2002 Ron Paul 90:1
Mr. Speaker, as an OB-GYN with over
30 years in private practice, I understand better than perhaps any other member of
Congress the burden imposed on both medical practitioners and patients by
excessive malpractice judgments and the corresponding explosion in malpractice
insurance premiums. Malpractice insurance has skyrocketed to the point where
doctors are unable to practice in some areas or see certain types of patients
because they cannot afford the insurance premiums. This crisis has particularly hit
my area of practice, leaving some pregnant woman unable to find a qualified
obstetrician in their city. Therefore, I am pleased to see Congress address this
problem.
2002 Ron Paul 90:2
However this bill raises several question of
constitutionality, as well as whether it treats those victimized by
large corporations and medical devices fairly. In addition, it places de
facto price controls on the amounts injured parties can receive in a lawsuit and
rewrites every contingency fee contract in the country. Yet, among all the new
assumptions of federal power, this bill does nothing to address the
power of insurance companies over the medical profession. Thus, even if the
reforms of HR 4600 become law, there will be nothing to stop the insurance companies
from continuing to charge exorbitant rates.
2002 Ron Paul 90:3
Of course, I am not suggesting
Congress place price controls on the insurance industry, Instead, Congress should
reexamine those federal laws such as ERISA and the HMO Act of 1973, which have
allowed insurers to achieve such a prominent role in the medical profession. As
I will detail below, Congress should also take steps to encourage contractual
means of resolving malpractice disputes. Such an approach may not be beneficial
to the insurance companies or the trial lawyers, but will certainly benefit
the patients and physicians which both sides in this debate claim to
represent.
2002 Ron Paul 90:4
HR 4600 does contain some positive
elements. For example, the language limiting joint and several liability to the
percentage of damage someone actually caused, is a reform I have long championed.
However, Mr. Speaker, HR 4600 exceeds Congress’ constitutional authority by
preempting state law. Congressional dissatisfaction with the malpractice laws in
some states provides no justification for Congress to impose uniform
standards on all 50 states. The 10th amendment does not authorize federal action in
areas otherwise reserved to the states simply because some members of
Congress are unhappy with the way the states have handled the problem. Furthermore,
Mr. Speaker, by imposing uniform laws on the states, Congress is preventing
the states from creating innovative solutions to the malpractice problems.
2002 Ron Paul 90:5
The current governor of my own state
of Texas has introduced a far reaching medical litigation reform plan that the
Texas state legislature will consider in January. However, if HR 4600 becomes
law, Texans will be deprived of the opportunity to address the malpractice
crisis in the way that meets their needs. Ironically, HR 4600 actually increases
the risk of frivolous litigation in Texas by lengthening the statue of
limitations and changing the definition of comparative negligence!
2002 Ron Paul 90:6
I am also disturbed by the language
that limits liability for those harmed by FDA-approved products. This language, in
effect, establishes FDA approval as the gold standard for measuring the safety
and soundness of medical devices. However, if FDA approval guaranteed
safety, then the FDA would not regularly issue recalls of approved products later
found to endanger human health and/or safety.
2002 Ron Paul 90:7
Mr. Speaker, HR 4600 also punishes
victims of government mandates by limiting the ability of those who have suffered
adverse reactions from vaccines to collect damages. Many of those affected by
these provisions are children forced by federal mandates to receive vaccines.
Oftentimes, parents reluctantly submit to these mandates in order to
ensure their children can attend public school. HR 4600 rubs salt in the
wounds of those parents whose children may have been harmed by government
policies forcing children to receive unsafe vaccines.
2002 Ron Paul 90:8
Rather than further expanding
unconstitutional mandates and harming those with a legitimate claim to collect
compensation, Congress should be looking for ways to encourage physicians and
patients to resolve questions of liability via private, binding contracts. The root
cause of the malpractice crisis (and all of the problems with the health care
system) is the shift away from treating the doctor-patient relationship as a
contractual one to viewing it as one governed by regulations imposed by insurance
company functionaries, politicians, government bureaucrats, and trial lawyers.
There is no reason why questions of the assessment of liability and compensation
cannot be determined by a private contractual agreement between physicians and
patients.
2002 Ron Paul 90:9
I am working on legislation to provide tax
incentives to individuals who agree to purchase malpractice insurance,
which will automatically provide coverage for any injuries sustained in
treatment. This will insure that those harmed by spiraling medical errors receive
timely and full compensation. My plan spares both patients and doctors the
costs of a lengthy, drawn-out trial and respects Congress’ constitutional
limitations.
2002 Ron Paul 90:10
Congress could also help physicians
lower insurance rates by passing legislation that removes the antitrust
restrictions preventing physicians from forming professional organizations for the
purpose of negotiating contracts with insurance companies and HMOs. These laws
give insurance companies and HMOs, who are often protected from excessive
malpractice claims by ERISA, the ability to force doctors to sign contracts
exposing them to excessive insurance premiums and limiting their exercise of
professional judgment. The lack of a level playing field also enables insurance
companies to raise premiums at will. In fact, it seems odd that malpractice premiums
have skyrocketed at a time when insurance companies need to find other
sources of revenue to compensate for their recent losses in the stock market.
2002 Ron Paul 90:11
In conclusion, Mr. Speaker, while I
support the efforts of the sponsors of HR 4600 to address the crisis in health care
caused by excessive malpractice litigation and insurance premiums, I cannot
support this bill. HR 4600 exceeds Congress’ constitutional limitations and
denies full compensation to those harmed by the unintentional effects of
federal vaccine mandates. Instead of furthering unconstitutional authority, my
colleagues should focus on addressing the root causes of the
malpractice crisis by supporting efforts to restore the primacy of contract to the
doctor-patient relationships.
This chapter appeared in Ron Pauls Congressional website at http://www.house.gov/paul/congrec/congrec2002/cr092602.htm