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tv   U.S. House Meets for Legislative Business  CSPAN  June 28, 2017 1:59pm-4:00pm EDT

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the speaker pro tempore: on this vote the yeas are 232. the nays are 183. two voting present. the journal stands approved. the chair lays before the house
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a communication. the clerk: the honorable the speaker, house of representatives, sir, pursuant to the permission granted in clause 2-h of rule 2 of the rules of the u.s. house of representatives, the clerk received the following message from the secretary of the senate on june 28, 2017, at 9:28 a.m. clerical correction, to an appointment made on march 22, 2017, to the board of visitors of the u.s. merchant marine academy. with best wishes i am, signed sincerely, karen l. haas. the speaker pro tempore: for what purpose does the gentleman from virginia rise? mr. goodlatte: mr. speaker, i ask unanimous consent that all members may have five legislative days to revise and tend their remarks and include extraneous materials on h.r. 1215. the speaker pro tempore: without objection. pursuant to house resolution 382 and rule 18, the chair
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declares the house in the committee of the whole house on the state of the union for consideration of h.r. 1215. the chair appoints the gentleman from louisiana, mr. graves, to preside over the ommittee of the whole. the chair: the house is in the committee of the whole house on the state of the union for consideration of h.r. 1215 which the clerk will report by title. the clerk: a bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health . re delivery system the chair: pursuant to the rule, the bill is considered as read the first time. the gentleman from virginia, mr. good lat, and the gentleman from michigan, mr. conyers -- mr. goodlatte, and the gentleman from michigan, mr. conyers, will each control 30 minutes. mr. goodlatte: mr. chairman, the house is not in order. the chair: the committee lr in
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order. -- the committee will be in order. the gentleman from virginia. mr. goodlatte: mr. speaker, i yield myself such time as i may consume. the chair: the gentleman is recognized. mr. goodlatte: the bill before us today is modeled on california's highly successful litigation reforms that have lowered health care costs and made health care much more accessible to the people of that state. because the evidence of the effects of those reforms on lowering health care costs is so overwhelming, the congressional budget office has estimated that if the same reforms were applied at the federal level, they would save over $50 billion over a 10-year period. and because the evidence that those reforms increase access to health care, it is so overwhelming, they are supported by a huge variety of public safety and labor unions, community clinics and health centers and organizations dedicated to disease
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prevention, all of whom have seen the beneficial effects of these reforms in california. so popular are these reforms among the citizens of california that a ballot initiative to raise the damages cap backed and funded by trial awyers was defeated by an over 2:1 maverage in 2014. this bill's commonsense reforms include a $250,000 cap on inherently unquantifiable, noneconomic damages and limits on the contingency fees lawyers can charge. they allow courts to require periodic payments for future damages instead of lump sum awards so when they would receive pennies on the dollar can be prevented and they include provisions creating a fair share rule by which damages are allocated fairly in direct proportion to fault. and this bill does all this without in any way limiting
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compensation for 100% of plaintiff's economic losses, which include anything to which a receipt can be attached. including all medical costs, lost wages, future lost wages, rehabilitation costs and any other economic out-of-pocket loss suffered as a result of a health care injury. far from limiting deserved recoveries in california, these reforms have led to medical damages awards in deserving cases in the $80 million to $90 million range. unlike past iterations, this bill applies to claims concerning the provision of goods and services for which coverage is provided in whole or in part via a federal program, subsidy or tax benefit, giving it a clear federal nexus. whether federal policy directly effects the distribution of health care, there is a clear federal interest in reducing the cost of such federal policy. the legislation before us today
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also protects any state law that otherwise caps damages. whether at a higher level or lower than the caps in the bill or provides greater protections that lower health care costs. when president ronald reagan established a special task force to study the need for federal tort reform, that task force concluded as follows. quote, in sum, tort law appears to be a major cause of the insurance availability and affordability crisis which the federal government can and should address in a variety of sensible and appropriate ways. indeed, the reagan task force specifically recommended eliminate joint and sever liability, provide periodic payments of future injuries, limit contingency fees of attorneys and limit noneconomic damages to a fair and reasonable amount. all of these recommended reforms are part of the bill
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before us today. i urge my colleagues to support this legislation that would enact much-needed, commonsense and cost saving litigation reforms that would increase health care accessibility for all. and i reserve the balance of my time. the chair: the gentleman from virginia reserves. for what purpose does the gentleman from michigan rise? mr. conyers: mr. chairman, i yield myself such time as i may consume. the chair: the gentleman is recognized. mr. conyers: members of the will do little to protect americans' access to safe and affordable health care. instead, it will deny victims of medical malpractice and defective medical products the opportunity to be fully compensated for their injuries and to hold wrong doers accountable. this legislation imposes
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various restrictions on lawsuits against health care providers concerning their provision of health care goods or services that would apply, regardless of the merits of the case. e misconduct at issue or the severity of the victim's injury. there are so many problems with this bill, but to begin with, this bill would cause real harm by severely limiting the ability of victims to be made whole. for instance, the bill's $250 ,000 aggregate limit for noneconomic damages, an amount established more than 40 years ago, pursuant to a california statute, would have a
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particularly adverse impact on women, children, the poor and other vulnerable members of our society. these groups are more likely to receive noneconomic damages in health care cases because they're less able to establish lost wages and other economic losses. women, for example, are often paid at a lower rate than men, even for the same job, and also more likely to suffer noneconomic loss such as disfigurement or loss of fertility. imposing a severe limit on noneconomic damages, therefore, hurts them disproportionately. and finally, this bill is particularly harmful for veterans, members of the military and their families.
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because the bill preempts state tort law in any health care-related lawsuit that includes any coverage provided by a federal health program, all cases arising from a tandard care received in veterans administration facility or a military hospital would be subject to the bill's restrictions. . as a diverse coalition of veterans organizations noted in their letter of opposition to h.r. 1215, would limit the ability of veterans and military families to hold health care providers, drug manufacturers, and medical products providers accountable for pain and suffering and
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death that result from substandard care, preventable medical errors, and defective drugs and devices. or these and other reasons iism plor and urge my colleagues to oppose h.r. 1215, and mr. chairman, i reserve the alance of my time. the speaker pro tempore: entleman from michigan reserves. the gentleman from virginia. mr. goodlatte: mr. chairman, at this time i'm pleased to reserves. yield leman from virginia. two minutes to the gentleman from florida, mr. gaetz, a member of the judiciary committee. the chair: the gentleman is recognized for two minutes. mr. gaetz: i thank the gentleman for yielding. today in the congress too many republicans and democrats are obsessed with health insurance. often at the expense of the reforms that could reduce the cost of health care. if we cut yield two minutes to the cost of heal care, we make solutions far more attainable for affordable coverage. i support this tort reform legislation because it will make health care in america
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more accessible and less expensive. defensive medicine costs americans over $50 billion. commonsense reform will eliminate these costs. help patients afford health care h. all while reducing the federal deficit. it's no surprise the defensive medicine costs so much. one survey recently reported that 93% of doctors practiced defensive medicine due to a broken tort system. it's outrageous that we force doctors to subject patients to costly, unnecessary, and occasionally harmful tests just to avoid frivolous lawsuits. let's go back to performing medical tests when needed for the patient not to simply avoid exposure in litigation for insurance companies. this will lower health care costs. the new england journal of medicine found that one in every 14 doctors gets sued each year, an earlier harvard study revealed 40% of these malpractice suits were groundless. yet over a quarter of these frivolous cases are settled and
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the average payout was $300,000. groundless cases overburden our legal system, making it harder for people with legitimate grievances to have their day in court. frivolous claims drive up the cost of insurance for all health care providers. driving many physicians away from the health care profession. we need more doctors and hospitals not less. and without reform, we get higher costs, fewer doctors, a larger federal deficit, and worse, health care outcomes. let's pass this bill and start delivering on more accessible health care for the american people. i yield back. the chair: the gentleman from florida yields back. gentleman from virginia reserves. i conyers: mr. chairman, yield to the distinguished gentleman from tennessee, mr. cohen, three minutes. the chair: gentleman from tennessee is recognized for three minutes. mr. cohen: thank you. thank you, member conyers. thank you for the time of the to the chair, i share your
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grief over last night's loss. sorry about that. this bill is a loss, too. it's a loss to people who have been injured by defective drugs, defective medical devices. been harmed in nursing homes. or been harmed by medical malpractice. because it sets a cap on neconomic damages of $250,000, no matter whom the person s. whatever their position was, no matter what damages they suffer. trial lawyers $250,000, no matter whom the person s. aren't the most liked people in america. they are a little bit above congresspeople, i think, but it's right in there with used car salesmen. none of the three of us are doing real good. it's easy to beat up on t people like their doctors. i see dr. roe over there. people like doctors. doctors provide health care. if they are allowed to by federal law and given the opportunity to get reimbursed and have a system. but people don't generally like trial lawyers. the fact is trial lawyers do a
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public service. because they represent people, when they do it on contingency fees, they do it for people who wouldn't be able to hire a lawyer but have been harmed and they go in on the idea sometimes they get nothing, and if they win they get a contingency fee. when they win they win because a jury, which is like little focus group of america, says, there was a duty that the doctor breached and a harm done to the patient and the patient should be a little focus group of america, . now, my chairman says this is just like california. there he goes again with that reagan stuff. reagan was 40 years ago, i think. 35 years ago, whatever. and california, this isn't california's law. this goes further than california on joint liability and the fact is, when you eliminate joint and several liability on -- in certain place, certain parts of california, certain part of it
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isn't, it's less likely the injured party will be able to collect t goes further in the terms of setting a statute of limitations. the big picture is state's rights. normally the folks on the other side of the aisle are all for states' rights. they are for states' rights when it comes to voting rights. they are for states' rights when it comes to civil rights. they are for states' rights on all kind of stuff that generally tend to tamp down the lower economic folk in our country, particularly in the south. but here on medical malpractice, which has always been a province of the state, they want to usurp it and make a federal standard that applies to everybody. and if a state hasn't set a cap on damages, then the federal cap of $250,000 will go into place. if you have a state that has -- it says is unconstitutional to have a cap because you have a right to a jury trial, then you be able to have that
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cap and you'll have this $250,000 cap set. there are all kind of problems with federalism. be all kind of problems with people who have been injured getting compensated and other problems. i yield back the balance of my time. go, tigers. the chair: the gentleman from tennessee yields back. the gentleman from michigan reserves. the gentleman from virginia. mr. goodlatte: mr. chairman, at this time it's my pleasure to yield two minutes to the west virginia, mr. jenkins. the chair: the gentleman from west virginia is recognized for two minutes. mr. jenkins: thank you, mr. chairman, for this opportunity. i have been sitting here listening very carefully about this debate and it sounds like a partisan fight. democrats say this is a bad bill. republicans say it's a good bill. if you're watching at home you think, here we go again. just gridlock in washington. can't get something done. well, let me tell you, and let me suggest that preserving and protecting access to care west should not be a partisan issue. why do i say that? i'm from west virginia. and 14 years ago we passed medical liability reform, very, very similar to what we're
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getting ready to pass today. including 250 caps on noneconomic damages. why do i know it was not a partisan issue back then? is because the governor of west virginia that introduced the bill, house bill 2122, was wise. sman, governor bob bob wise had been a governor -- a member of congress for 18 years as a democrat here in congress. he introduced the bill 14 years ago in west virginia. he signed the bill. it was his bill. the west virginia legislature, the house of delegates, was 70% -- 68% democrat. the west virginia senate was 70% democrat. a democrat legislature, a democrat governor, and the reforms just like what we're getting ready to pass today. democrat governor
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bob wise said about the bill and why they did it. what was the goal, quote, to work together towards a common goal preserving the democrat go bob wise said about the bill and why they health care system that serves all west virginians. what else did gfgf -- governor democrat bob wise say? he said, quote, this is a prime example of how government can work for the people when he passed this bill and signed it. and on the day he signed the bill, this is what democrat governor bob wise's newsletter said, my number one commitment is the health and safety of the citizens of west virginia. this should not -- the chair: the gentleman is recognized. mr. jenkins: ladies and gentlemen, this should not be a democrat, republican issue. this should be an american health care issue. this should be preserving and protecting access to quality care. and just like democrat, congressman bob wise in west virginia, 14 years ago, set the
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example. we ought to set the example here of passing this with strong bipartisan support. this is quality care for the american citizens. i yield back. the chair: the gentleman from west virginia yields back. the gentleman from virginia reserves. the gentleman from michigan. mr. conyers: mr. chairman, i proudly yield two minutes to a senior member of the house judiciary committee, the gentleman from new york, mr. nadler. the chair: the gentleman from new york is recognized for two minutes. mr. nadler: i thank the gentleman for yielding. yes, the previous speaker's right. there shouldn't be a partisan issue. but the republican party in both houses has been doing its best to destroy health care for the american people in the last couple months. this is just a different piece of the same pot. bob wise? didn't always have the best judgment. this cruel legislation does exactly the opposite of what it's title states t would place an artificial and very low cap on noneconomic damages in medical malpractice cases and
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lock that figure into lou law without adjustment for inflation which would reduce its value almost to zero over time. by capping damages this bill would ensure many victims of medical malpractice will not be fairly compensated for their injuries. many other victims may be unable to file a case in the first place because they'll be unable to retain lawyer. that is because medical malpractice cases often require significant up front costs, as high as $100,000, and few attorneys will take a case if the cap on damages means that there will be no reasonable likelihood of recouping their costs. this bill's cap on noneconomic damages is particularly insidious because of its discriminatory effect on women, children, and seniors. they may recover very little in the form of economic damages. but they may still have suffered a lasting injury that deserves compensation. this includes women who may have chosen to stay home and raise a family. children who have yet to begin their careers. or seniors who have retired and left the work force. why should they be punished
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under this bill and get very little compensation for a lost limb or something else? noneconomic damages are worthy of compensation, but supporters of this bill think congress, not juries, should decide what those injuries are worth. it's shamefully little this. legislation is based on a california law that includes a cap of $250,000 for noneconomic damages, but it was enacted back in 1975. whether or not that was an appropriate figure 40 years ago in today's dollars, it is clearly inadequate. after adjusting for inflation, the cap would need to be approximately $1.128 million to be the same as the $250,000 cap was when it was enacted. thinking of it another way, that $-- another minute? mr. conyers: i grant the gentleman 30 seconds additional. mr. nadler: that $250,000 cap is now just worth over $56,000. nearly a fifth as much.
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even assuming $250,000 is the appropriate figure today, this cap be indexed for inflation going forward so we don't see a similar erosion of value. but this bill locks in an already low cap and lets it dwindle away until it's worth nothing. i move an amendment to adjust the cap, but the rules committee did not make it in order. instead we're forced to vote on a bill that over time will consider pain and suffering to be worth nothing at all. this bill will not reduce the cost of malpractice insurance. not drive bad doctors out of practice. and certainly not protect patients. what it would do is give a free ride to a health care provider or entity that seriously harms a patient. i urge my colleagues to reject this unfair and unnecessary legislation. i yield back the balance of my time. the chair: the gentlelady's time has expired. the gentleman from michigan reserves. the gentleman from iowa. >> mr. chairman, i would like to yield four minutes to the gentleman from tennessee, dr. phil roe. the chair: the gentleman from tennessee is recognized for four minutes. mr. roe: thank you, mr.
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speaker. i rise today in support of h.r. 1215, protecting access to care act of 2017. a much needed piece of legislation aimed at reforming medical malpractice law to help drive down the cost of providing health care and thereby making it more affordable for all americans. i had the privilege of practicing medicine in the great state of tennessee for 31 years before coming to congress. and the one thing that took away some of the joy from that practice was a threat of frivolous lawsuits. because of trial attorneys, over the years the premiums for malpractice insurance have ballooned to levels that make it difficult for providers to practice and driving more people out of prack t. away from small practices and into large hospital systems just so they can survive as a practitioner. worse still, the jury awards aren't going to the victims of actual malpractice. in tennessee, prior to implementing some malpractice reforms, over half of the premium dollars were paid out to attorneys less than 40 cents of every dollar paid out had
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gone to people who have actually been injured. we're not compensating the injured party. thankfully states like my home state of tennessee are taking action and enacted much needed reforms in the last decade. and the costs associated with providing care have plummeted since then. in 2008, the tennessee medical malpractice act was signed into law and created requirements that the plaintiff in a health care liability action provide the defendant with a presuit notice of claim as well as a qualified expert to review the case and certify that it has merit. tennessee civil justice act was signed into law that included a $750,000 cap for noneconomic damages and a cap on punitive damages greater than twice the compensatory damages or $500,000. with these changes between 2008 and 2014, the number of medical
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m&a practice lawsuits in tennessee decreased by -- medical malpractice lawsuits in tennessee decreased by 35%. between 2009 and 2014 the annual medical malpractice premium for an ob-gyn doctor, like myself, decreased from $52,000-plus to $32,000. those of us who were here in 2009 when the affordable care act was debated, i remember that president obama acknowledged that the cost of defensive medicine was a bipartisan concern and something he wanted to address, but despite the fact of our legislation -- that our legislation is modeled on a california law that's stood the test for 40 years through both republican and democratic governors, democrats have made no serious attempt to address medical malpractice as their health care bill was pushed through which is another flaw of the a.c.c. today's bill is -- a.c.a.
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today's big is common sense. we will ensure patients, not trial attorneys, are compensated for legitimate malpractice claims, and there are legitimate claims out there, but will prevent frivolous litigation from moving forward. for those concerned about the 10th amendment, this bill respects states' rights and only subjects claims with a federal nexus to this law while giving a great deal of latitude for states to act in their own accord. mr. speaker, i loved what i did while i was in practice. i had the chance to deliver about 5,000 babies, and it never felt like a job. it's just what i did and enjoyed doing. but at a time when health care costs are spiraling out of control, an easy fix like h.r. 1215 just makes sense, and it's just another piece of puzzle to help the cost of health care go down. i strongly support the much-needed reforms in this legislation. i urge my colleagues to vote in favor of final passage, and one final thing, mr. speaker.
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i have a list here of our premiums in the state of tennessee. and under every specialty listed here -- and there are numerous -- there were dramatic decreases in each of these. with that i yield back the balance of my time. the chair: the gentleman from tennessee yields back. the gentleman from iowa reserves. the gentleman from michigan. mr. conyers: mr. chairman, i'm pleased to bring to now the ost active member in the 115th congress, the distinguished gentlelady from texas, ms. sheila jackson lee, and i yield to her two minutes. the chair: the gentlelady is recognized for two minutes. ms. jackson lee: i would say this is about bad medicine, not good medicine, and undermining good health care. as we've seen in the trumpcare saga causing some 49 million people to lose their insurance, here we go again. i would offer to say that the most difficult and hurtful and
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harmful aspect of this particular legislation is it will make it more difficult for plaintiffs to seek the redress for medical injuries that have been proven in court. in addition, it proposes to make dangerous and potentially unconstitutional changes that our nation's federal system -- by our nation's federal system, intruding on state sovereignty, the very thing that republicans seem to relish and to support. because this bill attempts to preempt the several areas of tort law that have been traditionally reserved to the states. i would tell my good friends in tennessee and west virginia, deal with your states just as other individuals deal with their own states. this bill as well provides a very difficult impact on medical mal because it was written so vague, the broad language sweeps into not on doctors and other medical professionals but hospitals and clinics and almost every entity
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that contributes in any way to making any health care product or service available. that clearly impacts the health care of americans. when your child is injured, through no fault of their own or your own, you need relief for that child. interestingly enough, the american bar association that represents all lawyers, trial lawyers which there is an attempt to impugn their work, contempt for trial lawyers and the good work they do, but the a.b.a. say they are opposed to this bill, and they represent lawyers who fight every day to make sure the injustices happen. but here is a real cause of my angst for this particular bill. medical error leaves families with unanswered questions. olivia was a senior in high school in santa monica, california, accomplished scholar, actress, musician who had earned early acceptance in smith college. can i get an additional -- the chair: the gentlewoman's time has expired. mr. conyers: 30 seconds more
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for the gentlelady. ms. jackson lee: olivia was born with a congenital heart condition. she was going into college but had a condition that caused her to go into the hop. when she went in she had -- go into the hospital. when she went in her vitals were dropping. hospital staff waited more than 10 minutes before attempting to resuscitation but it was too late. she remained in a coma and died. what do you want your children to face, no relief? the families -- no relief, or you want these constant errors to go unrecognized and reconciled? this bill will do that by denying the ability, it provides impunity to health care providers who dispense inadequate products. it imposes the risk or loss on victims rather than wrongdoers. the chair: the gentlewoman's time has expired. ms. jackson lee: this undermines health care and it undermines good health care. oppose this bill. i yield back. the chair: the gentleman from michigan reserves. the gentleman from iowa. mr. king: mr. chairman, i yield
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myself five minutes. the chair: the gentleman is recognized. mr. king: thank you, mr. chairman. first of all, the statement that this bill caps or limits the states on economic or noneconomic damages is incorrect. in fact, i'd point the gentlelady from texas to page 6 of the bill that says under state flexibility that specifies a particular monetary amount of economic or noneconomic damages, there's no provision to construe to preempt state law. we wrote that specifically to respect states' rights. i require recall a number of pieces of this legislation that came before this congress. i can remember back at least until 2007. i was uneasy about the constitutionality because it did preempt state law and i am a respector of states' rights but we have a federal interest in health care. that's the provision that's written into the bill. if there's federal dollars involved, if there's a federal program, then the federal government has a interest in limiting these damages.
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we cap the damages in this bill. not the economic damages. those real damages that are economic damages are fully compensated without limit, without cap, without the interference of this law unless states choose to cap economic damages. noneconomic damages, however, are capped at $250,000. and that $250,000 cap is something that exists in california state law for more than 40 years. signed into law by the very durable jerry brown. but if the states want to change that, if they want to raise the cap beyond $250,000, that's their right to do so. we specify that in the bill. and so i'd like to discuss the need for this bill and it's necessary to preserve fiscal sanity in federal health care policy and i'd like to point out also at this outset that this bill only applies to claims concerning the provision of goods and services for which coverages are -- a federal program, a federal subsidy or a federal tax benefit.
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it's a clear-clear, mr. chairman, federal nexus. where it affects federal -- the commonsense reforms which have been in law in california for over 40 years and that the c.b.o. has scored a couple times here. the previous score is $54 billion. this bill is $50 billion. it's $50 billion in savings to the people paying for health care in this country and that includes our taxpayers and the health care users. but $250,000 cap is reasonable. it's sustained itself over 40 years in california. it's good enough for other states to implate. when i hear pushback from texas i'm kind of thinking they want to keep the system they have and they don't want to have to compete with the rest of the country and i think we might lose a vote or two from texas on that alone. we don't want america to have anything like that because then we have to compete with all of america. but this bill allows courts to require periodic payments for future damages instead of lump sum awards and that helps limit
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bankruptcy so plaintiffs receive -- that might receive only pennies on the dollars can be prevented. and it includes provisions creating a fair share rule. and by way damages are allocated fairly and direct proportion to fault. that's got to help a lot when you're thinking about the cost of health care. the bill doesn't -- does also -- all this without in any way limiting compensation for 100% of the plaintiffs' economic losses which include anything to which a receipt can be attached including all medical costs, lost wages, future lost wages, rehabilitation costs or any out-of-pocket loss suffered as a result of a health care injury. far from limiting deserved recoveries in california, these reforms have led to medical damage awards -- deserving cases, mr. speaker -- in the areas to $80 million to $90 million range. "the washington post" reported a few months ago, and i quote, u.s. health care spending is projected to accelerate over
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the next decade. a study by the centers for medicare and medicaid services projects that the average growth in health spending will be even faster in 2016 on up through the decade of 2025. the projections are based on an assumption that the legislative status quo will prevail. if we don't change the law we will see these costs going up. and so as 108th congress silver pointed out -- so as nate silver pointed out in "the new york times," not my favorite document. they have been increasing relative to inflation but essentially all of the spending relative to economic growth and the potential tax base has come from entitlement programs. and about half of all that has come from health care entitlements specifically. closed quote. studies show that as health care costs rise, wages fall. and as the more companies pay in health care costs, the less they can pay in wages. so when health care costs increase, and that growth increases, wages stagnate and when health care costs growth
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slows, wages go up. members who want to see wages increase should vote for this bill. it's good for the health care workers because one of the drivers of higher health care spending is called defensive medicine. and it's a very real phenomenon confirmed by countless studies -- i'd yield myself an additional two minutes, mr. chairman. the chair: the gentleman is recognized. mr. king: thank you, mr. chairman. the very real phenomenon confirmed by countless studies in which health care studies, they conduct many costly tests and procedures with no medical value. that's charged to our federal taxpayers. and it's simply to avoid excessive litigation costs. a survey published in the archives of internal medicine found that 91% of the over 1,000 doctors surveyed reported, quote, reported believing physicians order more tests and proast in order to protect themselves from malpractice suits, closed quote. the study also asked, are protections against unwarranted medical malpractice lawsuits needed to decrease the unnecessary use of diagnostic
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tests? and the answer, identical number, 91% of the doctors surveyed agreed. there's one reporter that described the personal of individual doctors this way. typical was one doctor who had a list as long as my arm of procedures the e.r. docs performed for no patient benefit. they include following a bed side sonogram with a, quote, official sonogram because it's easier to defend yourself to a jury if you ordered the second sonogram. a c.t. scan for every child who bumped his head or her head to rule out things that can be diagnosed just fine by observation. x-rays that do not guide treatment such as for a simple broken arm. c.t.'s for suspected appendicitis which has perfectly been diagnosed without the c.t. although doctors may hate practicing defensive medicine they do so so they don't get sued. physicians estimate that 35% of diagnostic tests they ordered were to avoid lawsuits as were 19% of hospitalizations, 14% of
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prescriptions and 8% of surgeries. all told, according to the "newsweek" article, $650 billion in unnecessary care every year was provided by these doctors and another e.r. doctor said he ordered 52 c.t. scans in one 12-hour shift for a total of $104,000 in a single day. these are the things we're dealing with, mr. chairman. one of the most recent studies published in the american college of radiology studies the effects of tort reform on just radiographic tests alone -- yield myself an additional minute. thank you, mr. chairman. they found there were 2.4 llion to 2.7 million fewer radiographic tests because of tort reforms. just imagine if such reforms were attached to all federal health care programs as this bill would do. and it causes me to think of an orthopedic surgeon who told me
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he can diagnosis an a.c.l. almost every time but yet he's compelled by his liability insurance to do -- to do additional tests. 97% of which are unnecessary. that's the kind of thing we're dealing with, mr. chairman, and it's time for us to bring sanity to this litigation that we have in this country and i would reserve the balance of my time. the chair: the gentleman from iowa reserves. the gentleman from michigan. mr. conyers: mr. chairman, i'm pleased to yield 30 seconds to the gentlelady from texas. . the chair: the gentlewoman from texas is recognized for 30 second. ms. jackson lee: i think the question to the gentleman from michigan and the gentleman's comments from iowa is the question of good medicine. additional tests may, frankly, just be good medicine and maybe conyers, we should gather about insurance reform and capping premiums so that we can help our doctors. i would assure you that they would be very happy on that. but to the gentleman's point, i'm sorry to say, he was
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incorrect. because we note that there are almost 20 states that have a ariety of noncaps on certain aspects. and now the federal intrusion will come in and now tell them where they do not have caps that they have to have caps. in fact, he's incorrect. this bill does skew the med cal service or medical treatment in our states. i yield back. the chair: the gentlelady's time has expired. mr. conyers: i yield to the gentleman from rhode island, distinguished member of the house judiciary committee, mr. cicilliney, two minutes. the chair: the gentleman from rhode island is recognized for two minutes. mr. cicilline: i rise in strong opposition to h.r. 1215, which should be more accurately called the taking away access to care and justice act. this bill will do nothing to strengthen patient protections and will make careless health care providers less accountable. it will severely limit when an injured person is allowed to bring a health care lawsuit by
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shortening the time injured people have to seek relief t will also impose a one size fits all cap on how much compensation victims medical malpractice can receive for pain and suffering, regardless of the severity of a person's injury, in order to benefit insurance companies and wrongdoers. this cap even applies to intentional askets misconduct. this bill would unfairly limit a patient suing a health care provider for sexual assault, as well as a veteran who received substandard medical care. the bill is written so broadly it shields both negligent doctors and manufacturers of dangerous drugs and medical devices from liability. h.r. 1215 is before us at a time when republicans in the senate are working hard to pass a bill that eliminates health coverage for 22 million people to give the wealthiest of americans and insurance companies a huge tax cut. the american people deserve better than this. . our legal and health care system should work for the ben fifth hardworking americans. the people we represent, not for the powerful special interests. rrls are chomping at the bit
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for the opportunity to eliminate health coverage for honest hardworking americans and making deep cuts to medicaid just so they can give the richest people in this country a $600 billion tax cut. and now they want to prevent injured people from getting justice when they are hurt. middle class families need to see we're on their side. they don't need bills like h.r. 1215 which will rig the health care and justice systems against them. i urge my colleagues to vote no on h.r. 1215. i yield back. the chair: the gentleman from rhode island yields back. the gentleman from michigan reserves. the gentleman from iowa. mr. king: i yield myself one minute. the chair: the gentleman is recognized for one minute. mr. king: thank you, mr. chairman. it's interesting to me to hear this discussion about the senate addressing the health care situation in america. i stood on this floor time after time after time and in 2010, march 23, 2010, the final passage of obamacare was sent out of this -- out of the congress to the president of the united states who signed it immediately before the sun could come up in the morning.
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i was sick at heart at what happened to our constitution, our rule of law, our individual rights. now we have a mess of a health care system in america. this is a component of the fix. i wouldn't have a single democrat in the house or senate that's willing to commit to work with us to put up a single vote to improve the health care system in america. they made mayes take and they passed obamacare. they serve it over to us now you fix it. we're going to declare it a mess no matter what you do. we're going to fix t it's going to take ty. i reserve the balance of my time. the chair: the gentleman from iowa reserves. gentleman from michigan. mr. conyers: i'm pleased to recognize mr. deutch of florida, two minutes. distinguished member of the judiciary committee. the chair: the gentleman from florida is recognized for two minutes. mr. deutch: i thank my friend, the ranking member from michigan. mr. chairman, i'm thrilled to hear my colleague talk about the constitution. i'm sorry that the constitution
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that he's talking about doesn't include the right to a jury trial. because that's the constitution that i read. and this piece of legislation, h.r. 1215, will threaten that constitutional right. we have been told there is nothing to worry about in this bill because it will cover 100% of economic costs. anything that comes with a receipt, we were told. i'm going toil what's wrong with this bill in the store riffs four people. young child -- stories of four people. young child who goes in for a simple procedure and leaves the hospital paralyzed. a young adult who requires the amputation of his left leg, but the doctor amputates the right leg and leaves the hospital with neither. the woman whose physician used his power to sexually assault her while she is sedated. and the rape of a nursing home
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patient by a trusted health care provider. mr. chairman, there will be no receipts that will cover the costs that those four individuals would suffer for the rest of their lives that could be turned in and compensated and subject to this artificial cap. why is it that my colleagues believe that they are in a tter position to determine how those wronged individuals should be compensated for the atrocities that happened to hem instead of allowing a jury of their peers do the same? this bill is not meant to help reduce costs. this is an assault on injured people. this is an assault on those who value access to the courtroom
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in order to seek justice. i urge my colleagues in the strongest possible terms to reject this anti-consumer, this terrible piece of legislation. i yield back. the chair: the gentleman's time has expired. for what purpose does the gentleman from iowa -- mr. king: i yield myself one minute. the chair: the gentleman is recognized. mr. king: thank you, mr. chairman. listen to the stories that are here that have been delivered by the gentleman from florida. i'm wondering why we haven't heard these stories coming out of california, because this legislation essentially mirrors california legislation. that was the model we followed. they have had over 340 years to repeal it or a -- over 40 years to repeal it or amend t the right to a jury trial. there is a right to jury trial under this. it's just that there are caps that are set. that are reasonable caps. the states are free to change those caps up or down. so i don't quite follow this. i would say someone who would be raped in naursing home is not covered under this. it doesn't -- this legislation
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doesn't affect it at all. it has to have an effect by a diagnosis, prevention, or treatment of a disease impairment. a rape is not that. and so it would not be covered under this legislation. mr. chairman, i know that my opposition would like to have this legislation killed. i would just point out something that i heard on the floor of the house here about 10 years ago and it was this, that we can pass this legislation, but the senate may not pass it. and i would urge them to take it up. there is a special interest. it's the trial lawyers association. they are the ones that will not come out of this very well. i yield back the balance of my time. excuse me. i reserve. the chair: the gentleman from michigan. mr. conyers: thank you. i'm pleased now to recognize the gentleman from tennessee, mr. duncan, for one minute. the chair: the gentleman from tennessee is recognized for one minute. mr. duncan: mr. speaker, i rise in opposition to this bill. as the house liberty caucus
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wrote, this bill violates the 10th amendment that conservatives have always supported. more troubling, the way this bill is worded it could lead to what the liberty caucus describes as a, quote, massive expansion of federal authority, because it could make almost every malcase a merle case. every case should not be a federal cafmentse the states have already put pretty severe limits on medical malpractice cases. i have two other problems with this bill. i am in my 29th year in congress. the doctors were asking for this $250,000 limit then, too. $250,000 29 years ago is certainly not $250,000 today. finally, this bill in the end is saying there really are no limits on suits against 99.8% represent, but we're going to have special protection for this one very respected group of people. conservatives have traditionally had more faith in people than in government. i was a judge for 7 1/2 years before coming to congress. conservatives used to believe strongly in the jury system and still should believe in that
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today. thank you, mr. speaker. the chair: the gentleman from tennessee yields back. the gentleman from michigan reserves. gentleman from iowa. mr. king: mr. chairman. i yield myself one minute. the chair: the gentleman is recognized. mr. king: thank you, mr. chairman. i point out also that this bill keeps these cases in state court. it doesn't move them to federal court. previous legislation that's been brought to this floor a decade or so ago did move a loft these cases to federal court. but it's carefully drafted to keep this with the maximum amount of respect for states' rights that can be held and still have a federal interest. there has to be a federal interest in every dollar involved in this. every single case there has to be federal dollars involved in it or this bill wouldn't affect it at all. and -- i am one who is also a great respecter of state's rights. legislation has drafted with provisions in there over and over again that protect as many of the state's rights as can be.
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and if you take the other side of this argument, then it's far drafted with provisions in there over and over again that stronger that the right of the federal government would be usurped by the states if we don't have this legislation. that's what's taking place now. states that choose not to make a decision, not to set caps, and we're seeing huge settlements going on around the country. and this is what we want to end. so that we can save the $50 billion to $54 billion for the taxpayers. the thing that's even worth more than this is, how much of that $650 billion in defensive medicine will no longer be used in this country and how much safer and more less expensive will our health care be in america? i reserve. the chair: the gentleman's time has expired. for what purpose does the gentleman from michigan seek recognition? mr. conyers: mr. chairman, i yield myself as much time as i may consume. john sopko: the gentleman -- the chair: the gentleman is recognized. mr. conyers: i just have to adhere, h.r. 1215 deeply intrudes on state sovereignty. in particular, h.r. 1215 preempts state law governing
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joint and several liability. the availability of damages, the ability to introduce evidence of collateral source benefits, attorneys fees, and periodic payments of future damages. members should not be fooled by assertions that the bill preserves state law. in fact, the rule of construction contained in the bill expressly states that it preempts state law except in very limited circumstances where state law is more favorable to defendants. yield m now pleased to to the gentlelady from washington state, ms. jayapal, two minutes. the chair: the gentlewoman from washington is recognized for two yield to the minutes. ms. jayapal: i rise today to express my strong opposition to h.r. 1215. first of all, my state, my home state of washington, is one of
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those states where our supreme court has said, has ruled and said, that caps are not constitutional. so this bill is an intrusion of our state's rights. this bill also clearly puts the interests of big corporations over everyday people. and sends a signal to medical and health providers that they can act irresponsibly, perhaps, to make more money and get away with it. let me give you a very real example of what happens when hospitals put profit over people. the neurology program at swedish cherry hill hospital in seattle is under investigation for negligent care arising out of a program designed to incentivize neuro science doctors to take on heavy caseloads of complicated cases that lead to serious errors and even death. one of the patients was talia, a talented and vibrant young woman. she went in for a cervical spinal fusion with a
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neurosurgeon who has been embroiled in numerous investigations. as a result of gross medical malpractice, talia died. according to a "seattle times" investigation, numerous problems surfaced around her care or lack thereof and attention to the surgery and medical complications that arose from it. when she went for her surgery she was filled with hope in thinking about the life that she might have after surgery, she wrote this, so who am i? i am an artist. a dreamer. i am a stationary biker, i am a woman, girl, a person. i am a skier, i am an aspiring pole-vaulter, i am a reluctant yet faithful believer in the power of lucky underwear, i am someone with a voice. talia died. she is one of the many tragic instances of people losing their lives to medical malpractice. office, two own
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of my staffers have lost three of their grandparents due to medical malpractice. we have to make sure that we have consequences when we entrust our health care to somebody and there are grave errors. for the sake of talia and so many others like her who have dreams that are violated by preventable errors, we must defeat this bill. a no vote is a vote for the american people. i thank you. i yield back. the chair: the gentlewoman from washington's time has expired. the gentleman from michigan reserves. the gentleman from iowa. mr. king: i yield myself one minute. . i was surprised to hear that a judge in the state of washington had ruled that caps are unconstitutional. and curious to hear conflicting arguments coming from the other side. one of them said it's the states' rights and the other says it is unconstitutional to set caps. i think in either case, even though i disagree with both of
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those position go that if a washington state said caps are unconstitutional, i would say that a state legislature couldn't cap them, congress can't them. this is a function of the courts. i remember remember a decision that came out of the state of washington that ruled that the president's executive order on let's say in migrants coming into the united states as unconstitutional. i'm not going to defer to a single judge's opinion. we do protect states' rights and there is provision in this bill and entitled state flexibility. look through there and find the provisions of state flexibility where we respect state rights. and written as carefully as it can be to protect the maximum of tates' rights. i reserve. the chair: the gentleman from
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michigan. mr. conyers: i would like two minutes to the gentleman from new york, mr. jeffries. mr. jeffries: mr. speaker, let's be clear. this bill has nothing to do with litigation reform. it has nothing to do with a good-faith attempt to improve our health care system. in fact, this bill was described as phase three of an effort to improve our health care by the majority leader on the other side of the aisle. i put out a search committee and i can't find phase one or phase two. it has nothing to do with reforming our health care system. this bill is an unprecedented attack on states' rights. it's a wolf in sheep's clothing. it's a solution in search of a problem. it's nothing more than a reckless legislative joy ride guaranteed to crash and burn on
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the american people. this bill, if enacted, will hurt working families, middle-class folks, senior citizens, the poor, the sick, the afflicted, veterans and nursing home residents. the american people deserve a litigation system that works for everyone not simply the wealthy and well off. the american people deserve a litigation system that puts the public's interests ahead of special interests. the american people deserve a litigation system that promotes public health, not just excessive wealth. his bill fails on all of those counts. it is mean spirited, it is cruel, it is heartless. and that's why, mr. speaker, it must be defeated. i yield back. the chair: the gentleman yields
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back the balance of his time. the gentleman from michigan reserves. the gentleman from iowa. mr. king: i yield myself 15 seconds. i would point out to the body i didn't hear a single fact in the previous two minutes, it is all opinions and hurled accusations. i delivered a lot of data. and i would then reserve the balance of my time. the chair: the gentleman from iowa reserves. the gentleman from michigan. mr. conyers: mr. chairman, i'm pleased to recognize the gentleman from maryland, the distinguished member of the house judiciary committee, two minutes, mr. raskin. mr. raskin: thank you very much, mr. conyers. the floor leader has invited us to stick to the facts and so i want to stick to the facts in order to clear up some of the propaganda i heard today for this terrible bill. first of all, it has nothing to do with quote, groundless cases
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or frivolous claims because the new draconian limits proposed in their legislation apply only to valid claims in serious cases and nothing to do with groundless cases and frivolous cases. that is an irrelevant distraction, which is an attempt to reduce what you can recover when a jury has awarded you damages. number two, the floor leader says that it would not apply in the case of someone being raped in a nursing home. perhaps he thinks it wouldn't apply to a constituent, a 15-year-old girl who got raped by her dent activity. it says health care lawsuit means any action against a health care provider and that includes anyone who is providing health care. if a nursing home is providing health care or a dent activity is providing health care they would be covered. if he says rapes of patients in a nursing home or in a dentist
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office shouldn't count that should be history that we establish today, because we tried to amend the bill to that effect in committee and the majority voted it down. he said a rape would not count and i want him to commit whether or not a rape by a health care provider would count. the gentleman from iowa says it won't preempt the states and will not impose federal law. it is still in the state courts but federal law now applies. there are 28 states which have said you cannot limit people's' access to noneconomic injury. they have said in their constitution that there could be no limits at all, or the supreme courts have struck it down and it is a bulldozer that will run over the laws of 28 states. and they claim, mr. speaker, that somehow they're acting in the guise of federalism. they are destroying federalism.
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i'm happy that mr. duncan, a former judge and member of the g.o.p. got up to say this is against everything they stand back. and i yield back. the chair: the gentleman yields back the balance of his time. the gentleman from iowa. mr. king: i would yield myself one minute. i would point out the gentleman from maryland this isn't a criminal statute, this is still the law. and doesn't have anything to do with crime or criminal law. let's keep our discussion to the civil actions that we're discussing here. and it's not propaganda, it's facts that we have delivered on this side. i want to put this into the record. regarding cases of rape or physical abuse, h.r. 1215 does not cover such cases at all. that's because the bill only applies to medical malpractice claims based on the provision or use of health care services and health care services are defined in the bill as things related to
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the diagnosis, prevention or treatment of any human disease or impairment. clearly rape or any other physical abuse and neglect of sanitary conditions is not related to the diagnosis of any treatment. in cases involving rape or domestic abuse, the bill simply does not apply. but it does respect states' rights. it is carefully written to protect states' rights. it's a significant and huge improvement upon some efforts we have seen in the past. and one of those reasons is because many of us care about states' rights and we pay attention to the constitution. and there is a federal nexus in everything that goes on here. states are not limited from raising caps on economic or noneconomic damages or lowering those caps. we respect the states in every way possible and still get a positive result out of h.r. 1215. and i reserve the balance of my time.
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mr. conyers: mr. chairman, i'm pleased to recognize the gentleman from maryland, mr. raskin for 30 seconds. mr. raskin: first of all, there are only three states in the union that set the limit where they want congress to set it for every state which is $250,000. they are overriding the laws of 28 states. number two, the gentleman from iowa says a rape is criminal but not related but you can bring civil actions against the same conduct that constitutes a crime. and so if you look at your own bill, it said any theory of liability. that would include intentional acts. mr. speaker, is the majority representing this will not apply to intentional torts? because they were definitive in committee that it would apply to rapes and assaults. does it apply or does it not? because this is a critical matter. we are not talking about the good doctors. we are talking about doctors or nursing home providers or
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dentists that assault their patients, they would be limited and jury could get millions of dollars but their bill would limit you to $250,000. we have to clear this up. mr. conyers: i'm pleased to recognize the gentlelady from oregon for one minute. ms. bonamici: i rise in strong opposition to h.r. 1250 in a misguided and misnamed bill that will limit access to justice especially for women. the bill caps the amount of compensation to a victim who suffers medical injuries because it creates a lifetime cap of $250,000 for noneconomic damages. this means that women, or men, for that matter, who are at home raising families or children victims of devastating medical malpractice will be saying their life is worth less. that is unfair.
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it penalizes people who are family caregivers, a very important job, but one that does not involve wages. many women across the country have been victims of medical malpractice that has left them ununable to bear children. how can we say to those women, the loss they suffered, the opportunity to be a mother is without value. it is unacceptable and cruel. many medical errors are preventable. we should be focused on improving patient safety, not taking away rights from victims. i oppose this bill and i will fight back against attempts to limit access to justice for those who need it most. join me in voting no, and i yield back. the chair: the gentlewoman yields back. the gentleman from iowa. mr. king: i yield myself 30 seconds. i have heard the gentleman from maryland say that this legislation would override the laws of 28 states. that was a surprise to me when i
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heard that when i heard that number before the rules committee. it doesn't override laws but the absence of laws. there are states that don't have caps. that's what we are talking about here. states' t overriding laws. it is setting a federal foundation and guideline for them. and if i'm in the state legislature i have the authority to razor lower the caps on economic and noneconomic damages and my laws are not being overridden but being provided by the wisdom of the american people and i'm thankful to work with it and i reserve. the chair: the gentleman reserves the balance of his time. the gentleman from michigan. mr. conyers: mr. chairman, i refer my colleague, the floor leader on the other side, to section 9 of the bill. we've just looked at it. i'm pleased now to recognize the for lady from california
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one minute. ms. barragan: i rise in on opposition to h.r. 215 zsh 1215 and express my extreme concerns with this bill. i am from california and i am an attorney and i can tell you that this bill goes beyond medical malpractice and goes way beyond that. it includes cases involving unsafe drugs and nursing home abuse and neglect. that is not happening in california. if passed, it would prevent cases where seniors have endured tragic deaths and injuries, like an 88-year-old california woman who was sexually assaulted by her nursing assistant after she suffered a stroke resulting in lifelong physical and mental pain. 80 health care groups including the american association for justice and california advocates for nursing home reform have come out against this bill.
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they recognize we need to protect our vulnerable seniors. i urge my colleagues to oppose this bill. and i yield back the balance of my time. the chair: the gentleman from michigan reserves. the gentleman from iowa. mr. king: i reserve. the chair: the gentleman from iowa reserves. mr. conyers: i'm pleased to yield to the gentleman from pennsylvania, mr. cartwright, for one minute. the chair: the gentleman is recognized. mr. cartwright: i thank the ranking member. here we are dealing with some 1215. of irony with h.r. the year 1215 was the year that the magna carter was signed something that created the seeds of the american right to jury
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trial, for heaven's sakes. we were pleased to hear representative duncan say and i quote, conservatives believe strongly in the jury system, unquote. and i do, too. americans do, too. here in america, why where we trust juries to decide life and death for criminal defendants, why wouldn't we trust them to set a fair and proper dollar amount on a malpractice case? by definition these are cases where there was actual negligence, recklessness and intentional harm by health care providers or nursing homes. but maybe most importantly, none of us, nary a soul in this house would deny standing up for veterans and military families is a core value for all of us. this is a bill that prevents accountability for harm done to
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military and veterans in v.a. systems and i yield back. the chair: the gentleman yields back the balance of his time. the gentleman from michigan reserves. the gentleman from iowa. mr. king: i reserve. mr. conyers: mr. chairman, i'm pleased to yield to the gentleman from from maryland, mr. raskin, one minute. . mr. raskin: thank you very much. the good gentleman from iowa invites us to believe that the laws of the states are not being overridden because some of these states don't have laws. that's right. because their state supreme courts have said that their constitutions for bid the imposition of -- forbid the imposition on capps on what juries would -- caps on what juries would award people in medical cases. there are state constitutional prohibitions explicitly on damage caps. in new york and oklahoma there are explicit caps on damages in wrongful death cases. and in 11 states, state supreme courts have struck down
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statutorily enacted medical malpractice damage caps. alabama, florida, georgia, illinois, missouri, new hampshire, north dakota, south dakota, utah, washington, wisconsin. what's interesting, in my state, the 15-year-old girl who was raped by her dentist could recover after $785,000 because we had a whole special acception of our general assembly to arrive at that figure. but there are other states where they've said, you can't have any limits at all. those are the states that are being attacked by this legislation. because now they're reducing them from potentially $20 million or $10 million to $250,000. an outrageous invasion of states' rights and rights of juries to decide how people need to be compensated. i yield back. the chair: the gentleman's time has expired. mr. conyers: mr. chairman, i'm ready to close. if the gentleman is. mr. king: i am prepared to close. mr. conyers: thank you. the chair: the gentleman from michigan. mr. conyers: members of the house of representatives, numerous consumer, labor,
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veteran and legal groups all oppose h.r. 1215, including the afl-cio, the american college of physicians, the consumers' union, public citizens, vietnam vets of america, and 12 other national veterans' organizations. and the liberty caucus. h.r. 1215 is an extremely flawed bill that will deny access to justice for victims of medical malpractice and especially those who are most vulnerable among us. it would deny full compensation for injuries suffered by veterans and military families, children, the elderly and the poor. i hope my colleagues will join very pposing this very, unnecessary, mean-spirited bill.
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the chair: the gentleman from iowa. mr. king: mr. chairman, may i inquire the amount of time i have remaining? the chair: the gentleman from iowa has 4 1/2 minutes remaining. mr. king: thank you, mr. chairman. i yield myself the balance of the time. the chair: the gentleman is recognized. mr. king: first i say in response to the gentleman from maryland's discussion about the states that have had -- state courts that have prohibited caps . that's one of the reasons that we need this legislation. you have out of control liberal judges that have decided even their state legislatures can't pass the laws. that they want could to come in and pre-- that they want to come in and preeveryone the state rights and elect their general assemblies to make their decisions. often the judges are set in life-time appointments where . ey're not held accountable it would be interesting to look back in at each of these states that you mentioned, the gentleman from maryland, and
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address this thing from the perspective of we the people. because we the people are the power in this country. our rights come from god and they're vested in we the people. i thought the gentleman from pennsylvania's look at 1215 was a really deft way too foe -- to focus about this and speak about the magna carta. there wasn't anybody back in old england at that time that had any shot at filing a liability let alone receiving a frisklout claim -- frivolous claim that would make one individual vastly wealthy at the expense of a lot of other folks. so, this is something that's accumulated over the last 502 years, since the magna carta was signed. so i'd say. this health care costs are out of control. due in large part town limited lawsuits and other problems obamacare failed to solve, or else obamacare made worse. h.r. 1215 is commonsense litigation reform legislation that will rein in overly aggressive health care lawsuits, while preserving the ability of plaintiffs to recover unlimited economic damages. the bill applies only to claims concerning the provision of health care goods or services
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for which coverage is provided in whole or part by a federal program, a federal subsidy, or a federal tax benefit. giving it a clear federal nexus. this isn't criminal legislation. it doesn't address the cases of rape. we should arrest those people and lock them up in prison and punish them to the max. but it's not the subject of this legislation. so wherever the federal policy directs or affects the distribution of health care, there's a clear federal interest in reducing the cost of such federal policies. this bill's commonsense reforms, which have been the law in california for over 40 years, are the conservatively estimated -- by c.b.o., to save $50 billion. the previous estimate was $54 billion. in federal health care dollars. at the same time this bill doesn't in any way limit compensation for 100% of plaintiffs' losses. as reported in "the washington post" last month, the u.s. health care spending is projected to accelerate over the next decade. a study by the center for medicaid and medicare services
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projects that the annual growth in health care spending will be even faster between 2016 and 2025. the projections are based on an assumption that the legislative status quo will prevail. studies show as health care costs rise, wages fall. h.r. 1215 will save billions of dollars in health care costs and will thereby increase wages for workers nationwide. mr. chairman, as i look at the picture of how i've watched the defense medicine grow over the $650 and over the decades, billion potentially reported by "newsweek" article in unnecessary defense medicine tests that are done, a doctor that ordered c.t. scans in massive numbers in a single day, when i see a 97% of the m.r.a. gentlemen's, just to be sure that the diagnosis of an a.c.l. knee injury is protected in the case of liability insurance, we're not going to see just $50 billion in savings here. we're going to see hundreds of billions of dollars in savings.
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and as an he is theseologists told me, he was practicing in texas when texas passed the law that is roughly a mirror of california law, that his premium as was $26,000 a year and after the law passed in texas, it dropped to $6,500. exactly 1/4, a 75% reduction in that particular case. he's now practicing in iowa, where iowa's passed mirror legislation as well. so i urge all my colleagues to join me in supporting this vital legislation. and i yield back the balance of my time. the chair: the gentleman from iowa yields back. all time for general debate is expired. pursuant to the rule, the bill shall be considered for amendment under the five-minute rule. in luste amendment in the nature of a substitute recommended by the committee on the judiciary printed in the bill, it shall be in order to consider as an original bill the nature of an amendment in the nature of a substitute. that shall be considered as read. no amendment to that amendment in the nature of a substitute shall be in order except those
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printed in house report 115-179. each such amendment shall be offered only in the order printed in the report, by a member designated in the report. shall be considered as read and debatable for the time specified in the report. shall not be subject to an amendment. shall not be subject to demand for division of the question. it's now in order to consider amendment number 1 printed in house report 115-179. for what purpose does the gentleman from texas seek recognition? mr. sessions: mr. chairman, i have an amendment at the dess. the clerk: amendment number 1 printed in house report 115-179 offered by mr. sessions of texas. the chair: pursuant to house resolution 382, the gentleman from texas, mr. sessions, and a member opposed will each control five minutes. the chair recognizes the gentleman from texas. mr. sessions: thank you, mr. chairman. i'm pleased to offer this amendment with dr. michael burgess, also a member of the house rules committee. and also a gentleman from my home state of texas. the goal of our amendment is to strengthen the underlying legislation by clarifying the
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point at which the statute of limitations begin to run. in texas the statute of limitations begins to run from the date the alleged neglect or negligence occurs, or the date of last treatment. this is a certain date that does not leave room for controversy. i believe aligning the underlying text with this approach will benefit both physicians and patients, to clarify exactly where harm might occur. my amendment clarifies that when the date of the breach or tort is known, the statute runs from that date. when the date of the breach or ort, as it is known, the state -- this date runs from the last day of treatment. this method is provided to the defendant, plaintiff in the court. easy understanding.
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for example, if there's a surgical mishap, the stat wute run from that date -- statute would run if that date. on the other hand, if the injury is from a prescription of medication over a longer period of time, it would run from the date of the last treatment. i'm pleased that the texas medical association, the texas alliance for patient access, as well as the health coalition of liability and access support this process. and this amendment. as well as the national physicians' policy council. i hope my colleagues on both sides of the aisle will support this commonsense, reasonable reform that comes to us today in an amendment. i would like to thank chairman bob goodlatte from virginia and his awesome staff for their work to make sure that this amendment and the underlying legislation conform with their ideas, consistent with the legislation. i reserve the balance of my time. the chair: the gentleman from
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texas reserves. for what purpose does the gentleman from tennessee seek recognition? mr. cohen: thank you, mr. speaker. to oppose the amendment. the chair: the gentleman is recognized for five minutes. mr. cohen: the amendment does even more damage than the bill does because it makes it possible there will be even less time for a plaintiff, once they are aware of their injury, to bring action. this is something that makes it -- lessens the statute of limitations. that's what the bill is trying to do. to see that less people get their opportunity to get to court. which is what statute limitations are intended to do. and they've got good purposes. but when somebody's been injured from a medical malpractice case or negligence from a nursing home, we should encourage people to get relief, let a jury decide. these bills, and i suspect these amendments, but they're aimed at the same thing, are opposed by the afl-cio, the american federation of state counties of employees, the american bar
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association, not exactly a liberal lion, the center for justice and democracy, the national conference of state legislatures. also because this is a foray into federalism, unheard of before, taking -- making this a federal issue, not a state issue, the consumer federation of america, the consumers union, public citizen and vietnam veterans of america. there are many other groups as well. this amendment does just more to see that folks don't get access to a jury. and the irony of it is that the seemsal republican effort to be to talk badly about washington and congress and drain the swamp and believe in the individual back home and folks at home. well, the most pure form of justice comes from a jury. where you've got a jury of your peers in your own community who are chosen to determine what
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happened. to determine the facts and determine the damages. instead they're proposing that the republicans in congress know better what to do, to put limits on what a jury can reward their fellow citizens. and they're also putting limitations on the statute of limitations and lessening that. and on group and liability, which go toward helping -- civil liability, which go toward people who have gotten judgments being able to collect on judgments, which is so important. a judgment's no good unless you can collect on it. this is counter to what the republican party philosophy generally is and has been, that i've kind of perceived recently, about being against washington and laws coming on down high from washington, d.c. much of what we heard at our discussion from a gentleman from west virginia was about a west virginia law. that's what you're supposed to have is a west virginia law. somebody else talked about a texas law. and they're holding up a
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california law. each state's supposed to make their own lalls. we've got 50 states. you know, they talk a lot about the 50 states and the electric tofrl college. and the -- electoral college. and the states have an important function in our system of government. they're supposed to have provinces and act and juries -- and jury trials and trial courts, that's all state law. that should be determined by west virginia and texas and california and florida. not up here. this bill, when it went through committee, passed by one vote. because a couple of folks, i think it was judge poe and judge gohmert, pretty sure it was the two of them, two judges from the state of texas felt it went too ar in encroaching on the states' province -- dealing with tort law. . this amendment goes in the same direction. this is just unfortunate what we are trying to do is help insurance companies, not so much
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doctors. doctors might benefit some. but it's the insurance companies that would benefit the most. and that's what this is about. we oppose the amendment and oppose the bill. we support the american people and the right of the people and uries to dispense justice. i reserve my time. the chair: the gentleman from tennessee reserves. the gentleman from texas. mr. sessions: mr. chairman, perhaps the debate that mr. king had, he was not completely clear, which i would disagree with that statement. the gentleman from iowa stated very clearly that there are surgeries, there are procedures, there are processes that cost the federal government hundreds of millions -- and the gentleman went into the billions of dollars, which are parts of practices of medicine that doctors do as a defensive part
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of medicine to avoid exactly what we're talking about getting sued. and it is costing the federal government an enormous amount of money. the gentleman did refer to two members from texas. we'll see how they vote. but the clarifying amendment that we are offering now, amendment number 1 and amendment number 2, come directly from negotiations with an understanding with the texas medical association, the national physicians' policy council, to ensure, that, in fact, the compliance is made, that people not only in texas, but also in other states, that would offer a physician the ability for them to use their knowledge, their training and their expertise as opposed to practicing defensive medicine that harms every single taxpayer.
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that's why we are offering this today. i'm delighted what we have done is right. i yield back to congressman king so he may consume as necessary. mr. king: i thank the gentleman from texas for yielding to me. and i want to express, mr. chairman, the work that has been done by so many people. i rise in support of this improving amendment and it comes out of the minds of texas, which would clarify the timing of the statute of limitations in the provision base of the bill. and i urge the adoption of the sessions' amendment and i would yield back. mr. sessions: we reserve our time. the chair: the gentleman reserves the balance of his time. the gentleman from tennessee. mr. cohen: this is just a bad amendment that makes a bad bill worse. and all those folks from texas ought to be going to austin. this is where it be longs, in austin, not in washington. these are state issues. we had an amendment that these defensive measures that you say
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they are taking that wastes all this money and time, we had an amendment that said these caps wouldn't apply if you cut off the wrong arm, and you all wouldn't take it. i don't know how many defensive measures they have. this is the right arm and left arm. when you go in to do surgery, take off the right arm or the left arm, but not the wrong arm. and if you take off the wrong arm, damages, big time. and you didn't accept that amendment. this is shutting the courthouse door and closing down juries and not having faith with the american people to be able to ascertain facts and damages as they have throughout time and memorial. it's a power grab from washington. it's the swamp draining over to flood the state houses of all 50 of our states. i yield back. the chair: the gentleman's time has expired. the gentleman from texas. mr. sessions: i believe the gentleman, mr. king, has argued
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the point very successfully and we believe it's in the best interests of not only the taxpayer but physicians, physicians who have used their training and expertise and their knowledge to perform the necessary missions that are necessary. when those physicians do make mistakes and mistakes will happen, that we believe the rights of those that are afforded in california and texas would be consistent with those that would be great for the country and we're willing to share. and we appreciate the opportunity to present this. i ask my colleagues to support this amendment that i present today. and i yield back. the chair: the gentleman yields back the balance of his time. the question is on the amendment offered by the gentleman from texas. those in favor say aye. those opposed, no. in the opinion of the chair, the ayes have it and the amendment is agreed to. it is now in order to consider amendment number 2 printed in house report 115--179.
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for what purpose does the gentleman from texas seek recognition? mr. sessions: i have an amendment at the desk as the designee of the the gentleman from texas, michael burgess. the clerk: amendment offered by mr. sessions of texas. the chair: pursuant to house resolution 382, the gentleman from texas, mr. sessions, and a member opposed, each will control five minutes. mr. sessions: we offer our thanks not only to chairman bob goodlatte and distinguished the gentleman from iowa, mr. king, for his work on behalf of all members on the floor today for his work not only for the judiciary committee, but people of faith and confidence that this country can address the issues and needs. mr. chairman, i offer this amendment with dr. michael burgess, who is also from my home state of texas, as well as a member of the rules committee. the goal of our amendment is to clarify that health care
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liability claims covered by the legislation include safety, professional and administrative services directly related to health care. in other words, we're bringing in the entire scope, not just necessarily the medical procedure. and i was glad to see that h.r. 1215 adopts many of the reforms that states across this country have thoroughly tested in their efforts to improve medical liability law, including my home state of texas. not all claims asserted against health care providers arise from the direct provisions of medical care. my amendment addresses the full spectrum of health care claims by following the model that texas has successfully implemented. common examples of administrative claims related to health care are cases for negligence involving credentialing brought against
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hospitals and those serving on their professional committees. in these cases, the plaintiff typically is not a patient of the member serving on the committee but there is significant exposure for liability. safety claims are another necessary component in the scope of this bill. in these cases, a patient's injury does not arise out of the rendition of health care but pertains to the safety of a patient. the texas medical association, the texas lives for patient access, the national physicians' policy council are among those organizations who not only support this narrowly tailored amendment but offer their support of the entire bill and the inclusion of this amendment. at this time, i would reserve the balance of my time. the chair: the gentleman reserves the balance of his time. for what purpose does the gentleman from tennessee seek recognition? mr. cohen: i rise to basically
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say the same things i just said about the previous amendment. the chair: does the gentleman rise in opposition to this amendment? mr. cohen: yes, i do. this is called the protecting access to care act, but that's a misnomer because the purpose of these amendments and the bill, it takes as a given that there's going to be allegations that doctors, medical device companies, not exactly limited to financial resources or potential for harm, and nursing homes, are going to be alleged to have committed torts against individuals. , if at when that happens this becomes law, there will be less opportunity for individuals to get their day in court. most of those people, because most people are not wealthy,
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most of the people that get injured are going to bear the brunt of this when they don't get to court within the statute of limitations and don't collect because of the joint and semple liability changes in the law or get less because of the $250,000 cap. who is going to benefit from this? it's going to be the person who who found that was negligent, a nursing home, a medical device company or a physician. they are going to have less damages, less judgments against them and less costs. and insurance companies who can then make more money and doctors who will have lesser premiums. who loses? people who have been injured by medical device, defecttive merchandise, nursing home negligence or medical
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malpractice. we're not talking in limiting damages and the ability to recover by having a lesser joint and several liability law. we aren't talking about people who have not gotten the judgment. we're talking about people who have gotten a judgment for negligence. and just like the republican health care bill, which gives billions of dollars to the richest people in america with tax cuts at the expense of poor people who get medicaid, people with disabilities, pregnant women, poor people, seniors and nursing homes, they suffer. this is a microcosm of the health care proposals that the senate can't get 50 votes for. and they didn't even try for 60 which is they normally do, but know they can't get 50 under reconciliation and it's the microcosm of hurting the poor
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and enriching the rich. these are cases where there will be judgments, juries finding negligence and harm and damages if they get to the courthouse on time. and then you won't be able to collect as much. so who wins? the rich, the medical device companies, the nursing homes, the physicians. who loses? those who have suffered, those that juries have found that they are victims who should be able to collect but we are limiting how much they can collect and we are making it more difficult for them to collect. that's not what this congress should be doing is enriching the wealthy and hurting those who have been harmed by negligence. and if it's going to happen, it ought to happen in the states. so it's an attack on the 10th amendment. and mr. duncan from tennessee
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came here and gave beautiful testimony about a consistent life for protecting the 10th amendment and what mr. gohmert and what judge poe also did about what's left to the states. and that's why this amendment and the bill are both bad. i reserve my time. the chair: the gentleman from tennessee reserves. the gentleman from texas. mr. sessions: the gentleman, i respect not only much, not only the perspective that the gentleman holds, but perhaps ome of his argument could be true. mr. chairman, what we're trying to do is to balance out the opportunity for the american people to have access to health care for many times they are denied. i was reminded by the young chairman of the veterans committee, dr. phil roe who
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serves his great state and was an obstetrician and gynecologist and i was reminded of the case where when texas passed this, counties along our texas borders received instead of midwives and others who might perform these important services to deliver babies, all of a sudden, medical professionals, doctors, came into play, who had been shut out because of the fear of malpractice lawsuits against them. texas added in the first year some 4,500 doctors who came to texas knowing that it was a level playing field. in this case, mr. chairman, we are arguing that the united states of america and the citizens would not have to pay outrageous amounts of money in defense of defensive money whereby physicians, in order to protect themselves and protect
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themselves in a difficult circumstance, might order excessive amounts of either x-rays or other procedures that really cost the government money instead of providing better health care as a defensive mechanism. this has been an advantage in the states of california and in the states of texas where physicians used not only their training and their professional conduct, but they use what's in the best interest of the patient. and that's why we are here today. i would like to yield to the gentleman from iowa to speak on this, as he may consume. the chair: the gentleman is recognized. mr. king: i thank the gentleman from texas for his leadership on the rules committee and also dr. burgess from the rules committee, whose amendment is being offered by mr. sessions. as i listen to this dialogue, i'm just thinking, states do have rights.
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and they have the right to control any of the health care services that are funded by individuals or states. this only affects the federal dollars in it. we drive a 55 mile-an-hour speed limit because the federal government sets that. so i rise in support of this amendment. but the states are not funding medicare, medicaid, not funding obamacare -- the chair: the gentleman's time has expired. . . the gentleman from tennessee. mr. cohen: i'd like to give my time to mr. king because i i think it helps my case -- because i think it helps my case. the chair: i'm happy to accept the time from the gentleman from tennessee. -- the chair: the gentleman is recognized. mr. king: i'm happy to accept the time from the gentleman from tennessee. where there are federal dollars involved, there has been federal regulations that have matched along with that. and we've written all kinds of
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legislation in this congress, a lot of which i disagreed with. but as there was a federal nexus. and it hasn't been litigated successfully, time after time after time. we saw obamacare itself was litigated over and over again in the supreme court -- again, and the supreme court came down with rulings that let that legislation stand. that's one of the reason we have the angst we have today. e case, the case that this usurps states' rights is thin. it's not without some consequence but it's thin. we've gone way over to the other side and written everything we could possibly write into this bill that respects the rights of states. there's always a federal nexus we can couldn't on that. it's -- we can count on that. so the small compared to some of the things that the federal government is overreaching on. this is not. this is minimal. in order to regulate this over the top d trial lawyers -- over the top trial lawyers that are the only losers today, mr. chairman. and i yield back the balance of
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the gentleman from tennessee's time. the chair: the gentleman's time has expired. the question son the amendment offered by the gentleman from -- the question is on the amendment offered by the gentleman from texas. those in favor say aye. those opposed, no. in the opinion of the chair, the ayes have it. the amendment is agreed to. it's now in order to consider amendment number 3 printed in house report 115-179. for what purpose does the gentleman from tennessee seek recognition? mr. roe: mr. chairman, i have an amendment at the desk. the chair: clth clerk will designate the amendment. the clerk: amendment number 3 printed in house report 115-179 offered by mr. roe of tennessee. the chair: pursuant to house resolution 382, the gentleman from tennessee, mr. roe, and a member opposed will each control five minutes. the chair recognizes the gentleman from tennessee. mr. roe: i thank you, mr. chairman. medical malpractice lawsuits, excuse me, i yield myself such time as i may consume. the speaker pro tempore: the gentleman is recognized. mr. roe: mr. chairman, medical malpractice lawsuits in this country have gotten out of hand. which is hurting both providers and patients.
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something must be done. i spent 31 years practicing medicine in tennessee before coming to congress. in that time, i saw my medical malpractice insurance premiums increase from $4,000 a year to over $50,000, by the time i left practice. why were the premiums so expensive? my practice group took everyone. private insurance, medicare, medicaid, tricare and the uninsured. some practices limit their patient population, but when you're in rural appalachia and i've also practiced in inner city memphis, you take all comers. the reality is when you're taking care of patients with elevated risk, you get more frequent negative outcomes, increasing your risk of lawsuits. this creates an issue for patient access to care. finally, right when i was leaving practice in 2008, the governor signed into law some of the best reforms we have in tennessee, in the tennessee medical malpractice act, which created a 60-day notice statute in the certificate of good faith
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certifying a case has merit before it can be filed. 2011 the governor then signed a tennessee civil justice act into law. which contained the restriction on who could testify as an expert witness in a medical malpractice litigation. too often physicians practicing medicine are pitted in litigation ghens a professional witness who -- litigation against a professional witness who has gone to medical school but isn't even licensed to practice in their state or another state. that's absolutely wrong. the fact is these changes worked. in tennessee we saw medical malpractice premiums reduced from 2009 -- 2014, between 25% and 40%, despend -- depending on the specialty. o.b.'s saw their premiums down to 3ds3,000. neurosurgeon saw their premiums reduced from $49,000. cardiovascular.
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there were other changes that were put into place that helped. including caps. but the fact was, this change had a major impact. my amendment follows tennessee's law and strengthens the changes contained in the underlying text of the bill, h.r. 1215, by adding further restrictions to those individuals who would qualify as an expert witness for medical malpractice litigation. my amendment limits who can be called as an expert witness, not only by the individual's professional accreditation, but also by their location. the fact is, as tennessee's law proved, we needed medical professionals from the area where the incident in question occurred to testify as an expert, not a foreign jurisdiction hundreds of thousands of miles away. if that proves to be impossible, the court can wave this requirement -- waive this requirement, if a witness that fits this criteria is otherwise unavailable. no one knows the people or health care providers in an area better than the people and health care providers in that
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area. whether testifying for the plaintiff or defendant, it's important those individuals called as experts to really know the people in the area and aren't simply flown in from a far-away place just to get a paycheck. we all want improved quality and lower costs of care for patients. reforming medical malpractice litigation process is a step in the right direction. i encourage members to support my amendment and i reserve the balance of my time. the chair: the gentleman reserves the balance of his time. for what purpose does the gentleman from tennessee seek recognition? mr. cohen: to claim time in opposition. the chair: the gentleman is recognized for five minutes. mr. cohen: thank you. this is the tennessee law, i remember it. it's really probably not such a wonderful law. tennessee is an unusual state. you see it when you go to rock city. because from rock city you can see seven, eight, nine statess? pretty good. if you're in memphis, it would say that you can have an expert from arlington, virginia, come to memphis.
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that's a long way. and yet we're so much closer to, say, to springfield, illinois, or even to dallas, texas. we're much closer to baton rouge, where they have a lot of great doctors. and those doctors from baton rouge could come to memphis, they'd be closer to memphis than somebody from arlington, virginia. but the fact is the states should decide this. tennessee made this contiguous state or your own state law. that's -- alaska that means you have alaska. hawaii means you got hawaii. the states should decide who's an expert and who isn't. it also says you have to be in practice for the previous year. if somebody's not in practice and they're a professor at a medical school and maybe the outstanding expert on cardiovascular diseases, and they happen to be someplace like harvard, they wouldn't be able to go to a state that's not
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contiguous to massachusetts. and if they weren't practicing, they wouldn't be able to be an expert at all. these arbitrary time limits, arbitrary requirements, and arbitrary demographic limitations are not aimed at justice or saving costs. they're aimed at reducing the number of experts who might be available. in a state it's more difficult to get an ex forth come testify because you may get ostracized by your fellow professionals. it might be easier for a plaintiff to find an expert from a state that's a little bit of a distance. maine, i guess, i'm not that family with maine, as far as what does it touch? maybe vermont and new hampshire? kind of limits itself too. tennessee you'd have nine or 10 states. alaska, none. hawaii, none. maine, two. minnesota's got to be limited because we wouldn't go to canada. because that's not part of our
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system. of course this isn't really part of our system either. our system is a federal system where we give states the right to make these decision and not make them up here in washington. with a one-size-fits-all kind of way to stop people who have been damaged by medical malpractice or medical device defects or nursing home negligence from getting whole compensation. we put a limit from washington on the old person who is being taken advantage of by some individual in a nursing home. or some individual who's been given a defective valve in their heart. because of a medical device problem. we in washington, under this bill, think we know more than what a jury should know about the affects and the damages, when that person testifies in that courtroom in front of that jury, and before that judge, and have their damages proven, and you can see that individual and know the harm they've been caused. but their damages are going to
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be limited because of something that goes on here in washington, d.c. that is something the other side argues against constantly. they say, things should be decided back home in the states. things like voting rights and trying to limit them and limit the opportunity for people in the justice department to see to it that people get a chance to vote. they say that states' rights are primary when it suits their purposes. but in this purpose, when the insurance -- and in tennessee, the doctors own the medical malpractice insurance companies. i think it's called volunteer whatever. it's the doctors that own it. so they will be direct beneficiaries. i reserve the balance of my time. the chair: the gentleman reserves the balance of his time. for what purpose does -- the gentleman from tennessee is recognized. mr. roe: thank you, mr. chairman. where the subsidies are going in our state was to the lawyers. since they got over 60% of any medical malpractice settlement. the patient got less than 40
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cents on the dollar. i now yield one minute to mr. king. the chair: the gentleman is recognized for one minute. mr. king: thank you, mr. chairman. i thank dr. roe, the gentleman from tennessee, for bringing this amendment. looking at the language here, it was interesting that the concern was that the witnesses may not be available within a large state. i just notice as i read the language that unless the person was licensed to practice in the state or a contiguous border state -- that's pretty good. if you're hawaii, maybe not so good. but dr. roe, typical to his style, anticipates these things by putting the waiver authority in and the last provision in the amendment, which says the court may waive their requirements in this subsection if it determines that the appropriate witnesses otherwise would not be available. so this is a sound, well thought out directive that ensures we have a high level of professionalism. and when the gentleman earlier talked about a jury of your peers, what about having
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professionals that are highly credentialed, that do understand the locality and the normal practices within the region? not only do i support this amendment that's here, but i encourage its adoption. it requires expert witnesses to have knowledge of the standard of care in their local communities, commonsense amendment. i urge its adoption. i yield back to the gentleman from tennessee. the chair: the gentleman from tennessee reserves. mr. cohen: thank you, mr. chair. i was going to try to find that language but the really kind of -- years ago a trial lawyer told me when i was just a 28-year-old constitutional convention delegate, don't go down rabbit trails. and the gentleman from iowa's throwing rabbit trails out there. i'm not going to go down one. the fact is, this is a state issue that should be determined by the states and should be determined by judges and jurors in their jurisdiction, who see the defendant and see the plaintiff by their own eyes and determine the facts as the facts
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dictate and justice demands is what we hear and live by in jury cases and that's what we should live by in washington in determining what damages are and not making the decisions up here in washington, d.c. this is a bad amendment. it's a bad bill. it's contrary to the mantra that you normally hear from the other side. i yield back the balance of my time. the chair: the gentleman yields back the balance of his time. the gentleman from tennessee. mr. roe: thank you, mr. chairman. i wish the damages did go to patients in tennessee. they don't. the majority go to lawyers. i'll now yield a minute to my the friend, fellow ob-gyn, gentleman from kansas. the chair: the gentleman has 15 seconds remaining. mr. marshall: i rise to support this amendment offered by the gentleman from tennessee. like dr. roe, i too an am ob-gyn. the standard of care should be defined by local physicians. and how medicine is practiced

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