Bill Frist

Mr. FRIST

Mr. FRIST. Mr. President, on Thursday, February 12, 2004, the Senate appointed conferees on the pension bill, H.R. 3108. The legislation, as amended, passed on January 28 on an overwhelming 86-9 vote. Of course, the regular order on a bill of this type would have been to insist on the Senate position and appoint conferees to begin negotiations with the House over the contents of this bill. Normally, this would have occurred without comment immediately after passage of the legislation. Sadly, that was not the case. Instead, the Senate was diverted into an argument over past patterns and practices--how many times a bill has gone to conference, or been preconferenced, or simply agreed to by the other body or who has been at what meeting, when, or where. This argument may mean much to a few, but it stood in the way of the many. The Senate and the House are different institutions, with different rules, different pressures, different Members, and different outlooks. The most reasonable way for them to blend these differences is together, with representatives from both bodies sitting down at a table, reconciling legislation that each House has endorsed as its best idea to resolve pressing national problems. The pension legislation passed both the House and the Senate with large bipartisan majorities. In the Senate, the legislation was developed over 3 months with bipartisan input from across the ideological and party spectrum. Both leaders, as well as the chairmen and ranking members of the HELP and the Finance Committee, wrote the bill, negotiated with multiple interested members, and spearheaded the legislation to passage. When it came to the pension legislation, I listened carefully to what the minority leader said in various statements. I was gratified by the leader's assurance, given on the floor February 4, that he was ``not asking for any predetermined outcome,'' and that he was ``not asking for a certain set of expectations with regard to the legislation itself.'' Such an expectation on the part of any Member would have been another sharp departure about how we do our work here. It was the regular order that we go to conference on this legislation. I also believe it is the regular order that Senate conferees, majority and minority, participate in conference deliberations as compromise between the House and Senate is developed. I will work with my Senate majority colleagues to validate this commitment. We should not stymie over process when there is so much substance for us to work on, together, as the year progresses.

Mr. FRIST

Mr. FRIST. I now withdraw the motion to proceed to S. 1805.

Mr. FRIST. I ask unanimous consent that the live quorum under rule XXII be waived.

Mr. FRIST. Mr. President, there have been a number of conversations regarding the gun manufacturers liability bill. Those discussions were about the likelihood of reaching an agreement to allow the Senate to consider that bill under an orderly time agreement. Now it appears that we will be unable to reach an agreement on the bill and there is an objection to even proceeding to that measure. With that said, I now ask unanimous consent that at a time determined by the majority leader, after consultation with the Democratic leader, the Senate proceed to the consideration of Calendar No. 363, S. 1805, the Protection of Lawful Commerce In Arms Act.

Mr. FRIST

Mr. FRIST. I ask unanimous consent the Senate now proceed to a period of morning business with Senators permitted to speak for up to 10 minutes each.

Mr. FRIST

Mr. FRIST. Mr. President, for the information of my colleagues and those watching, we have a scheduled cloture vote on the motion to proceed to the OB/GYN medical liability bill tomorrow afternoon. As I stated earlier, along with many of my colleagues, I hope that cloture will be invoked and that the Senate will be able to consider this bill. If we are prevented from even debating this legislation, it is our hope to take up the bipartisan gun liability bill. Given the earlier objection, it was necessary to file that cloture motion to proceed tonight. So the vote will occur on the gun liability bill on Wednesday of this week.

Mr. FRIST

Mr. FRIST. Mr. President, let me welcome everybody back from the Presidents Day recess. I also thank Senator Breaux and congratulate him on the delivery of George Washington's Farewell Address. He is the 112th Senator to give the address. The first reading of George Washington's address actually occurred on February 22, 1862, during a joint session of Congress and was given by the Secretary of the Senate. Beginning in 1893, the Senate made the reading of the address an annual tradition. And since that time, each year, in an alternating fashion between the parties, George Washington's birthday is observed by the reading of the 7,641-word address. I commend Senator Breaux for his contribution today. Today the Senate will begin consideration of the motion to proceed to S. 2061, the OB/GYN medical liability bill. Chairman Gregg is here to manage debate, and I encourage Senators to come to the floor to debate this sorely needed women's health access issue. Due to objections on the other side of the aisle, it was necessary to file a cloture motion on this pending motion to proceed. That cloture vote on proceeding to the OB/GYN medical malpractice bill is scheduled for tomorrow at 5 p.m. Therefore, there will be additional debate time tomorrow before the vote. However, I know many Members are interested in this bill and hopefully are prepared to speak today. We will have no rollcall votes today. The cloture vote will be the first vote tomorrow. Over the next few minutes I would like to make a statement on the Healthy Mothers and Healthy Babies Access to Care Act. Mr. President, our medical litigation system is failing the American public. It is failing our communities, our hospitals, our doctors, and our families. Most importantly, it is failing our patients. Its purpose should be to promote the common good and improve the health care of all Americans through the fair and efficient resolution of meritorious medical negligence claims. But instead of accomplishing this noble goal, our litigation system is out of control. It is broken. It is causing a health care crisis. Due to this broken system of medical justice, medical liability premiums are skyrocketing. The result: The system is in crisis. The ultimate victims are the patients who see that their access to care being threatened and in some cases their access to care is disappearing altogether. In addition, this ailing system hurts our Nation even more by directly and indirectly costing us billions of dollars. The situation is grave. It is being brought to the Senate floor because it is grave, because the system is broken, and because the crisis is getting worse by the day. Every day that we talk without acting is a day of continued decline. We have all seen the headlines of the horror stories of hospitals closing obstetric wards; of trauma centers having to shut their doors because of the liability crisis; of expectant mothers unable to find obstetricians, having to switch from obstetrician to obstetrician because their obstetrician is having to leave town or leave their practice; the stories of doctors dropping services of specialized care; the stories of doctors having to move from a State where the liability premiums are so high that they can't afford it to other States where effective liability reform may have already taken place and they have lower premiums. The headlines go on and on and on. Almost daily there are fresh stories and new victims. The problems are so severe that Time magazine, in its June 9 cover article, devoted the article and the front page to this very problem. The American Medical Association lists 19 States where access to quality care is in serious jeopardy right now. As a physician, as a doctor, this crisis and the worsening of this crisis really strikes home to me personally. When I go back home or travel around the country and talk to my physician colleagues, they tell me of personal stories that are causing changes in the way they practice medicine. Many doctors consider the current medical litigation system as the single greatest threat to providing patients today with affordable, high- quality health care. At first, the problem of skyrocketing medical liability costs presents doctors with uncomfortable choices. But in the end, it is the patients who are hurt. It is the patients who suffer. Skills of physicians are redirected. They leave their practice. They are no longer available to give care and patients receive less care. No longer is this a problem of an additional expense of doctors or for doctors all across the country; it is now an issue of health care for all. What makes this situation so tragic is that highly qualified and committed doctors are literally being forced from their fields of medicine, fields they have devoted their lives to, fields they cherish. We are not talking about a few bad doctors who are leaving. Rather, we are talking about the very best men and women in the health care field today who have devoted their entire professional lives to healing others. These good men and women don't want to drop these specialized services such as trauma care, delivering babies, working in emergency rooms. They don't want to move from already underserved areas, either urban or rural. They don't want to stop seeing those expectant mothers. They don't want to be unavailable if somebody comes to a trauma center or to an emergency room. Tragically, and all too often, the current liability system leaves them with no choice. The current system doesn't single out bad doctors or negligent acts or poor quality of medicine. Our medical litigation system has not made medical care in the United States safer or better. In fact, in many cases it has made care just the opposite--less safe. How? By discouraging doctors from sharing information that could prevent medical errors and by encouraging doctors to order unnecessary and costly tests that sometimes do more harm than good. The exploding costs hit almost all doctors and hurt patients by driving up unnecessarily the cost of medical care of everyone who is listening to me right now. Your health care costs are higher because of these unnecessary and frivolous lawsuits. You are being affected. Our current medical litigation system is the root cause of this crisis. It is an inefficient system that is full of perverse incentives. The current system hurts everyone seeking access to quality and affordable health care, and it hurts the very negligently injured patients it is supposed to be helping. The system encourages lawsuit abuse by rewarding trial lawyers who file huge claims in friendly venues in search of the big payout. These lawyers often pocket up to 40 percent of any settlement or any payment the injured patients receive. That is 40 cents on the dollar that the trial lawyer pockets that does not get to that injured patient. At the same time, many of the negligently injured patients--those who deserve to be compensated--never receive any compensation at all because their legitimate claims are too small for that personal injury lawyer who is out there looking for his or her big payday. (Mr. ROBERTS assumed the Chair.) The system compensates a few at the expense of the many. The effects of these massive suits are staggering. Between 1995 and 2002, the average claim payout for medical malpractice jumped 83 percent. Between 1997 and 2002, the percentage of medical malpractice payments of a million dollars or more more than doubled. The mere threat of huge jury awards forces many doctors and insurance companies to settle cases for large amounts, even if they are not guilty. The current system encourages frivolous lawsuits, unnecessary lawsuits. Most of the cases filed in U.S. courts are without merit, with almost two-thirds being dropped or dismissed; that is, two out of three are being dropped or dismissed. Only 1 out of 20, or 5 percent of cases, actually go on to trial, and a staggering 80 percent of those cases are won by the defendant. These numbers are clear evidence of the rampant abuse of the current system, and the system must be reformed. It should be no surprise that this excessive litigation is forcing malpractice premiums to rise dramatically. In 2002, physicians in many States saw their premium rates rise by 30 percent or more. In some States, for some specialties, malpractice insurance is rising by as much as 300 percent per year. We debated this issue last July with a comprehensive bill, S. 11, the Patients First Act. That broad, comprehensive reform measure was designed to put our medical litigation system back to work for all Americans. Bringing the bill forward in July was the first time that the Senate had ever considered comprehensive medical litigation reform as its own freestanding bill. Unfortunately, the measure was never fully debated, as opponents of reform blocked it by filibustering the motion to proceed. Since that time, the horror stories have not stopped. In fact, they have increased. Because this issue is so critical to the health of Americans, and because this crisis continues to escalate, we will try once again to address it on the floor of the Senate. This time, instead of bringing up a broad, comprehensive bill and letting it suffer from the same political attacks as before, we have narrowed our focus on one of the groups most severely hurt by the crisis, obstetricians and gynecologists. More importantly, we want to focus specifically on the health care needs of women and children and babies. The underlying bill, the Healthy Mothers and Healthy Access to Care Act of 2003, is narrowly tailored to focus on obstetricians, gynecologists, and other doctors who perform these services. In the more narrow scope, the reform measures are almost identical to the ones in the more comprehensive bill, S. 11. OB/GYNs, by the very nature of their work, are a higher risk specialty group, so it is understandable that their liability premiums would be somewhat higher than lower risk doctors. However, the amounts that OB/GYNs are paying throughout the country for liability insurance today are staggering. For example, locally, in Virginia, OB/GYNs are paying up to $84,000 in medical liability premiums per year. At the outset, I will say all OB/GYNs have to have liability insurance. Today, all physicians have to buy medical liability malpractice insurance to practice. Locally, it is $84,000. In New York, they are paying up to $124,000 per year. In Pennsylvania, they are paying up to $153,000 per year. In Florida, OB/GYNs are now paying up to an astonishing $250,000 in premiums each and every year to stay in the practice of delivering babies. That is a quarter of a million dollars every year that obstetricians are paying in Florida. I wish to stress once again that these are payments the doctors are making merely to purchase the liability insurance. Whether or not they have ever had a case brought against them, whether or not there has ever been a medical error or mistake made at all, this is what many obstetricians are having to pay in these States. There is no added value in that $250,000 to health care. These payments are not helping the patients live better lives or receive higher quality of health care, and these amounts are not being paid just by a few bad doctors. They are being paid by doctors who have never been sued, who are the best in their profession, who have dedicated their lives to helping women and children. Because of these skyrocketing premiums and the constant threat of litigation, many obstetricians are leaving their practice because they simply cannot afford it. Who can blame them? If an obstetrician delivers 100 babies a year, and let's say just in Florida they are paying $250,000 for that opportunity to deliver babies, that is a tax of over $2,000 each time that obstetrician delivers a baby. If you are a mother listening, or an expectant mother who is getting ready to go in the hospital, I am saying that there is an additional $2,000 tax that the doctor is paying, which may well be passed on to you because somebody has to pay it. That is money that doesn't add to the care of your baby, or to the care of the delivery, or to the safety of the delivery, or to health care itself. Women living in rural areas have an additional problem. They are finding now that there are too few doctors to deliver the babies in these rural communities. By now, most of my colleagues have heard the horror stories of women having to drive hours just to see an obstetrician, or in the course of a 9-month pregnancy, having two, three, four, or five obstetricians because many doctors are having to leave either a region or the practice altogether. A June 9 Time magazine article tells the tragic story of an expectant mother in rural Arizona having to drive 2 hours on a desolate highway just to see a doctor. This should not happen in America. We should be encouraging physicians to practice in rural, underserved areas, not chasing them away with the threat of frivolous lawsuits. It should be no surprise that the American College of Obstetricians and Gynecologists is one of the strongest supporters of meaningful medical liability reform. Of course, they support this narrowly tailored bill. Their primary concern is women's access to affordable, quality health care. They are uniquely situated to understand the threat the current system has placed on women's health and babies' health, and they are demanding action by Congress. They will not tolerate filibusters or blocking this issue. I urge my colleagues to listen to their unique concerns. In a statement to the Senate Judiciary and HELP Committees last year, the American College of Obstetricians and Gynecologists very clearly outlined the problem facing women. They said: An ailing civil justice system is severely jeopardizing patient care for women and their newborns. Across the country, liability insurance for obstetricians-gynecologists has become prohibitively expensive. Premiums have tripled and quadrupled practically overnight. In some areas, OB/GYNs can no longer obtain liability insurance at all, as insurance companies fold or abruptly stop insuring doctors. When OB/GYNs cannot find or afford liability insurance, they are forced to stop delivering babies, curtail surgical services, or close their doors. The shortage of care affects hospitals, public health clinics, and medical facilities in rural areas, inner cities, and communities across the country. These are the words of the American College of Obstetricians and Gynecologists, the ones on the front line in women's health care today. The system is broken. The system is hurting women and babies today. This was very clearly spelled to the Senate Judiciary and HELP Committees last year. I have a series of letters from doctors in Tennessee and, indeed, from around the country. At the appropriate time, I will enter several of these letters into the Record rather than take the time now because there are Senators in the Chamber who wish to debate this particular issue. Let me simply say that as a physician, as majority leader, as a representative of the people of the great State of Tennessee, I have letters from Paris, TN, from Athens, TN, Shelbyville, TN, from Memphis, TN, from obstetricians who are basically saying there is a crisis going on and asking that we do something about it. I do hope the opponents of reform at least acknowledge the severity and gravity of the problem and don't run from it once again. We must acknowledge the symptoms of the crisis before we start to address its cause. Unfortunately, these horror stories are truly just the tip of the iceberg of the problems caused by our broken litigation system. The system costs our country directly and indirectly billions of dollars-- wasted dollars, I would argue--each year. These costs are the sort of costs that don't find their way into letters to us as elected officials or into newspaper articles, but they hurt the American people. The fear of these outrageous lawsuits forces doctors, for example, to practice defensive medicine. Slowly, but surely, people are understanding what defensive medicine is. As a doctor, I know these pressures all too well. In order to avoid lawsuits--frivolous lawsuits--and to make sure they would be fully protected in the event they were called into question by an unnecessary or frivolous lawsuit, we find extra tests and procedures are ordered. They are unnecessary to the care of that particular patient or that particular patient's problem. It is a waste. Yet the system we have today incentivizes those unnecessary tests. These extra steps add little, if anything, to the quality of health care, but they add a lot to the bottom line of health care costs because hundreds of thousands of doctors actually order these unnecessary tests. The cost adds up. We all hear of the $700 CAT scan or MRI scan for a routine headache that an emergency physician orders simply out of practicing defensive medicine. It is no surprise to me that surveys show 75 percent or more of doctors acknowledge practicing defensive medicine. The exact number is hard to calculate, but reports have put the cost of defensive medicine at tens of billions of dollars per year. When you realize that three out of four doctors frequently order tests or procedures, these total dollar figures, indeed, are realistic. In fact, a recent Government report estimated reasonable liability reform would save the country health care costs of $70 billion to $126 billion per year in defensive medicine expenditures. In addition to these massive indirect costs, the Federal Government would save over $14 billion directly over 10 years with comprehensive liability reform, according to the Congressional Budget Office. The CBO attributes most of these savings to the Medicare and Medicaid programs which would experience lower health care costs. The Federal Government would also realize savings from lower costs of health care benefits for Federal employees. The current medical litigation system also impedes our ability to improve patient safety. The threat of excessive litigation by unscrupulous lawyers discourages doctors from openly discussing medical errors in ways that, if that discussion could take place, would dramatically improve health care delivery in this country. These facts were outlined and well documented in the 1999 Institute of Medicine report ``To Err Is Human.'' That is why in addition to the reforms in this bill which hopefully we will be considering on the floor of the Senate, most of us are strong supporters--or we should be--of S. 720, the Patient Safety and Quality Improvement Act. This is vital legislation that will encourage a culture of safety and quality by providing for voluntary reporting of patient safety data without the fear of being sued. Some of the opponents of the legislation we are debating today will try to confuse the medical malpractice issue with patient safety. If you listen closely, you will hear them say, in effect, that we need to maintain our broken medical liability system in order to reduce medical mistakes. Do not be misled. This argument amounts to nothing more than defending the status quo. In fact, as the IOM has said, and as we know from adopting voluntary reporting and learning systems in other contexts, such as in general aviation--more lawsuits don't improve quality--they make matters worse. Our health care system must put a greater emphasis on preventing medical errors, not hiding or surpressing these errors due to fear of lawsuits. To create such a system, we must pass both patient safety legislation and litigation reform. And I am committed to passing patient safety legislation too. It is now being blocked by at least one Senator on the other side of the aisle despite the fact that it has passed the HELP committee unanimously. Fortunately, we know how to address the cause of the crisis because reform measures have already succeeded at the state level. The Healthy Mothers, Healthy Babies Access to Care Act is based on these reforms. It is a common sense measure that will restore balance to our broken litigation system in the narrow area of OB/GYN services. It will protect the right of the negligently injured patient to sue for just compensation while curtailing lawsuit abuse. Though this bill has a narrow scope, it is comprehensive reform with several critical components. Let me briefly mention just a few key provisions. The bill ensures that injured patients will receive a larger percentage of their award by limiting attorneys contingency fee to a reasonable sliding scale. For awards over $600,000, lawyers can keep 15 percent of any payment. Currently, lawyers in many states can take up to 40 percent of all awards and settlements, leaving the injured patient grossly undercompensated. The bill places a statute of limitations of three years on bringing a suit. This ensures that a suit will be brought in a timely manner and evidence preserved. The bill controls excessive awards for noneconomic damages by placing a $250,000 cap on these types of awards. Noneconomic damages are subjective awards for pain and suffering that cannot be easily quantified. They contribute greatly to the personal injury lawyers' lawsuit abuse. Of note, the caps contained in this bill are ``flexible'' and do not preempt state law. Thus, if a state has already defined a different cap on noneconomic damages or subsequently passes a different cap--whether higher or lower--that State designated cap prevails. At the same time, the bill ensures that negligently injured patients will receive full economic damages. Economic damages are the out-of- pocket expenses that a victim might suffer due to a doctor's negligence, such as hospital costs, doctor bills, long-term care, other medical expenses, and lost wages. When a patient is negligently injured, they deserve full economic recovery. Experience at the State level clearly shows that comprehensive medical liability reform works. The Healthy Mothers, Healthy Babies Access to Care Act is modeled after California's Medical Injury and Compensation Reform Act, or MICRA, which became law in the mid 70's. Thanks to MICRA, California doctors and patients have been spared the medical liability crisis that other states are facing. You simply don't hear the horror stories about OB/GYNs quitting their practice or women unable to find an obstetrician in California. This is true despite the fact that it is a big State with a high cost of living. In fact, since MICRA passed, total insurance premiums paid in California have risen by only 167 percent while total insurance premiums paid for the rest for the country have risen by 505 percent--more than three times as much. Over the next day or two as we discuss this bill, opponents of reform will likely go to great lengths to blame the current crisis on insurance companies, the stock market, the bond market, doctors, hospitals and on and on. I fear we will hear this crisis blamed on just about everyone and everything except for the true cause--the current litigation system. The system is broken. This broken system is hurting patients and now is the time to fix it. I urge my colleagues to support the Healthy Babies, Healthy Mothers Access to Care Act. This narrowly tailored, commonsense reform of our broken and inefficient medical litigation system will be a big step in improving our health care system for all Americans. Passage of this measure will help ensure access to quality health care for women and babies, protect negligently injured patients, and save our country billions of dollars in health care costs every year. Mr. President, I yield the floor.

Mr. FRIST. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. FRIST

Mr. FRIST. I ask unanimous consent that the committee amendment be agreed to, the bill as amended be read a third time and passed, the motion to reconsider be laid on the table, and any statements relating to the bill be printed in the Record.

Mr. FRIST. I ask unanimous consent that the Senate proceed to the immediate consideration of Calendar No. 414, S. 1786.

Mr. FRIST

Mr. FRIST. Mr. President, I am proud to join today with Senator Mary Landrieu, Senator Thad Cochran, Senator Mike DeWine, Senator Christopher Bond, Senator James Talent, Senator John Warner, and Senator Kay Bailey Hutchison to introduce the ``Closing the Health Care Gap Act of 2004.'' Earlier today, I was pleased to be joined at a press conference by an impressive array of leaders in this fight--Dr. Louis Sullivan, Dr. Rene Rodriguez, Dr. Randall Maxey, Dr. John Maupin, and Dr. James Gavin. I appreciate their support for this legislation, and also appreciate the support of other national leaders committed to closing the health care disparity gap in America. Last May, in a speech to graduating students and families at Morehouse University's School of Medicine, I outlined a framework for action to combat disparities. Since then, I have reached out broadly and worked with a wide range of stakeholders and leaders to gather their input and ideas to ensure the legislation we are introducing today includes the best possible strategies to eliminate health disparities. I am also proud to be joined today by a number of colleagues who are committed to this cause. I particularly want to thank Senator Landrieu for working across party lines on this bipartisan legislation. As former Surgeon General Louis W. Sullivan, MD, said at a press briefing earlier today on this legislation, ``[e]thnic minorities represent the fastest growing segment of the U.S. population, and therefore, it is critical that we have a sustained and coordinated commitment to addressing this national problem. The ``Closing the Health Care Gap Act'' seeks to do that. . .'' This legislation builds on past bipartisan efforts to address disparities in our health care system--most importantly, the ``Minority Health and Health Disparities Research and Education Act of 2000,'' which I authored with Senator Edward Kennedy. The legislation we are introducing today goes much farther. Over recent years, we have made tremendous advances in our knowledge of and fight against disease. But we know that millions of Americans still experience disparities in health outcomes as a result of ethnicity, race, gender, or limited access to quality health care. For example, disparity populations exhibit poorer health outcomes and have higher rates of HIV/AIDS, diabetes, infant mortality, cancer, heart disease, and other illnesses. African Americans and Native Americans die younger than any other racial or ethnic group. African Americans and Native American babies die at significantly higher rates than the rest of the population. African Americans, Native Americans, and Hispanic Americans are at least twice as likely to suffer from diabetes and experience serious complications from diabetes. These gaps are simply unacceptable in America today. Let me repeat, they are unacceptable. And, today, we begin a new and aggressive effort to address these inequities. The root causes of the health care disparities are multiple and certainly complex. That is why we need a broad and comprehensive approach to reduce and eliminate these disparities. This legislation takes a bold step in that direction. Many of our Nation's smartest minds have examined this problem in detail. The Institute of Medicine (IOM) in its landmark report ``Unequal Treatment,'' concluded that health care disparities are caused by socioeconomic factors, language barriers, access to services problems, behavioral risk factors, and cultural issues including, unfortunately, mistrust and misunderstanding of some patients toward the health care system. The ``Closing the Health Care Gap Act'' directly addresses the root causes of health care disparities by focusing on five key areas: expanding access to quality health care; strengthening national leadership efforts and coordination; helping increase the diversity of health professionals; promoting more aggressive health professional education intended to reduce barriers to care; and enhancing research to identify sources of racial, ethnic, and geographic disparities and assess promising intervention strategies. More specifically, this bill: promotes improved understanding of the quality of health care delivered to racial and ethnic minorities and health disparity populations; improves collection and reporting of data on the health care of racial and ethnic minorities and health disparity populations; reduces some of the fragmentation of health care delivery experienced by disparity populations; strengthens the doctor-patient relationship by providing a series of tools to improve communication and continuity of care; supports the use of community health workers; supports the implementation of multidisciplinary treatment and preventive care teams; improves education and information to allow patients to better manage and control their own care; and increases the proportion of racial and ethnic minorities among health professionals. It is important that we act, as well, because health care disparities magnify many of the quality deficiencies in our overall health care system. This point was well documented by the IOM in a series of reports issued during the past several years. Therefore, the bill takes aggressive steps to improve the quality of health care for all Americans. A key part of this effort necessarily involves the need to strive for greater standardization of health data collection. At the same time, we must ensure that this information allows us to better identify and address gaps in our health care system by including important information about patients' race and ethnicity. While the Federal Government has a critical role to play, it is important to remember that government alone is incapable of closing the care and treatment gaps which exist in our health care system. Therefore, the legislation promotes partnerships between the Government and the private sector, and fosters collaboration at the community level to improve care, as well as access to care. The bill expands access to quality health care for minority and underserved patients through a community-based model that seeks to help patients utilize health coverage that may be available, to provide health system patient navigator services so that they may best utilize available coverage, to emphasize health awareness, prevention and health literacy efforts so that patients can effectively take part in their or their children's treatment decisions, and to improve chronic disease management. Turning our back on these health disparity problems would be a national failure. Every American deserves the best quality of health care possible, regardless of their race, ethnicity, gender, or where they live. Again, I appreciate the commitment of many of my colleagues. Together, I know we can make great progress against this critical problem. There is a growing awareness on the national level of the existence and importance of the serious disparities in the quality of health care that many minority and underserved Americans receive. This presents us with an important opportunity to move forward. My intention is to continue to build this national awareness, which can provide the basis for bipartisan efforts to fight and reduce these disparities. Today's bipartisan bill introduction represents a key step in this process. I would like to very quickly thank some of the organizations that are supporting this bill: Interamerican College of Physicians and Surgeons, National Hispanic Medical Association, National Medical Association, The National Conference for Community and Justice, The Association of Minority Health Professions Schools, National Urban League, American Association of Family Physicians, National Patient Advocate Foundation, National Association of Community Health Centers, Health Choice Network, National Association of Public Hospitals, American Hospital Association, The Endocrine Society, St. Thomas Health Services, Ascension Health, The American Society of Transplantation. With this strong base of initial support, the broad consensus that is beginning to emerge on this issue, and the bipartisan commitment of so many, it is my hope that we can make real progress toward eliminating health care disparities and end--once and for all--this intolerable blight on our Nation.

Mr. FRIST

Mr. FRIST. Mr. President, with that objection, I now move to proceed to the consideration of S. 2061, the OB/GYN medical malpractice bill, and I send a cloture motion to the desk.

Mr. FRIST. Mr. President, I ask unanimous consent that the live quorum under rule XXII be waived, and I ask unanimous consent that this vote occur at 5 p.m. on Tuesday, February 24.

Mr. FRIST

Mr. FRIST. Mr. President, I ask unanimous consent that the Senate resume consideration of H.R. 3108, the pensions bill, and that the Senate insist upon its amendment, request a conference with the House, and the Chair be authorized to appoint conferees on behalf of the Senate at a ratio of 3 to 2.

Mr. FRIST

Mr. FRIST. Mr. President, I ask unanimous consent that notwithstanding the resolution of the Senate of January 24, 1901, on Monday, February 23, 2004, immediately following the prayer, the Pledge of Allegiance to the flag, and disposition of the Journal, the traditional reading of Washington's Farewell Address take place.

Mr. FRIST

Mr. FRIST. Mr. President, I ask unanimous consent that the Senate immediately proceed to executive session to consider the nomination of Samuel W. Bodman to be Deputy Secretary of the Treasury, which was reported by the Finance Committee today. I further ask unanimous consent that the nomination be confirmed, the motion to reconsider be laid upon the table, the President be immediately notified of the Senate's action, and the Senate then return to legislative session.

Mr. FRIST

Mr. FRIST. Mr. President, I ask unanimous consent that the Senate now proceed to the consideration of S. Res. 303, submitted by Senators Burns and Baucus earlier today.

Mr. FRIST. I ask unanimous consent that the resolution be agreed to, the preamble be agreed to, the motion to reconsider be laid upon the table, and any statements be printed in the Record.

Mr. FRIST

Mr. FRIST. Mr. President, I ask unanimous consent that at a time to be determined by the majority leader, in consultation with the Democratic leader, the Senate proceed to the consideration of Calendar No. 429, S. 2061, the OB/GYN medical malpractice bill.

Mr. FRIST

Mr. FRIST. Mr. President, I ask unanimous consent that notwithstanding the recess committees be allowed to file reports on Wednesday, February 18, between the hours of 10 a.m. and 12 noon.

Mr. FRIST

Mr. FRIST. Mr. President, I ask unanimous consent that during this adjournment of the Senate the majority leader or the assistant majority leader be authorized to sign duly enrolled bills or joint resolutions.

Mr. FRIST

Mr. FRIST. Mr. President, at this juncture, I have several statements and comments I will make. I will be happy to turn to the Democrat leader if he has comments which he wishes to make.

Mr. FRIST

Mr. FRIST. Mr. President, I want to spend a few minutes to make some comments on some current issues that occurred over the course of the day and in the news. To begin with, I wish to make a statement on a bill I had the opportunity to introduce earlier today but have not yet taken the opportunity to comment on, a bill entitled Closing the Health Care Gap of 2004. I was proud to join today with my colleagues, Senator Mary Landrieu, Senator Thad Cochran, Senator Mike DeWine, Senator Kit Bond, Senator James Talent, Senator John Warner, and Senator Kay Bailey Hutchison to introduce this bill, Closing the Health Care Gap of 2004. It is a bill that addresses a major problem and a major challenge we have today in health care; that is, health care disparities. Last year, I outlined the framework for action to combat these health care disparities that plague our Nation's health care system. Since then, we have reached out broadly to a wide range of national leaders and Senate colleagues to gather their input and their ideas. As a result, I believe that legislation embodies an effective strategy to reduce and work toward elimination of these health care disparities. Over recent years, we have made tremendous advances in our knowledge of and our fight against disease. But we know millions of Americans today still experience disparities in health outcomes as a result of ethnicity, or race, or gender, or limited access to quality health care. A couple of examples: Disparity populations exhibit poor health outcomes and have higher rates of HIV/AIDS, diabetes, cancer, infant mortality, and heart disease. The list of illnesses goes on and on. African Americans and Native Americans die younger than any other racial or ethnic group. African American and Native American babies die at significantly higher rates than the rest of the population. Native Americans, Hispanic Americans, and African Americans are twice as likely to suffer from diabetes and experience serious complications from their disease. Today these gaps are simply unacceptable. Today we begin a new and aggressive effort to address these inequities. This bill--Closing the Health Care Gap Act of 2004--addresses the root causes of health care disparities by focusing on five key areas. First, expanding access to quality health care. Second, strengthening national leadership efforts and coordination. Third, helping increase the diversity of health care professionals. Fourth, promoting more aggressive health professional education intended to reduce barriers to care. Fifth, enhancing research to identify sources of racial, of ethnic, and geographic disparities and assess promising intervention strategies. Every American believes that the best quality of health care possible, regardless of race, ethnicity, gender, or where they live, is deserving. The bipartisan ``closing the health care gap'' would go a long way toward achieving this goal. I appreciate the support of so many colleagues and prominent outside organizations, including the National Medical Association, the National Hispanic Medical Association, the Urban League, and the National Conference for Community and Justice. Together, we can make real progress toward eliminating health care disparities, closing the Health Care Gap Act of 2004.

Mr. FRIST

Mr. FRIST. Mr. President, this morning, many awoke to the news that South Korean scientists have successfully cloned a mature human embryo. This is an alarming development. Decades ago C.S. Lewis saw the dangers facing human dignity. In his essay ``The Abolition of Man,'' he warned in conquering nature, nature is actually conquering mankind. To clone a human being is to move from procreation to the manufacture of human life. And this is dangerous. My own profession is medicine. A good physician, must, I fundamentally believe, also be a very good scientist. I can tell you from my own experiences as a heart and lung transplant surgeon that without the revolutionary advances in medical science and in technology, my own transplant patients, heart and lung transplant patients of a decade ago, simply would not be alive today. Indeed, we must reject an irrational fear of technological advance. But the secret of human dignity is living within limits. Those are ethical limits and they are moral limits. They are limits that do not hamper human advances but they preserve them and indeed they promote them. We strongly support ethical stem cell research but we reject the cloning of human beings. Not only does human cloning experimentation of any kind offend the conscience, it is not medically necessary. As I have said on many occasions, there is no scientific basis to claim that human cloning experimentation is necessary for the long-term success or clinical application of stem cell research. If human beings are special, if human beings are truly sacred, then we must devote ourselves to a better world but we must not do evil to bring about good.

Mr. FRIST

Mr. FRIST. I understand that S. 2095, introduced earlier today, is at the desk. I ask for its first reading.