all for
    coming. I want to thank all your fellow citizens for lining the road and
    being so gracious in their hospitality. I love coming to North Carolina.
    It's a fabulous State, full of fabulous people. I'm honored to be here.
        And I'm glad my friend Tommy Thompson
    came with me. He was the Governor of the State of Wisconsin, and then I
    convinced him to come to Washington to head up the Department of Health
    and Human Services. I did so because I understand he knows health
    issues; he knows welfare issues; he knows a good system when he sees one
    and a system that needs to be reformed when he sees one. And I'm glad
    Tommy came to Washington. He's doing a heck of a job on behalf of the
    American people, and I want to thank you, Tommy.
        I want to thank Richard Budd and all the
    folks here at High Point University for giving me a chance to come and
    discuss some important issues that face our Nation. It's a beautiful
    campus. The gymnasium could use a little air-conditioning. [Laughter]
    We'll try to keep the hot air down to a minimum. [Laughter] But we're
    thrilled to be here on this fine campus.
        I also want to thank Jeff Miller of the High
    Point Regional Health System for--[applause]. We just had a fantastic
    and very interesting discussion about problems that affect patients,
    patients in North Carolina, health care patients in Nevada, problems
    that affect our docs. And I want to talk about some of that in a minute.
    But we just had a great discussion. I want to thank all the doctors and
    my fellow Americans who were there to share with me their stories, some
    of which I will share with you in a minute.
        I appreciate Don Palmisano, who is the
    head of the--president-elect of the American Medical Association out of
    New Orleans, Louisiana, who flew in for this event. I want to thank you
    for being here, Don, and I want to thank you for your support on the
    initiative which I'm fixing to talk about.
        I also want to thank the mayors of some of the communities here.
    We've got the mayor of High Point, the
    mayor of Greensboro, and the mayor of
    Thomasville. I appreciate all three mayors
    coming. I want to thank my friend Elizabeth Dole for coming over today to say hello. I appreciate
    you being here, Elizabeth.
        I want to thank members of the North Carolina health and medical
    community, all you who worry about your fellow Americans and who work
    hard to provide good, quality health care. Thank you for coming here
    today.
        Every time I come to a community, I like to herald some of the
    heroes of the community. And today, when I landed in Air Force One,
    there to greet me was a citizen named Jane Lambert. She's a--she's been volunteering here in this community
    for 50 years. She has been working hard to make people's lives better.
    It didn't require a Government law saying, ``Jane, you will help people
    in need.'' It required a good heart.
        Jane has worked with Girl Scouts. She's
    worked through her church to bring meals to people who need food. She is
    the kind of person I call a soldier in the army of compassion. The truth
    of the matter is, the reason I like to introduce the Jane Lamberts of
    the world is because the great strength of America lies in the hearts
    and souls of our fellow citizens who love--[applause]. So I want to
    thank Jane. I think

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    Jane is here. Where are you, Jane? Thank you for coming. Thank you for
    your work. Thank you for setting such a fine example, 50 years of
    service.
        You know, I believe out of the evil done to America is going to come
    some good. And part of the good is for people to understand that serving
    something greater than yourself in life is a part of being a complete
    American. And Jane shows us what that means.
        The security of our country is on the minds of a lot of our
    citizens. I want to talk a little bit about the security of America. It
    first starts with the homeland security. You hear a lot of talk about
    the President working with the Congress to set up the Department of
    Homeland Security, and we are. We're working hard on that. I just want
    to make sure that Congress understands that when we do create this
    Department, I've got to have the ability to manage the Department in a
    way to make the homeland more secure. I readily concede I didn't run for
    office saying, ``Vote for me. I promise to make Government bigger.'' So
    I'm not interested in something big; I'm interested in something that
    works.
        The number one priority of our Government is to protect the American
    people. We live in a new era. We're under the threat of coldblooded
    killers who hate America and hate our freedom. So our top priority, in
    all levels of government, has got to be to protect America. That's what
    we've got to do. I see some of our first-responders here, our police and
    EMS and firefighters. I want to thank you for the work you do.
        We've got work to do in Washington. You just need to know that we've
    got a lot of good people, people who work for all levels of government,
    working overtime, working hard, to chase down any kind of lead that we
    get, any kind of hint. And we're following up on it. Protecting our
    homeland is our most important priority. But the best way to protect the
    homeland is to hunt the killers down one by one and bring them to
    justice, and that's what this Government is going to do.
        And I know this great State houses a lot of our military. And on
    behalf of a grateful nation, I say thanks to those who wear our uniform
    and to those who support those who wear our uniform.
        And you need to know we're making pretty good progress. It's a
    different kind of war. It's hard to measure the results of this war
    based upon the old way of thinking. It used to be you could see tanks
    moving across a plain, and if the tanks made it to destination A, it was
    successful. This isn't the kind of war we're under. We're facing
    international criminals who hide in caves, send youngsters to their
    death, and think they can escape the long arm of justice of America. But
    they're not going to. No matter how long it takes--no matter how long it
    takes--this country will prevail.
        And the reason why is, we love freedom. We love the values our
    country stands for. Anybody who wants to take our freedoms away is going
    to find a determined and tough and patient nation.
        Secondly, a lot of people in this country are worried about the
    economy. They're worried about their job. I want you to know that I
    believe the economy is fundamentally strong. Our economy is growing.
    Inflation is low. We've got lower taxes, which help people keep their
    own money. And when you have your own money, it means you've got more
    money to spend. And when you spend that money for a good and service, it
    means somebody is going to provide a good or service for you. And as
    they provide a good or service, it means somebody is more likely to be
    able to find work.
        We've got--the fundamentals for economic growth are strong.
    Employment is stabilizing. It looks like I'm going to have a bill on my
    desk very soon which will bring reforms to our corporate sector,

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    which will mean that there will be accountability for chief executive
    officers and accountability for those who count the numbers, to make
    sure that our investors and employees across America feel confident in
    what they're being told from corporate America. It's a good piece of
    legislation. I look forward to signing it. In the meantime, you need to
    know that this administration will investigate, will haul in, and will
    prosecute any CEO which breaks the law.
        The foundation for growth is there. But one of the things I think we
    understand is that without health security, there's no economic
    security. If we're not confident about our health care system, we won't
    be confident about the future of the country.
        And we've got a problem. Right now, rising health care costs are
    undermining the availability of health care, of medical care, not only
    here in North Carolina but throughout our country. And the rising costs
    are forcing too many people to go without, and that's not right. That is
    a problem, and we need to address it soon rather than late.
        As Tommy just told us, the report he
    put out from the Department of Health and Human Services shows that our
    badly broken medical liability system is responsible for higher costs
    for patients, for lower quality of care, and for decreased access. And I
    worry about it. I worry about it in big-town America, and I worry about
    it for small-town America.
        I don't appreciate the fact that we see a health care system that is
    broken and riddled with bad--bad law, and we're not moving. And so one
    of the reasons I've come to North Carolina today is to lay down what I
    think we need to get done and call upon the Congress to act as quickly
    as possible to help us solve these problems. We're working hard to give
    more and more Americans access to quality care, and here are some of the
    initiatives.
        America's seniors need an improved Medicare system which includes
    prescription drug benefits and a system which trusts our seniors to make
    the right decision for themselves. Medicare has worked in the past.
    Today, it is outmoded; it is antiquated. It is a great idea that needs
    to be modernized, and we're making progress. The House passed a bill.
    The Senate is squabbling about one right now. I think they can get
    something done. I hope I can report to the American people that we've
    finally begun to modernize Medicare to include prescription drug
    benefits for all seniors.
        Secondly, we need to allow small-business owners to pool insurance
    risk across jurisdictional boundaries. A restaurant in Raleigh, North
    Carolina, ought to be allowed to pool the risk with a restaurant in
    Crawford, Texas, so that the small-business owner and his or her
    employees can have affordable health care insurance.
        We need personal health accounts to let workers pay smaller monthly
    premiums and save money for their medical costs. In other words, we've
    got to trust patients; we've got to trust the American people with their
    own money, to make their own decisions that best suit them for medical
    care.
        And too many Americans are uninsured; I understand that. And that's
    why I called upon Congress to enact tax credits to enable the uninsured
    to buy the health care coverage they need and, at the same time, to
    expand what we call community health centers to provide quality care for
    low-income Americans. You see, we've got to make sure, for the
    efficiency of the system, that those poor folks who do not have health
    care get health care, but not in the emergency rooms all across America.
    The most efficient way to provide health care is in community health
    centers.
        We're also, as you well know, getting a lot of health coverage to
    low-income Americans through Medicaid and uninsured children through
    Children's Health Insurance Programs.
        And we're working hard to make sure health care is available,
    quality health care

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    is accessible. Yet, any progress being made is being undermined,
    dramatically undermined by rising health care costs. And one of the main
    reasons that costs are rising is a broken liability system. And that's
    what I want to talk about today, what we ought to do about it.
        First, too many lawsuits filed against American doctors are being
    filed that have no merit. Too many lawsuits filed against our doctors
    have no merit. But since it costs so much for doctors to defend
    themselves, they often settle cases, even though they have not committed
    a medical error. And the unpredictability of our liability system means
    that even frivolous cases, even what we call junk lawsuits, carry the
    risk of enormous verdicts. In either case, health care costs rise for
    all of us, and you just need to know that.
        Another cost driver is that the fear of even baseless lawsuits
    causes good doctors to order excessive tests and procedures and
    treatments. It's called defensive medicine. If you think you're going to
    get sued, you do everything you possibly can to prevent the trial lawyer
    from coming after you. Unfortunately, that costs patients a lot of
    money. Health care costs are up because docs are worried about getting
    sued and, therefore, oftentimes prescribe unnecessary and costly
    treatments.
        Even when legitimate cases go to trial, the current system often
    doesn't serve the patient. Legal procedures are slow. It takes a long
    time. They can be very wasteful. And sometimes the lawyers take up to 40
    percent of the verdict--40 percent. And while patients injured by a
    doctor's malpractice deserve fair compensation, there are too many cases
    of grossly excessive jury awards. And you know what I'm talking about.
    You hear them all the time these days, massive numbers laid out there.
    The thing that Americans have got to understand is, every one of us pay
    for those awards. Those excessive jury awards cost us all money, and
    it's part of why rising--why there's rising costs in the health care
    system.
        Some insurers are now dropping medical liability coverage for
    doctors. Because of the system, insurers no longer insure docs. And
    they're hiking premiums as well. In your State of North Carolina, as
    well as eight other States, at least two companies raised liability
    insurance premiums more than 30 percent this year. You pay; you pay
    either as a patient, or you pay as a taxpayer. Higher and higher--
    because the reason you pay as a taxpayer is because your Government is
    paying a lot of health care bills.
        Higher and higher insurance premiums make it nearly impossible for a
    lot of doctors to practice medicine, and if docs don't practice
    medicine, it's hard to have good health care. Without insurance, they
    cannot afford to treat patients. Without insurance, the trust between
    doctor and their patients becomes a broken trust.
        Today, I mentioned, I had a discussion with some of the medical care
    providers and patients. There was a doctor here from Nevada. I don't
    know if you've been reading about what's taking place in Nevada, but
    they've got a real problem. As a matter of fact, an entire trauma center
    shut down because of medical malpractice. The fellow's name is Dr.
    Shelby Wilbourn, ob-gyn in Las Vegas. He had
    never been sued. He had never had a claim filed against him. Yet this
    year's insurance premium went from $33,000 to $108,000. The system needs
    to be fixed.
        This poor fellow who had borrowed money
    to get out of medical school faced a choice. Does he want to run up a
    bunch of debt because somebody has threatened a lawsuit on him, or does
    he want to continue to practice his love, which is helping people,
    healing people? And so this month, he's closing his practice in Nevada,
    and he's moving to Maine, because the costs of doing business are about
    a quarter of what they were in Nevada. The trial lawyers, suit after
    suit after suit, have driven this good

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    man out of Nevada. But more significantly, there are hundreds of
    patients who will miss his care.
        Jill and Chet Barnes
    are with us. Jill is a student teacher, and her husband is a fireman.
    Actually, the fireman is not here; Jill is here. They live near Las
    Vegas, where her doctor left his practice in the State of Nevada because
    of high malpractice insurance rates. She's 8 weeks pregnant. She talks
    about the inability to find a doc. That's got to be really frightening
    for a young mom, not to be able to find a doctor with whom she can
    consult. She said that she found one doctor, but there's a limit to the
    number of deliveries this doctor can agree to take because of
    skyrocketing medical malpractice premiums. She now is driving to Arizona
    for an hour and a half--she's a teacher, and she's driving to Arizona to
    get her prenatal care. And she's worried. The medical system is hurting
    because of a lot of lawsuits driving up the cost of business. It's also
    making it hard for a lot of Americans to find quality care.
        Laurie Peel had trouble finding a doc when
    she moved to Raleigh, because a lot of the practices were full. Then she
    ran into Dr. Schmitt. He's a nice fellow,
    OB/GYN. He agreed to take her on as a patient. They got a wonderful
    relationship. He helped her a lot. He decided recently to go to
    Virginia, because of the high liability premiums here in North Carolina.
    He said, ``It's no longer fun to practice medicine here.'' Not just
    here, it's no longer fun to practice medicine when there's a constant
    threat of a lawsuit hanging over your head. Laurie has to find a new
    doctor she can trust. Laurie's looking for a doc right now--yet another
    compelling, real-life story about what's taking place all across the
    country.
        Fear of lawsuits is awful--also stifling innovation and the
    improvement of health care, which means sometimes patients aren't
    getting the best care possible. Here's why: If a hospital and a doctor
    share information about how they can serve their patients better, under
    the current systems, lawyers can use those discussions and that
    information to file lawsuits. If you sit down to decide how best to
    improve the practice, that becomes a piece of evidence in a lawsuit. And
    therefore, a lot of good folks, like the good folks at High Point
    Regional Health System, think long and hard about making changes.
        I met with Paula Szypko today. She's a fine
    doctor. They've been warned, anytime they write anything down about
    improving the health care in this town, it can be given to lawyers who
    are fishing for lawsuits. And that's not right; it's just not right. The
    system is broken. It puts a burden on taxpayers, and we need to do
    something about it.
        People say, ``Well, is it a Federal responsibility? Should the
    Federal Government act on this problem?'' And the answer is yes, and I
    tell you one clear reason why, besides my deep concern for our fellow
    citizens and whether or not they can find health care. The Federal
    Government uses taxpayers' money to fund health care programs, Medicare,
    Medicaid, children's health care, veterans' health care, military health
    care. And anytime a frivolous lawsuit drives up the cost of health care,
    it affects the taxpayers. It is a Federal issue.
        It is estimated that frivolous lawsuits drive up the cost of
    Government health programs by over $25 billion every year. It's a
    national problem that requires a national solution. And it is my honor
    to come here today to describe what I think that solution is. The
    Federal Government ought to set a minimum Federal standard to reform the
    medical liability system. That's what we ought to do.
        We must, of course, protect any injured patient's right to a fair
    trial and fair compensation, including full compensation for economic
    damages. Anybody who goes into court and wins their case ought to get
    full economic damages. At the same time, we must prevent excessive
    awards that drive up costs, encourage frivolous lawsuits, and

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    promote drawn-out legal proceedings. And that is why we need a
    reasonable Federal limit on noneconomic damages awarded in medical
    liability lawsuits, and the reasonable limit, in my judgment, ought to
    be $250,000.
        And we need a cap or a reasonable limit on what they call punitive
    damages. Doctors ought not--ought to be judged based upon clear
    misconduct. And our Federal Government ought to put a cap on punitive
    damages as well.
        And finally, it's important to understand that in many cases, the
    current system forces doctors to pay damages for harm they do not cause.
    And therefore, we need what was called joint and several liability
    reform in Washington, DC, as well.
        And finally, this law ought to include the ability for doctors to
    evaluate and hospitals to evaluate their practices so they can improve
    care without having the discussions discoverable for lawsuits. I mean,
    what we've got to focus on in America--what we've got to focus on is
    what's best for the patients. And what's best for patients is affordable
    health care.
        We can get this job done. In California, when they had a problem
    with their medical malpractice insurance premiums, they put a law in
    place, and it worked. This is a reasonable law. This says that what we
    want is quality health care, not rich trial lawyers. What we want is
    people to feel comfortable with their system. People who are injured
    ought to be able to take their case to court, no question about it. But
    we've got to understand that frivolous lawsuits clog our courts and deny
    people with legitimate claims.
        Doctors who practice bad medicine ought to be held accountable, no
    question about it. It's important for the system that they be held
    accountable. But what we need is a system that doesn't drive people out
    of medicine and doesn't hurt patients. And the Federal Government needs
    to act, and the Congress needs to get a bill to me before they go home
    next--this late fall, a bill that will protect the American patients
    from medical malpractice.
        I believe that when we pass this law, the system will be much
    better, and people will feel more secure. And that's what I'm interested
    in. I want the homeland to be secure. I want our fellow citizens to feel
    economically secure. I want the health care systems to continue to be
    the best in the world.
        You know, I like to remind my fellow citizens of this: When the
    enemy hit us, they thought they were--they must have thought they were
    hitting a weak nation. Speaking about lawsuits, they probably thought
    all we would do was file a lawsuit. [Laughter] They didn't understand
    America, did they? They didn't understand, when it comes to defending
    freedom, we're plenty tough. But what they didn't also understand is
    that out of this evil done to our country, we believe can come some
    good.
        See, one of the interesting things that's happening in this country
    is that people understand that to be a patriotic citizen no longer means
    putting your hand over your heart--and by the way, saying, ``one Nation,
    under God.'' [Applause] Thank you. But being a patriot means you're
    willing to help a neighbor in need, to serve something greater than
    yourself in life. That's what a patriot is.
        You know, I was out at the airplane today, and I met the dad of a
    young boy and girl whose wife, Sandy, was on Flight 93. And
    Phil was there, and I appreciate him being
    there. And it just reminded me, seeing Phil Bradshaw, that the country
    understands that when you serve something greater than yourself in life,
    it's a part of being a great citizen. Obviously, these citizens made the
    ultimate sacrifice of personal responsibility, taking an airplane into
    the ground to save somebody's life. But I believe that out of the evil
    done to America is going to come some incredible good, as people realize
    that serving something greater than yourself in life is a noble calling,
    an important part of being an American.

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        So today, as I want to thank you again for coming, I hope that if
    you see somebody in need, you'll help them. If you find a child that
    can't read, help them read. If you know a shut-in who needs somebody to
    love them, tell him you love him. If you're a mom or a dad, love your
    children with all your heart and all your soul. It's a--this country has
    got problems, but we're going to solve them, because we're the greatest
    country on the face of the Earth.
        Thanks for coming. God bless.

    Note: The President spoke at 3 p.m. in the James H. and Jesse E. Millis
    Athletic/Convocation Center. In his remarks, he referred to Richard
    Budd, board of trustees chairman, High Point University; Jeff Miller,
    president, High Point Regional Health Systems; Mayor Arnold J. Koonce,
    Jr., of High Point; Mayor Keith A. Holliday of Greensboro, NC; Mayor
    Hubert M. Leonard of Thomasville, NC; senatorial candidate Elizabeth
    Dole; John W. Schmitt, M.D., faculty member, Department of Obstetrics
    and Gynecology, University of Virginia; and Phil Bradshaw, whose wife,
    Sandy, was a flight attendant on United Airlines Flight 93 that crashed
    in Shanksville, PA, on September 11, 2001.