By Dana Milbank
Tuesday, May 9, 2006
When it comes to health care, the Senate has developed a repetitive stress injury.
Five times in the past five years, Republicans brought medical malpractice limits to the floor -- and five times they lost. Yesterday, they brought two more medical malpractice bills to the floor and, to nobody's surprise, lost twice more.
The only thing that's changed is the urgency with which proponents declare a "crisis" in the medical profession.
"This is crisis proportion in my state," Sen. Rick Santorum (R-Pa.), whose state is famous for its observance of Groundhog Day, said on the Senate floor. "This is a crisis that's horrible now. It's only going to get worse if we don't do something about it."
The situation must have deteriorated quickly, for when Santorum arrived an hour later at a rally of OB/GYNs in the Dirksen Building, he proclaimed, "We have reached beyond crisis proportion!"
Kicking off what he dubbed "Health Week" in the Senate, Majority Leader Bill Frist (R-Tenn.) admitted from the start that he didn't have the 60 votes he needed to force action on the two malpractice bills. But this is an election year, and limits on jury awards are a favorite of the chamber of commerce set. So Frist and his colleagues dusted off their two-year-old medical malpractice speeches and read them again.
"The AMA -- the American Medical Association -- says we've reached crisis proportions in 21 states," Frist told his colleagues yesterday. Thus did he fulfill a prophecy he offered 27 months ago from the same lectern: "More states will be added to the AMA crisis list, a list that already has 19 states."
Others didn't even bother to update their speeches.
"These bills address the medical liability and litigation crisis in our country, a crisis that is preventing patients from receiving high-quality health care -- or, in some cases, any care at all," Sen. Orrin Hatch (R-Utah) said yesterday. Compare that with his thoughts from February 2004: "This bill addresses the medical liability and litigation crisis in our country, a crisis that is preventing patients from receiving high quality health care -- or, in some cases, any care at all."
In his defense, Hatch had little incentive to waste time writing a new text. Seventy-four bills have been introduced mentioning medical malpractice since President Bush came to office. But only one has become law, and that was a minor provision of a terrorism-insurance law from 2002.
It's not for lack of creativity. Yesterday's efforts were marketed as the "Healthy Mothers and Healthy Babies Access to Care Act" and the "Medical Access Protection Act." Earlier attempts surfaced in the "Health Act," the "Better Health Act" and the "Physician Relief Act."
But opponents aren't buying it. "Nothing has changed from the prior Republican bill," Sen. Edward Kennedy (D-Mass.) charged on the Senate floor.
Actually, plenty has changed. Eighteen states have taken action in the past six years, and 45 either have some form of malpractice-award caps or are working on them. That has complicated the "crisis" cry.
Senate Minority Leader Harry Reid (D-Nev.) accused the majority of ignoring "the real health-care crisis" in favor of "a bill that's unnecessary and will go nowhere."
"It is a crisis," insisted Sen. Lisa Murkowski (R-Alaska).
"The magnitude of the crisis has been drastically overstated," said Sen. Christopher Dodd (D-Conn.).
"There is a crisis," maintained Sen. Judd Gregg (R-N.H.)
"So-called crisis" was the description of Sen. Patrick Leahy (D-Vt.).
At the very least, submitted Sen. John Ensign (R-Nev.), "we do have a serious problem."
Ah, but what's the solution? The OB/GYNs, in their white coats, cheered loudly as lawmakers, assembled at a rally in the Dirksen Building, promised action to limit malpractice awards. Rep. Phil Gingrey (R-Ga.), himself an obstetrician, pointed out that the assembled doctors "could have delivered 150 babies" in the time they were at the rally.
This led Rep. Michael Burgess (R-Tex.) to wonder: "Who's covering labor and delivery if they're all here?"
Turning to Frist, Burgess, also an obstetrician, urged: "I hope you get it done."
"We'll get it done," Frist promised.
But he didn't get it done. Even with the white coats filling the Senate gallery, the two malpractice bills got just 48 and 49 of the 60 votes needed. In a cruel twist, it was exactly the same margin of defeat their cousins suffered two years ago when there were four fewer GOP senators.