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Washington, D.C. – U.S. Sen. Mike Enzi, R-Wyo., said today the minority party in the Senate should stop obstructing a bill that would help people in Wyoming maintain access to affordable healthcare in their communities.

The Senate is expected to vote on whether to proceed to consideration of the Pregnancy and Trauma Care Access Protection Bill, S. 2207. In order to proceed to consideration of the bill, the Senate must vote for cloture, which is a parliamentary move that requires 60 votes to stop debate and move to an up-or-down majority vote on a bill.

The bill would permit full and fair compensation of economic losses to patients injured through obstetrical and emergency medical services. The bill would limit awards for non-economic damages to $250,000 in states that do not have their own limits on such awards. The bill would not limit awards for economic losses.

Enzi said the legislation is particularly important to states like Wyoming where the rising cost of medical liability insurance is forcing doctors to curtail or close their practices, which limits patient access to doctor's services.

The Senate is expected to vote on cloture tomorrow.

Enzi's complete statement follows.


Statement of U.S. Senator Mike Enzi
Pregnancy and Trauma Care Access Protection Act of 2004



Our nation's medical litigation system is broken, and we need to start working to fix it. I urge my colleagues to vote for cloture on the Gregg-Ensign bill. It's time to stop filibustering and start working.

This is the third time in this Congress that we have brought a medical litigation reform bill to the Senate floor. We need to pass this legislation. Passing this bill would be the best thing we can do to stabilize medical liability premiums in the short term.

Mr. President, I've proposed legislation aimed at solving this problem over the long term, and I will speak to that later. But for right now, we need to vote in favor of ending this filibuster against this bill.

I'm willing to consider any amendments my colleagues in the minority might have - but we can't consider your amendments until we agree to end this filibuster.

I understand that some Senators are concerned that this bill would limit the ability of an injured patient to get fair compensation. This bill would not do any such thing.

The bill would permit full and fair compensation to patients for their economic losses. This is an important point for everyone to keep in mind.

If a judge and jury were to decide that a person suffered an injury due to a doctor's mistake or a hospital's negligence, that person would still be entitled under this bill to receive full compensation for their economic loss - including everything from rehabilitation to lost wages resulting from their injury.

I can't stress this point strongly enough - this bill would not limit awards for economic losses. What the bill would do is place a ceiling on non-economic damages. The bill would limit the maximum award for non-economic damages to $250,000 in states that do not have their own limits on such awards.

So if you hear that this bill would limit an injured patient to receiving $250,000 in compensation - that is simply false. There is no other way to put it. That contention is false.

This bill also would only apply to obstetrical services and emergency medical services. These are two of the areas of medicine where patients are in the most danger of losing their access to these services.

Physicians are being hit with six-figure annual premiums in the medical specialties of obstetrics and trauma care. As a result, they are curtailing their practices, retiring early, or moving to states with better legal environments - because a better legal environment means lower insurance premiums.

In Wyoming, we've got one of those bad legal environments. We don't have limits on non-economic damage awards. We don't have limits, despite evidence that shows that reasonable limits on non-economic damage awards have helped control the rising cost of medical liability insurance premiums in other states.

As a result, people in Wyoming are losing access to affordable healthcare in their communities. The rising cost of medical liability insurance in my state of Wyoming is forcing doctors to curtail their practices or close them entirely. We have a shortage of doctors as it is in Wyoming, and the cost of medical liability insurance is making a bad problem even worse.

I want my colleagues to know that we've got a full-fledged medical liability crisis on our hands in Wyoming. Just last month, the largest of the three insurers in Wyoming announced that they would be leaving the Wyoming market later this year. As a result, 381 doctors and seven hospitals are going to have to find new insurance coverage.

Of the two companies that are left, one of them is not writing new policies for emergency and trauma care physicians. So the few emergency-room specialists we have in Wyoming soon will have only one company to choose from for their professional insurance.

You know, these insurance company executives aren't dumb people. Just like doctors are moving to states with better legal environments, so are the insurance companies.

Now, I don't much care which insurance companies are writing policies in my state - just as long as there are some. But I do care when good doctors leave the state.

Wyoming is a big state, with a lot of small communities. If you grew up in a small town, you probably got to know your family doctor pretty well. Doctors are part of the fabric of life in the small towns that dot the map of my state. It's not easy for them to pick up and leave, but that's what happening.

And as hard as it is for the doctor to leave, it's even harder on the families that they serve - the families that have grown comfortable with the care that these doctors provide.

So I commend Senators Gregg and Ensign and our Majority Leader Dr. Frist for trying again to pass a sensible short-term solution to this national crisis. They've developed a bill that is focused on providing relief to the doctors that serve mothers and their babies, and on the doctors that save lives in our nation's emergency rooms.

Every day, thousands of patients depend on these doctors when it comes time to bring a new life into the world - or to save a life that's already here. I hope we can all agree to support this short-term solution that will maintain access to the services these doctors provide.

I've noticed something interesting during our debates on the issue of medical liability reform. While we've been debating the "pros and cons" of reform, no one is standing up to defend our current system of medical litigation.

I have yet to hear a rousing defense of our medical litigation system. Even some of the lawyers in this body have agreed that frivolous lawsuits are a problem and that our medical litigation system needs reform.

Why aren't we hearing anyone defend the merits of our current medical litigation system? It's because it's indefensible. Our system doesn't work. It simply doesn't work for patients or their doctors.

The bill we're debating today is a good bill - it will help us stabilize insurance premiums and preserve access to critical medical services. But even the sponsors would probably admit it's a short-term measure that doesn't address the fundamental problems with our medical litigation system.

This is an important bill, but it's just a tourniquet to stop the bleeding. It's not going to heal our broken system.

We like to say that justice is blind. With respect to our medical litigation system, I would say that justice is absent and nowhere to be found.

Every member of this body wants to make sure that someone who is truly injured by a medical error gets the compensation they deserve. But a number of studies have shown that many patients who are hurt by negligent actions receive no compensation at all for their losses.

I've also seen studies that suggest that those who do receive compensation end up with about 40 cents of every dollar in insurance premiums, once the lawyers' fees and other courtroom costs are subtracted.

What's more, studies have demonstrated that the likelihood of a doctor or hospital being sued -- and the result of such a suit -- bears little relation to whether or not the doctor or hospital was at fault.

These facts led the Congressionally-chartered Institute of Medicine to issue a report in 2002. Their report called upon Congress to create demonstration projects to encourage states to evaluate alternatives to current medical tort litigation.

In response, I've introduced a bill that would turn these expert recommendations into action.

My bill, the Reliable Medical Justice Act, would authorize funding for states to create alternatives to current tort litigation. The funding would cover the costs of planning and initiating proposals. My bill would require participating states and the federal government to work together in evaluating the results of the alternatives as compared to traditional tort litigation. This way, all states and the federal government could learn from new approaches.

The bill outlines some model approaches that the states could employ. For instance, one state might want to evaluate the idea of healthcare courts, where judges with special expertise could hear medical cases. This concept is similar to the special courts we have for taxes, domestic violence, drugs, and other complex and sometimes emotional issues.

Another state might want to test an administrative approach. For instance, a state could set up classes of avoidable injuries and a schedule of compensation for them, and then establish an administrative board to resolve claims related to those injuries. A scientific process of identifying preventable injuries and setting appropriate compensation for them might offer better results than the randomness of the court system.

Another state might want to provide healthcare providers and organizations with immunity from lawsuits if they make a timely offer to compensate an injured patient for his or her losses. This could give a healthcare provider who makes an honest mistake the chance to make amends financially with a patient, without the provider fearing that their honesty would land them in a lawsuit.

The point of my bill, Mr. President, is that there are plenty of ideas for better ways to resolve medical disputes - and one of the best ways Congress can help fix the flawed litigation system in the long term is by encouraging states to test alternatives and learn from them.

As I speak, some states are already looking into alternatives. My home state of Wyoming is one of them. Another is Massachusetts, where the Governor is working with Harvard University on an innovative project. Another is Florida, where the Governor's task force recommended projects for which my bill could provide support.

Believe it or not, both Newt Gingrich and the editors of the New York Times have endorsed this idea. If Newt Gingrich and the New York Times can agree on something, maybe we can find enough support for it in this chamber as well.

I want to remind my colleagues that I support the Gregg-Ensign bill. It will provide some short-term relief from this medical liability crisis. Many of you will join me in voting for it, and many will vote against.

Regardless of whether you feel this is the right solution for the short term, let's acknowledge that our medical litigation system is failing us, and that we must work together to find a long-term solution.

Medical lawsuits are supposed to compensate people fairly and deter future errors. But most patients don't get fair and timely compensation, and there's nothing to show that lawsuits are deterring medical errors or making patients safer.

I urge you to vote for the Gregg-Ensign bill.

I also ask that you take a serious look at my legislation - Senate Bill 1518.

My basic reason for introducing S. 1518 is that most patients don't want to sue their doctors. If their doctor makes a mistake, they want an apology, they want to be compensated for their loss, and they want the situation to be resolved quickly and fairly.

I believe most physicians want the same thing. They want to apologize, and they want to make amends financially.

If patients and their doctors want the same thing, what stands in their way? Our legal system, that's what.

Our legal system pits doctors against their patients. Doctors can't apologize to their patients, because admitting a mistake might end a doctor up in court. As a result, doctors order more expensive tests and spend less time getting to know their patients - anything to protect against a career-threatening lawsuit.

Patients feel this distrust, and they respond in kind. If a patient has a bad medical outcome, they assume their doctor was as fault, even if there was nothing their doctor would or could have done differently. Well, sometimes bad outcomes happen in healthcare, and no one is at fault. But if a doctor doesn't feel free to say "I'm sorry" when he or she makes a mistake, how will a patient know whether their doctor is at fault or not? It's hard to blame the patient for assuming the worst.

This is the fundamental flaw in the way we resolve medical disputes today. The courtroom stands between the people who matter most - the patient and his or her doctor. The courtroom ought to be the last resort for resolving disputes, not the only resort. Patients and doctors ought to be on the same side, working together -- but fear of the legal system puts them in opposite corners and pits them against one another.

There has to be a better way, and I believe my bill is the first step toward replacing medical lawsuits with better and fairer systems for compensating and protecting patients.

Even if you don't support the Gregg-Ensign bill - as I do - I hope we can work together to find a long-term solution to this problem.

We need to do so, because patients and their doctors deserve better that our current medical litigation system.

They deserve reliability, fairness, and justice - and any one of those three would be more than they have today.

I thank the Chair, and I yield the floor.