[Weekly Compilation of Presidential Documents Volume 38, Number 30 (Monday, July 29, 2002)]
[Pages 1248-1253]
[Online from the Government Publishing Office, www.gpo.gov]

<R04>
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

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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 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, 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

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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 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

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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 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

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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 any time 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 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

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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.
    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.