Senate Proceeding on Dec 5th, 2009 :: 5:25:40 to 5:45:35
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5:25:32 to 5:25:54( Edit History Discussion )

John Ensign: i have a separate bill from this amendment, a complete comprehensive medical liabili reform that i've introduced earlier known as s. 45. it's an effort -- in an effort, though, to find xri mierksz offer -- compromise, i'm offering this amendment today. this amendment was originally

5:25:40 to 5:45:35( Edit History Discussion )
Speech By: John Ensign

5:25:55 to 5:26:17( Edit History Discussion )

John Ensign: offered by edward kennedy in 1995. while many of the members of the senate were not here in 1995, 21 members from the other side of the aisle who were the majority at the time supported this amendment. those members included, senator aka, senator baucus, bingaman, boxer, byrd, conrad, dodd,

5:26:18 to 5:26:38( Edit History Discussion )

John Ensign: dorgan, feingold, feinstein, harkin, inouye, kerry, kohl, senator lautenberg, leahy, 11, mikulski, murray, reid, and senator specter. i would hope continue to support senator kennedy's amendment from 1995 today.

5:26:39 to 5:26:59( Edit History Discussion )

John Ensign: clearly the issue of medical liability reform is even more pressing than it was back 1995. we, as americans, spend more money on lawsuits than any other country in the world. and more than twice as much as all but one other country. and, according to a recent

5:27:00 to 5:27:21( Edit History Discussion )

John Ensign: nonpartisan study, the direct cost of health care lawsuits is around $30 billion a year. that's a direct cost to our health care system is around $30 billion a year. now, these costs are multiplied by indirect costs, especially doctors ordering costly tests

5:27:22 to 5:27:42( Edit History Discussion )

John Ensign: out of fear of being stewed. estimated money spent on unneed tests range frdz dz 100 billion annually to $250 billion a year annually. let me repeat the numbers. in unnecessary tests, the estimates are as high a as $100 billion to $250 billion in unnecessary tests by doctors

5:27:43 to 5:28:03( Edit History Discussion )

John Ensign: annually. most of those because of out of fear of lawsuits. and in 2006, in the "new england journal of medicine," suggests in this article that as much as 40% of medical liability lawsuits are without merit. medical liability insurance premiums are threatening the

5:28:04 to 5:28:25( Edit History Discussion )

John Ensign: stability of our nation's health care system. these rates are forcing many physicians, hospitals and other health care providers t move out of high-liability states, limit the scope of their practices and even to close their doors permanently. mr. ensign: this crisis is affecting more and more patients

5:28:26 to 5:28:47( Edit History Discussion )

John Ensign: and is threatening access to reliable, quality health care services. i have a good friend in southern nevada who practices obstrics. in his practice he specializ in high-risk pregnancies. because of the medical liability problems that we have seen in the past several years, his insurance company limits the

5:28:48 to 5:29:08( Edit History Discussion )

John Ensign: number of high-risk pregnancies in which he so you have one of the best doctors practicing obstetrics because of the fear of lawsuits by his insurance company. they limit the number of pregnancies -- high-risk pregnancies in which he can assist in. if you are a woman and you're

5:29:09 to 5:29:30( Edit History Discussion )

John Ensign: pregnant with a high-risk pregnancy, it would seem to me that you would want the best doctors tyke care of you -- to take care of you. this only makes sense. however, because of the medical ability faces -- we are facing in this country, the best of the best are limited to the number of cases in which they can handle. because of the unaffordable

5:29:31 to 5:29:51( Edit History Discussion )

John Ensign: medical liability premiums, it is now common for obstetricians to not even deliver babies an just practice gynecology. and for other specialists to no longer provide emergency calls or to provide certain high-risk procedures.

5:29:52 to 5:30:12( Edit History Discussion )

John Ensign: ask yourself this question: what if you were in need of a high-prisk procedure? what if you were a woman in need of a high-risk procedure and could not find a specialist to provide you with the care that you needed? the medical liability crisis is threatening patient access to reliable, quality health care services all over america? additionally, costly medical liability insurance premiums

5:30:13 to 5:30:34( Edit History Discussion )

John Ensign: have forced some emergency departments to shut down temporarily in recent years. in my home state of nevada, our level 1 trauma center was closed for ten days back in 2002. this closure left every pient within a 10,000-square-mile radius unserved by a level 1

5:30:35 to 5:30:55( Edit History Discussion )

John Ensign: trauma center. 10,000-square-mile area, excuse me. unfortunately, jim lawson was one of those in need of trauma -- of the trauma unit at the time. jim lived in las vegas, was just one month shy of his 60th birth day. he had recently returned from visiting his daughter in california, and when he returned, he was injured in a

5:30:56 to 5:31:18( Edit History Discussion )

John Ensign: severe car accident. jim should have been taken to the university medical center's level 1 trauma center. unfortunately, 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

5:31:19 to 5:31:39( Edit History Discussion )

John Ensign: arrest caused by the blunt force from physical trauma. why was nevada's only level 1 trauma center closed for those ten days? due to a simple fact. the to come ters coul doctors could not afford medical liability premiums and there were not enough doctors to provide the careme care.

5:31:40 to 5:32:01( Edit History Discussion )

John Ensign: ultimately the state had to step in and take over the liability for these doctors and this level 1 trauma center in order to reopen this level 1 trauma center. more than 35% of the neurosurgeons have altered their emergency or trauma call coverage because of this medical liability crisis that we have in america. this means that patients with head injuries, those who are in

5:32:02 to 5:32:22( Edit History Discussion )

John Ensign: ed of neurosurgical services must be transferred to other facilities, delaying much-need medical care. dr. alamo of henderson, nevada, brought another example to my attention. dr. alamo was presented with a teenager suffering from myastinigravis.

5:32:23 to 5:32:43( Edit History Discussion )

John Ensign: she was in a crisis at the time and needed immediate medical treatment. because of the medical liability situation, however, 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

5:32:44 to 5:33:04( Edit History Discussion )

John Ensign: transpted to california by helicopter to receive the medical care that she needed. just imagine if that was your daughter or some close friend or relative was suffering from this situation, how would you feel? these kinds of situations should not happen and should not be forced to happen because of

5:33:05 to 5:33:25( Edit History Discussion )

John Ensign: medical liability problems that we have in america today. stories such as these are all too common in america today. to address liability cris in my home state of nevada, the state enacted legislation that included a cap on noneconomic damages and a cap on total

5:33:26 to 5:33:47( Edit History Discussion )

John Ensign: damages for trauma care. several other states have enacted similar reforms.. this should not be a republican or a democrat issue. this is fundamentally a patient issue. simply put, the current medical liability crisis means patients cannot find access to care when they need it most in many areas.

5:33:48 to 5:34:08( Edit History Discussion )

John Ensign: and without federal legislation, the exodus of providers from the practice of medicine will it increasingly difficult to obtain the care that they need. so as we work on a comprehensive health care reform bill, one of our primary goals must be to enact meaningful medical

5:34:09 to 5:34:29( Edit History Discussion )

John Ensign: liability reform, to help ensure patients the access to the care that they need. as you know, president obama addressed the intiefer congress on health care reform back in september. during his speech, he said -- and i quote -- "i don't believe medical malpractice reform is a silver bullet, but i've talked to enough doctors to know that

5:34:30 to 5:34:50( Edit History Discussion )

John Ensign: defensive medicine may be contributing to unnecessary costs. well, i think that's quite an understatement. talk to health care providers. it's just -- it just not may be a contributor to unnecessary costs, that it drastically contributes to unnecessary costs. the presidentent on to say

5:34:51 to 5:35:11( Edit History Discussion )

John Ensign: that he asked secretary sebelius to move forward on demonstration projects in individual states to test ways to put patient safety first and let doctors focus on practicing medicine. let's face reality, though. there is no doubt that defensive medicine occurs. every day and that the costs to the health

5:35:12 to 5:35:33( Edit History Discussion )

John Ensign: care system are staggering. and as i mentioned earlier, tens if not hundreds of billions of dollars are wasted of year due to the prosecute of defensive medicine. largely in an attempt to avoid frivolous, junk lawsuits. so just think of how many uninsured patients we can take

5:35:34 to 5:35:55( Edit History Discussion )

John Ensign: care of with that money or how much cheaper premiums will be for those who currently have insurance. we must stop playing games and start doing something real to address this important health care iss. unfortunately, the underlying bill does not meaningfully address medical liability reform. it only contains a toothless sense of the senate. this sense of the senate notes that congress should consider

5:35:56 to 5:36:16( Edit History Discussion )

John Ensign: establishing a state demonstration program -- should consider establishing a state demonstration program to evaluate alternatives. this is just window dressing that does nothing. let's be honest with ourselves. this sense of the senate is just bluff. it ignores the substantial

5:36:17 to 5:36:39( Edit History Discussion )

John Ensign: progress that many states have already made with medical liability reform. capping noneconomic damage awards has been highly successful in a number of states, such as texas, and is something that we should consider as part of health care reform. but if we cannot reach a consensus on this, then we

5:36:40 to 5:37:03( Edit History Discussion )

John Ensign: should at least follow senator edward kennedy's example and limit the amount of attorneys' contingency fees as an important first step. let's do the right form -- let's do the right thing. let'snact real liability reform. -- real liability medical reform. the amendment i'm offering to place real limits on attorneys' fees on medical malpractice cases.

5:37:04 to 5:37:25( Edit History Discussion )

John Ensign: it would limit to 33.3% of the first $150,000 of the total amount recovered by the judgment or settlement. anything further than $50,000, the contingency fee would be limited to 25%. and while helping to rein in the costs of frivolous medical malpractice lawsuits, this

5:37:26 to 5:37:51( Edit History Discussion )

John Ensign: ensures that states' rights aalso protected. this amendment explicitly allows states that have different fee limitations to keep them in place instead of these caps. this amendment ensures appropriate state flexibility while at the same time helping to include access for care and reduce health care costs. let me repeat again, back in 1995, when senator edward

5:37:52 to 5:38:12( Edit History Discussion )

John Ensign: kennedy offered this amendment, these 21 senators who were here at the time, who are part of the democrat majority, all voted for senator kennedy's amendment. to be clear, my amendment contains more detailed limitations on contingency fees than those contained in the

5:38:13 to 5:38:33( Edit History Discussion )

John Ensign: amendment i am proposing today, but in the interest of finding a starting point on medical liability reform, i am willing to start off the debate bee enacting senator kennedy's limitations before. oh, by the way, the other side's going to say that the trial lawyers need this money because these cases -- to be able to take these cases.

5:38:34 to 5:38:55( Edit History Discussion )

John Ensign: but let's face it, the trial lawyers are mostly the ones that get the money out of these cases. we want to make sure that that money also goes mostly to the patients. so when you see pictures put up on -- by the other side, you'll notice that my amendment would actually help those very patients that they're going to

5:38:56 to 5:39:17( Edit History Discussion )

John Ensign: put those pictures up about. medical liability reform does work and it'slready turning the tide against frivolous lawsuits and outrageous jury awards in some states. we've seen it in california, in texas, in my home state of nevada, where the number of medical malpractice lawsuits has decreased dramatically. it's been a crisis driving doctors out of business long now.

5:39:18 to 5:39:38( Edit History Discussion )

John Ensign: it's time to protect patients across the contract and ensure access to quality health care. to illustrate my point, i'd like to tell you the point of medical liability reform in texas. to begin with, access to health care has improved. over 18,000 new physicians have come to texas.

5:39:39 to 5:39:59( Edit History Discussion )

John Ensign: texas. the ohio-risk medical specialists in -- the number of high-risk medical specialists in texas is growing since 2003. in 1993, the state has offered over 100 new doctors, over 200 new orthopedic surgeons. these additions are not limited

5:40:00 to 5:40:20( Edit History Discussion )

John Ensign: to metro texas, though. the ranks of rural obstetricians has grown by almost 30%. 22 rural counties have added an obstetrician and ten counties have added their very first o.b. so 23 rural counties have added at least one emergency medicine physician. so it's not just helping the

5:40:21 to 5:40:41( Edit History Discussion )

John Ensign: cities, it's also helping rural parts of texas. in addition to these improvements in access to health care, charity care has also greatly expanded due to medical liability reform. today, texas hospitals are rendering around $0 million more in charity care each year than they were just a few years

5:40:42 to 5:41:02( Edit History Discussion )

John Ensign: ago. that is a -- almost a 25% increase in charity care. which is due mostly because of the savings in liability. liability savings in states across the country have allowed hospitals to upgrade medical equipment, expand their

5:41:03 to 5:41:23( Edit History Discussion )

John Ensign: emergency rooms, expand outpatient services, staff e.r. rooms 24/7 with high-risk specialists, improve salaries for nurses, and launch patient safety programs. without reforms and attendant savings, these healthy developments would not have been possible. lawsuit reform has been a magnet fo attracting doctors and the

5:41:24 to 5:41:44( Edit History Discussion )

John Ensign: funding mechanism to improve access to care and to enhance patient safety. physicians have seen a decrease in their medical liability reforms also, and since 2003, for instance, in texas, physicians have saved a collective, almost $600 million in their liability premiums.

5:41:45 to 5:42:05( Edit History Discussion )

John Ensign: all major physician liability carriers in texas have cut their rates since the passage of this reform. and more than 43% of texas doctors have seen their liability premiums cut in half n. my home state of nevada, limitedations on economic damages with medical liability

5:42:06 to 5:42:26( Edit History Discussion )

John Ensign: reforms have helped to stabilize the medical liability climate which was severely in crisis just a few years ago. the independent nevada doctors insurance exchange to keep rates -- they followed a 20% deincrease in 2007 and rates stayed steady in 2008.

5:42:27 to 5:42:47( Edit History Discussion )

John Ensign: after years and years of increasing dramatically, in mississippi, in 2004, they created a hard $500,000 limit on noneconomic damages. and since that law took affect, the number of medical malpractice lawsuits -- get this number -- has decreased 0% in the state of mississippi, and

5:42:48 to 5:43:09( Edit History Discussion )

John Ensign: their insurance -- 90% in the state of mississippi, and their insurance -- medical malpractice insurance costs have dropped anywhere from 30% to 45%. other states have seen similar types of results. these examples prove that lawsuit reform can improve access to number of doctors, and -- and types of care that hospitals are able to offer, and help reduce

5:43:10 to 5:43:31( Edit History Discussion )

John Ensign: overall costs in our health care system. according to a very conservative estimate by the congressional budget office, medical liability reform, such as what i've introduced, would decrease the deficit by $54 billion. it would also, according to the c.b.o., save the private sector about the same amount of money.

5:43:32 to 5:43:53( Edit History Discussion )

John Ensign: so over $100 billion in savings that now goes to propping up a lot of frivolous lawsuits across the country. and by the way, think about it, if you had medical malpractice committed against you, you -- i believe you should have access to the courts. i believe you should be able to sue. i believe that you should be able to get just compensation.

5:43:54 to 5:44:18( Edit History Discussion )

John Ensign: the problem that happens now because our courts are so clogged up with all these frivolous lawsuits, it takes years, if not up to a decade, to be able to get through the court system. and many of these patients who were severely hurt, many of them die before the case is ever settled. that's another reason that we need medical liability reform.

5:44:21 to 5:44:41( Edit History Discussion )

John Ensign: and we need it now. let me tell you why i believe that medical malpractice reform has been left out of this bill. actually i don't want to tell you why. let me let howard dean tell you why. howard dean, obviously the former chairman of the democrat national committee, i'm going to quote fromim. "the reason why tort reform is

5:44:42 to 5:45:02( Edit History Discussion )

John Ensign: not in this bill is because the people who wrote it did not want to take on the trial lawyers in addition to everybody else they were taking on. and that is the plain and simple truth. now that's the truth." that's a direct quote from howard dean, the former chairman of the democrat national committee.

5:45:03 to 5:45:23( Edit History Discussion )

John Ensign: so i hope as this debate unfolds, many of my colleagues on the other side of the aisle will change their mind about enacting serious medical liability reform. i hope at least these 21 senators who voted for this amendment before will vote for this amendment again when it comes to a vote tomorrow. this isn't a battle between the

5:45:24 to 5:45:36( Edit History Discussion )

John Ensign: right and the left. it's a battle between right and wrong. this amendment is a helpful prescription for patients, and i know many on the other side of the aisle would like to cap salaries of people who work in the health insurance industry.