Health Summit 2010

Sen. John McCain on medical malpractice reform at White House health summit

CQ Transcriptions
Thursday, February 25, 2010; 5:08 PM

OBAMA: I want to see if there are any Republicans who want to speak. I still have Dick Durbin.

MCCONNELL: Mr. President, I think John McCain.

MCCAIN: Thank you, Mr. President. And I say to my friend from North Dakota, none of us want to do nothing, but we do want to start over. We just had a discussion about the 800,000 carve-out and all of the other special deals and special interests that were included in this bill, which is more than offensive.

But I want to talk about one specific issue on deficit reduction, and that is medical malpractice reform.

Last year, Mr. President, you said when you gave -- spoke to the Congress, you asked your distinguished secretary of health and human services to look at ways that we could address the issue and then again this year. And I pay close attention to all of your speeches.

OBAMA: Thank you. That's more than Michelle does.


MCCAIN: And the -- and the point is that we don't have to go very far. There's two examples right now of medical malpractice reform that is working. One's called California, the other called -- called Texas.

I won't talk about California, because the Arizonans hate California, because they've stolen our water. But the fact is that Texas has established a $750,000 stack cap (ph) for non-economic damages, caps doctors at $250,000, hospitals at $250,000, and any additional institution $250,000, and patient's harmed do -- do a finding (ph) of medical malpractice are not subject to any limitations on recoveries for economic losses. And I hope you'll examine it.

But the important aspect of what they've done in Texas is the following. Lawsuit filings are down. Medical cost -- defensive medicine increases annual medical costs by 10 percent. They've saved 200 physicians -- recruitment is up. In the last two years, 6,945 new physicians have been licensed, 65 percent increase from two years preceding their reforms, 31 percent increase in recruitment of rural emergency medicine physicians.

Amarillo lost 26 physicians in the two years preceding the legislation, has gained 37. The largest malpractice insurance company in the state slashed its premiums by 35 percent, saving doctors some $217 million over four years. There are now over 30 companies competing for business.

It's already there. Now, all we have to do is enact this into legislation, and it's already been proven. So I don't think we have to experiment around.

The two states that have proven that you can enact medical malpractice reform and you can act great (ph) savings and provide health care providers with the incentives they need.

Now, I'd just like to finally mention one other thing. There's an issue that's overhanging this entire conversation. We all know what it is. It's whether the majority leader of the Senate will impose the, quote, "reconciliation," the 51 votes.

Now, having been in the majority and the minority -- I prefer the majority -- I understand the frustration that the majority feels when they can't get their agenda through. And it's real, and I understand it, and I have some sympathy.

But I remember -- and I think you do, too, Mr. President -- the last time when there was a proposal that we Republicans in the majority would adopt a 51-vote majority on the issue of the confirmation of judges. There was a group of us that got together, said, no, that's not the right way to go, because that could deal a fatal blow to the unique aspect in the United States Senate, which is a 60-vote majority. And we came to an agreement, and it was brought to a halt.

If a 51-vote reconciliation is enacted on one-sixth of our gross national product, never before has been -- there have been reconciliation, but not at the level like -- of an issue of this magnitude. I think it could harm the future of our country and our institution, which I love a great deal for a long, long time.

OBAMA: OK, let me just address two of the points that you made, and then I'm going to turn to Dick.

OBAMA: You know, this issue of reconciliation has been brought up. Again, I think the American people aren't always all that interested in procedures inside the Senate. I do think that they want a vote on how we're going to move this forward. And, you know, I think most Americans think that a majority vote makes sense, but I also think that this is an issue that could be bridged if we can arrive at some agreement on ways to move forward.

Medicare, or the issue of malpractice that you brought up. I've already said that I think this is a real issue. I disagree with John Boehner. John, when you say that it is the single biggest driver of medical inflation, that is just not the case. The Congressional Budget Office took a look at the proposal you've got for medical malpractice, and estimates that the government system would save about $50 billion over 10 years, which is $5 billion a year, which is real money, but understand that we've got a $2 trillion system.

Let's assume that you extrapolate that into the private marketplace. Let's say it's another $5 billion or another $10 billion. It's still a small portion of our overall health inflation problem. But having said that, it's still something that I care about, and I've said I care about it.

Now, not only have I asked Kathleen to initiate some pilot programs at the state level, but there are some examples of legislation that I actually would be interested in pursuing. Tom Coburn, you and Richard Burr have talked about incentivizing and allowing states to experiment much more vigorously with ways to reduce frivolous lawsuits, to pursue settlements, to reduce defensive medicine. That's something I'd like to see if we could potentially get going.

So I might not agree to what John Boehner has proposed. And it's interesting that I think I've heard a lot today about how we shouldn't have Washington impose on the states ideas, except when it comes to the ideas that you guys like, in which case it's fine to override what states are doing. There seems to be a little bit of a contradiction on this. But I think there may be a way of doing it that allows states to tackle this issue in a very serious way.

And I'd be interested in working with you, John, and working with Tom to see if we can potentially make that happen, if we can arrive at a package that also deals with the other drivers of health care inflation that are so important.

Now, we're running out of time. I've got Dick Durbin. And then what we're going to just do is go into coverage, and that will, I know Henry and John and Charles have been interested in talking about it. And frankly, it's something that we haven't spoken a lot about lately, and that is a whole bunch of people who just don't have health care.

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