Bill Frist

Mr. FRIST

Mr. FRIST. Mr. President, that is the case, and the understanding as put forth in the unanimous consent request is that we proceed to them en bloc. They are the other three on the claims court.

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 President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. FRIST. Mr. President, I ask unanimous consent that the cloture vote with respect to the Wolski nomination be vitiated; provided further that at 2:15 today the Senate resume the motion to proceed to S. 11; further, I ask unanimous consent that on Wednesday the time between 9:30 a.m. and 11 a.m. be equally divided between the two leaders or their designees; that at 11:30 the Senate proceed to the vote on invoking cloture on the motion to proceed to S. 11; and, regardless of the outcome of that vote the Senate then proceed to an immediate vote on the confirmation of Victor Wolski to be a judge of the U.S. Court of Federal Claims. I further ask unanimous consent that immediately after the confirmation of the Wolski nomination the Senate proceed en bloc to Executive Calendar Nos. 89, 129, and 130; and, further, that the nominations be confirmed and the motions to reconsider be laid upon the table, the President be immediately notified of the Senate's action, and the Senate then resume legislative session. Finally, I ask unanimous consent that following that action the Senate then proceed to the consideration of Calendar No. 77, S. 925, the State Department authorization bill.

Mr. FRIST

Mr. FRIST. Mr. President, this morning the Senate will be in a period of morning business until 11:30 a.m. Following morning business, the Senate will begin up to 15 minutes of debate on the nomination of David Campbell to be a U.S. District Judge for the District of Arizona. At 11:45, the Senate will vote on the Campbell nomination. Immediately following that vote, the Senate will proceed to a vote on the motion to invoke cloture on the nomination of Victor Wolski to be a judge of the U.S. Court of Federal Claims. Therefore, the first vote will occur at 11:45 and that vote will be the first of two back-to-back votes. For the remainder of the day, the Senate will resume debate on the motion to proceed to S. 11, the Patients First Act. A cloture motion on the motion to proceed to the bill was filed yesterday and that cloture vote will occur on Wednesday. I ask unanimous consent that following disposition of the Wolski nomination, the Senate resume consideration of the motion to proceed to S. 11.

Mr. FRIST. Mr. President, I would certainly entertain that. I ask if I might have a discussion with Chairman Hatch, the chairman of the Judiciary Committee, before committing to that, and I will get back shortly with the assistant Democratic leader.

Mr. FRIST. No, it is not.

Mr. FRIST

Mr. FRIST. Mr. President, I suggest the absence of a quorum.

Mr. FRIST

Mr. FRIST. Mr. President, for the information of all Senators, tomorrow the Senate will be in a period of morning business until 11:30 a.m. Following morning business, the Senate will begin up to 15 minutes of debate on the nomination of David Campbell to be a U.S. District Judge for the District of Arizona. At 11:45 a.m., the Senate will vote on the Campbell nomination. Immediately following that vote, the Senate will proceed to a vote on the motion to invoke cloture on the nomination of Victor Wolski to be a judge of the U.S. Court of Federal Claims. Therefore, the first vote in tomorrow's session will occur at 11:45 a.m. That vote will be the first of two back-to-back votes. For the remainder of the day, the Senate will resume debate on the motion to proceed to S. 11, the Patients First Act. A short while ago, I filed a cloture motion on the motion to proceed to the bill and that cloture vote will occur on Wednesday. In addition to debating the motion to proceed tomorrow, the Senate may proceed to any Executive Calendar item that can be cleared for action. Therefore, Senators should anticipate additional votes during tomorrow's session. I thank the distinguished majority whip for his leadership on managing the attempt to proceed to the underlying bill today. The debate, I thought, was superb. I outlined a number of the issues that we should aggressively be addressing on the floor of the Senate for the benefit of the American people.

Mr. FRIST

Mr. FRIST. Mr. President, I ask unanimous consent that the Senate now proceed to the consideration of Calendar No. 186, S. 11, the Patients First Act of 2003.

Mr. FRIST. Mr. President, with that objection, I now move to proceed to S. 11. I understand that Members on the other side of the aisle are prepared to debate the motion itself. The majority whip, Senator McConnell, is prepared to open our debate on this issue as well. It would be my intent later today to file a cloture motion on the motion to proceed to this medical liabilities reform bill. This vote would then occur on Wednesday of this week. I look forward to the very important debate on this truly national crisis, and I encourage Members who want to speak to come to the floor today. We will be debating this legislation today as well as tomorrow. We encourage Members to come to the floor today. I yield the floor.

Mr. FRIST. Mr. President, I rise to continue the discussion on the health care crisis that exists because of our medical liability system. It is an issue we began talking about 4 hours ago, and it is an issue that does affect every single American. I have been very pleased in listening to the debate with the wide range of issues that have been discussed. For those who have listened, I think the debate today provides a very effective beginning of a debate the American people deserve and the American people expect. Much of the discussion today has been about procedure and the fact that we are moving to proceed with a discussion of this bill on the Senate floor. Although we can argue procedure back and forth, what we are trying to do is respond to a health care crisis that is real. The crisis affects not just doctors and providers in health care today but does, in effect, have an impact on every American, whether it is through being beneficiaries of our Government program, Medicare, Medicaid, the Federal Employees Health Benefit Plan, or through the private sector, or even for those who have no insurance today. I will outline a little bit about how every American is affected and why it is a bill that is important to every State and every citizen in every State. Medical malpractice premiums, as we reviewed over the course of the day, have skyrocketed in recent years. So it is a problem we have been able to identify for a period of time. A lot of people will date the debate back to the mid-1970s when MICRA, or the health care medical liability refrom that was put forth in California, was first passed and then implemented. It is an issue that in States which have not addressed the problem that is growing and is growing rapidly. We see access to doctors being threatened, especially for women, and I will come back to that particular point. Especially in rural areas, we see this access to care being threatened, and this is why it is a crisis. Access to care is being totally taken away in certain regions of the country. The AMA has a chart to be brought out, I am sure, in the next day or so that depicts those States which are in crisis. Since we last talked about some of these issues on the Senate floor, the number of States in crisis, where access to health care is threatened, has grown and grown dramatically. Every American should participate in this debate. We hear the anecdotes. We see the trauma centers closing down. If one talks to their doctor or if my colleagues would talk to their doctors, or if the people who are listening talk to their doctors, they know it is a real problem and challenge that is increasing every day. The situation is grave now. The crisis is there. It is getting worse and thus we bring the bill to the floor of the Senate for open debate. Once we get to the bill, it will be open for amendment where we can discuss these issues before the American people. The horror stories are there. The headlines are there. Hospitals are closing labor wards, delivery units, obstetric units. We see the trauma centers that have either threatened to close or have actually closed. We hear the stories of the expectant mothers who are unable to find obstetricians. Doctors, especially orthopedic doctors, bone doctors, who often are in a high-risk specialty, are the ones who are involved most often in trauma centers. We see the specialties, neurosurgeons, as well as orthopedists and obstetricians, all high-risk specialities, treating the very sick in many cases, leaving their States. If they are in a high-risk State with skyrocketing premiums, they are often moving to a low-risk State. In the case of obstetricians, they are leaving the practice of specializing in the delivery of children and stopping the delivery of children totally. There are neurosurgeons who are no longer signing up to take trauma calls or work in trauma centers because of the risk of being sued. The headlines go on. What I really want to stress as a physician, because I talk to my colleagues on a regular basis about this issue, the problem is getting worse, and getting worse by the day. Time Magazine, June 9, the cover article--actually, I did not see Time when it came out but have gone back to look at that particular front page cover and then the articles behind it. They talk about this problem in very real terms. I do encourage people, if they are unfamiliar with the debate, to go back and read the stories, the anecdotes, about what is happening around the country. A year ago last July, when we talked about a particular amendment my distinguished colleague from Kentucky had offered and we debated the issue, there were 12 States that were in crisis according to criteria used by the American Medical Association. That number went from 12 States to 13, to 14, to 16, and 19. Now it is 19 States. Seven additional States have reached that threshold of being in crisis level. Crisis level means that premiums are skyrocketing. There are increasing numbers of frivolous lawsuits, but that translates now to worse access, greater barriers to access, to everybody. All the citizens of that crisis State are harmed in the event there is a trauma accident, in the event somebody needs to see a neurosurgeon or somebody needs to see an orthopedic surgeon or somebody is going to have a baby delivered. That is really the simple reason why we need to bring this legislation to the floor now. We should not be blocking proceeding to this very important bill. As a physician, this crisis is something I am close to because I watch what it is doing to my colleagues. These colleagues have chosen to go into this profession which is very special. I have a bias, but it is very special because they can go in and can heal, prevent disease, and people can live a better quality of life, day in, day out. That is why people go into the profession of medicine. Yet as we talk to doctors today, many will say--and this is very different than 15 or 20 years ago--that the greatest threat to their being able to continue in this healing profession is this skyrocketing escalation of malpractice premiums. They are being forced to pay for what ends up being a lot of frivolous lawsuits. These lawsuits are engendered or occur because the current system, which needs to be reformed, gives incentives to those trial lawyers--not all trial lawyers--to go out and stir up business. I think that is what is most offensive to the American people, that a component of our liability system is unnecessarily driving up the numbers of lawsuits which in turn is diminishing access to health care. Driving up the cost of health care, which we all know, makes it more difficult for people to receive the care they deserve. The fact that highly qualified and committed health care providers are being literally driven from the field they entered so they would have that opportunity to heal and to make others' lives better, is tragic. These individuals do not want to drop these vital services. They do not want to leave the specialities they spent years to develop, whether it is obstetrics, neurosurgery, or trauma surgery. They do not want to have to walk away from these fields. They do not want to have to leave underserved areas where this problem can be particularly bad. Tomorrow or once we get on the bill, I will bring letters to the Senate from physicians writing if they worked in, say, the Appalachian Mountains. In underserved areas or rural areas, they are being hit particularly hard because they are having to pay these skyrocketing premiums, going from $20,000 to $40,000 to 60,000 to $80,000. They simply cannot stay in business. They cannot afford paying an $80,000 or $100,000 premium for malpractice insurance. Without the insurance, they cannot ``go bare'' because then if they do get sued, it destroys their livelihood and any chance of practicing medicine in the future. The crisis is made real by the victims themselves. I hope the opponents of the underlying reform measure, or even those people who are saying, now is not the time to be addressing this in the Senate--I hope they look at those anecdotes, those individual stories now which, when accumulated in the aggregate, have reached crisis proportion. I hope they will agree that there is a crisis and now is the time to respond. The medical liability system is the root cause of this crisis. It is the perverse incentives we need to address and that this underlying bill, when we are allowed to go to the bill, does address. The current system, with the inefficiencies, with the perverse incentives, hurts every American. In addition, it hurts the negligently injured patients it is supposed to help. The good news is there is something to be done about the problem to make the system more fair, more just, to get rid of the waste and frivolous lawsuits. That is what the underlying bill does. Our system encourages lawsuit abuse in lots of different ways, in part, by rewarding personal injury lawyers who file huge claims in friendly venues, looking for that big payday. These lawyers often keep up to 40 percent--I think the least is probably around 30 percent or 33 percent. They keep up to 40 percent of many of the settlements or verdicts of those injured. If there is a million-dollar verdict, for example, in some States the personal injury lawyer, the trial lawyer, pockets 40 percent, or $400,000, and the injured patient gets only $600,000. At the same time, negligently injured patient many times don't receive any compensation at all. They are never addressed because the personal injury lawyers go after the big bucks, the big pockets, the large lawsuits. When one is negligently injured and should be appropriately compensated, the personal injury lawyers are not there to address their particular needs. Again, they are going after the big pockets, the big sum. We have a system that compensates the few all too often at the expense of the many. The effect of these suits is staggering. Between 1996 and 2002, the average jury award in medical liability cases jumped 83 percent. Between 1997 and 2002, over that 5-year period, the percentage of medical malpractice payments of more than $1 million more than doubled. Again, this illustrates that the problem we have in this system is getting worse by the day. The mere threat of these huge, multimillion-dollar awards forces many doctors and many insurance companies to settle cases for large amounts even if that individual physician is not guilty. The incentive is to settle, simply to avoid the exorbitant suit, even if there is no guilt involved. We will show charts in the Senate that most of the cases filed in the U.S. courts are without merit. The most recent statistics showed that two out of three, or 67 percent, of those cases filed in U.S. courts are being dismissed or being dropped--not being settled and not actually going to trial. In addition, only 7 percent of cases actually go to trial, and a staggering 85 percent of those cases are won by the defendant. So these numbers are clear evidence of the abuse of the current system, of the inefficiencies, of the number of lawsuits that are frivolous. It is that waste, those inefficiencies, those disincentives, those perverse incentives that this legislation addresses. Frivolous lawsuits are unnecessarily driving up the premiums to physicians. For the most part, for the physician to stay in business with those premiums, skyrocketing premiums, increasing 10, 15, 20, 30, 40 percent a year, if that physician is to stay in business, those costs must be passed on to those patients directly. It should be no surprise that the excessive litigation and frivolous lawsuits are forcing these malpractice premiums up. In 2002, physicians in many States did see their rates rise by 30 percent or more. In some States, and in some specialties, malpractice insurance premiums are rising by as much as 300 percent a year. In New York and Florida, obstetricians, gynecologists, and surgeons pay more than $100,000 for every $1 million in coverage. Soon the annual premium these doctors pay could reach more than $200,000. I mentioned earlier that the sky-high premiums uniquely affect women. This will be heard again and again in the Chamber. One of the three high-risk specialties is obstetrics. Many obstetricians are leaving the practice, leaving obstetrics, and are involved just in the practice of gynecology or family practice because they cannot afford the premiums. Right now, nearly 1 out of 11 obstetricians no longer deliver babies. Who can blame them? If you ask why, again and again it comes back to this threat of these frivolous lawsuits. It is a tax that affects women in many ways disproportionately. If an obstetrician today pays $100,000 for premiums--and that is not unusual--say they deliver 100 babies. That is a $1,000 tax that has nothing to do with the health care that is actually delivered or the delivery itself, but it is a $1,000 tax that, in effect, is placed right on top of the delivery of that baby. Thus, if you are a woman and you have a family, you need to realize that the doctor is having to pay that $1,000 tax on each baby delivered. This cost is ultimately passed on to the patient. This is clearly unacceptable because it reflects the waste, the perverse incentives in the system, all of which, again, can be fixed. Again, women living in rural areas are disproportionately affected and are even more threatened by the current system. In a June 9 front-page issue of Time magazine, there is one tragic story of an expectant mother in rural Arizona having to drive more than 2 hours on a desolate desert highway just to see a doctor. That is not the sort of story that should be happening in America, especially when we have physicians who want to stay in obstetrics, who want to practice in rural areas. However, they are being discouraged from doing so by the current system of medical liability. If anything, the incentives should be just the opposite. We should be encouraging physicians to deliver this care to women. We ought to encourage them to go to these underserved areas which are being disproportionately affected. It should be no surprise that the American College of Obstetrics and Gynecology is one of the strongest supporters of meaningful medical liability reform. They are uniquely positioned to understand the threat that the current system places on women. They are demanding action by Congress. I do urge my colleagues to listen to their unique concerns. The broken liability system does more than just raise the liability premiums on individual physicians. It adds tremendous costs, both direct and indirect, throughout the health care system. We have all heard of what is called defensive medicine and the increase in defensive medicine that is, indeed, practiced because of the fear, the legitimate fear, of these outrageous and skyrocketing lawsuits. To avoid lawsuits or to make sure that they are protected as a physician if there happens to be one of these lawsuits, physicians will simply order more tests, establish more of a paper trail. You think of the case of a simple headache. With defensive medicine, for a headache coming into the emergency room, a physician might just order, instead of a good physical exam and maybe some medicine, simple diagnostic tests. With defensive medicine we might go to the extreme of a CAT scan that might cost $800 or magnetic resonance imaging, an MRI of the head, which might cost $1,000. Why? Because people are at risk if they are in emergency rooms, treating somebody who comes to the door, even for something as simple as a headache. You do that, not just once or twice but hundreds of times, indeed thousands of times all across the United States of America--again, driven by the incentive of frivolous lawsuits being directed against you--and all of a sudden you can understand why these defensive medicine costs tens of billions every year. Recent surveys show that 75 percent or more of doctors acknowledge practicing defensive medicine. The exact cost is hard to calculate, but we do know it is tens of billions of dollars per year. When we realize that three out of four doctors are practicing defensive medicine, those numbers seem to be very realistic. In an authoritative study out of Stanford, two researchers there estimated that reasonable liability reform could save the country anywhere from $70 billion a year to $126 billion a year in defensive medicine expenditures; that is overall defensive medicine. If you look just at what the Federal Government could save by comprehensive medical liability reform, the Congressional Budget Office estimates about $18 billion a year could be saved over 10 years with such reform. They are looking at just the Medicare Program and the Medicaid Program and the Federal Employees Health Benefits Program. Often in the Chamber today, a lot of people have talked about this issue of medical errors and patient safety. I think a lot of good points have been brought up in the Chamber. It is absolutely critical that we do address the issue of reporting of medical errors. I will have to say, just listening to physicians and having been in the field of medicine myself, the current system where you know that anything you say, in terms of even a possible medical error or mistake could result in a lawsuit is unacceptable. If they are there, you need to shine a light on them, you need to elevate them, you need to talk among your peers and talk among others; that is the only way you are going to fix and reduce these medical errors. But when above your health care system you do have some predatory lawyers who are sitting there looking for the big bucks, recognizing they are going to take home 30 percent or 40 percent of a settlement it discourages that light that we all know is critically important to allow a discussion, to allow a self-examination so you can have a system of ongoing, continuous quality improvement in health care. In the Chamber, people have referred and will continue to refer to the report of 3 years ago by the Institute of Medicine, ``To Err Is Human.'' A lot of these issues are talked about there. That is why I am a strong supporter of the patient safety legislation that has been developed by Senators Gregg and Jeffords and many others in a bipartisan way, the Patient Safety and Quality Improvement Act. That needs to be done. That needs to be addressed. But at the same time, by improving in a comprehensive way our medical liability system, we will actually improve the system itself. That will allow light to shine openly with, I believe, a lot more discussion and self-reporting by the provider system in order to have that quality improvement. It is an inefficient system that we have today. It does waste tens of billions of dollars. It does drive underground, I believe, our ability to improve patient safety. Thus, comprehensive reform of our medical liability system is, I believe, demanded. This bill, the Patients First Act, is a commonsense measure. It does restore a balance to the system itself. It protects the right of the negligently injured patient to sue for just compensation while at the same time curtailing the abuses that we know currently exist in our system--today. It has a number of critical components. I will look forward, once we get on the bill itself, to talking about a number of those components. I am delighted with the debate thus far. I look forward to continued participation on this important bill. We have seen at the State level that liability reform can work. This particular bill we are trying to bring to the floor is a bill based on the MICRA system, Medical Injury and Compensation Reform Act that was passed in California in the mid- 1970s. We know that is a big State. It has a high cost of living. Yet the overall premiums paid by physicians there have been much more controlled than in other parts of the country. MICRA works. We have that track record. We have that to look back to. That is why I feel so good about the legislation we will hopefully bring to the floor. There will be lots of blame passed around in terms of why the system today is not working. Some people say it is the doctors. Some people say it is hospitals. Others will say it is the insurance companies. Some people say the stock market and the bond market. We will have this crisis blamed on lots of different things as we go forward. I would argue that at the heart of the crisis is the current liability system which promotes these excessive lawsuits, and that it can be fixed. It can be fixed. That is what I look forward to doing with my colleagues on the floor of the Senate. Passage of this measure will help on both the access issues in health care as well as the expense issues for all Americans. If we do it, and we do it right, it will improve health care for all Americans.

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

Mr. FRIST

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

Mr. FRIST

Mr. FRIST. Mr. President, if there is no further business to come before the Senate, I ask unanimous consent that the Senate stand in adjournment under the previous order.

Mr. FRIST

Mr. FRIST. Mr. President, I ask unanimous consent that the Senate proceed to a period for morning business.

Mr. FRIST

Mr. FRIST. I now send a resolution to the desk to discharge from the Judiciary Committee the nomination of David W. McKeague, of Michigan, to be a United States Circuit Judge for the Sixth Circuit. I ask for its immediate consideration.

Mr. FRIST

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

Mr. FRIST. Mr. President, before we left for the Fourth of July recess, we passed historic legislation to improve Medicare, to strengthen Medicare, and to offer for the first time a prescription drug benefit through the Medicare Program for our seniors and individuals with disabilities. We worked hard in that endeavor to produce a bipartisan consensus, working together on both sides of the aisle, with this common mission, this common goal, and we succeeded. We were successful in passing a bipartisan bill that for the first time since 1965, in the history of Medicare, offers access to this new prescription drug benefit, and at the same time reforms, modernizes, and strengthens Medicare in a very significant way. Both individuals with disabilities and seniors collectively, 40 million people, will have health care coverage that in the future will be responsive to their needs in order to achieve that goal of health care security after the age of 65 or, if you are an individual with a disability, in the near future. It is responsive to them directly but also in a way that will allow the Medicare Program to take advantage of the great innovations in technology, in new prescription drugs that can make people's lives better, which will improve the quality of life. I mentioned the fact that this was bipartisan legislation. I think it is important that we showed a spirit of cooperation in taking on an issue many people in the United States thought would be too partisan and too political. We addressed it in a bipartisan fashion with the leadership of Chairman Grassley and Senator Baucus in a way that was reasoned, showed common sense, and that accomplished that goal of significant modernization while at the same time adding a new benefit. We identified the issue. We tackled it head on, and we delivered a bill that reflected the priorities of both sides of the aisle. That demonstrated to me, and I think to the American people, that even in a very evenly, closely divided Senate, if we share a common goal we can indeed move America forward on issues that are important to the American people. Coming back from recess, we will very shortly begin the conference where once again both sides of the aisle will work together, the Senate and the House, to fashion a final product that will be a resolution of the differences between that House and Senate bill. I am confident in that process we will have the same resolve and determination in meeting that goal, that we will be able to bridge those differences, and develop a strong bill that can be supported in a bipartisan way and signed by the President of the United States. Both Chambers are committed to accomplishing this, to doing it right, and to getting it done. Presidential Trip to Africa I do want to comment on the President's trip to Africa. I commend President Bush for his bold leadership and his personal, as well as governmental--meaning the Senate, the House, and the executive branch-- commitment to the pressing needs of Africa. President Bush will be leaving this afternoon for Africa to see firsthand the opportunities, and indeed the challenges, that exist on that continent. Approximately once a year I have had the opportunity, since being in the Senate, to go to that continent, to a range of countries, several of which he will be going to. The countries I usually go to are the Sudan, Kenya, Tanzania, and Uganda. He will visit a range of other countries. I think it is important for members of the executive branch as well as Members of this body and the House of Representatives to go firsthand and see the ravages that occur as a product of this little virus, HIV/AIDS, to see the impact of malaria, to see the impact of resistant tuberculosis and, at the same time, to look at the issues that surround the security of those nations as well as international security. The President's trip will highlight a positive, substantive agenda that the administration has put on the table. Part of that agenda and vision is this AIDS initiative which we addressed in the Senate a little over a month ago, a 5-year, $15 billion commitment that this body passed and was ultimately signed by the President. This global HIV/AIDS initiative is the largest international public health initiative on a single disease, a single entity, in the history of this country. I look forward to taking a delegation of U.S. Senators to Africa sometime in August--next month--to advance our collective effort in this regard. As I mentioned earlier in opening the Senate, we have a very challenging month ahead with medical liability, with energy, with the appropriations process, which will be well underway in a few days, with the judicial nominees, with State Department authorization. There is a lot to accomplish. I am confident we can meet the goals I set out this afternoon. I look forward to working with my colleagues to make this one of the most productive sessions thus far. I suggest the absence of a quorum.

Mr. FRIST

Mr. FRIST. Mr. President, today the Senate returns from the Fourth of July recess, and I do hope everybody had a safe and restful period. As I announced before the recess, there will be no rollcall votes during today's session. The next scheduled rollcall votes will begin tomorrow at 11:45 a.m. The first vote will be on the confirmation of David Campbell to be a U.S. District Judge for Arizona. The second vote will be invoking cloture on the nomination of Victor Wolski to be a judge for the U.S. Court of Federal Claims. I would like to take a minute or two to talk about this month's schedule. We are now entering a very busy legislative session for the Senate. There is much work to be done, and we have only 4 weeks to do that. One major focus for the Senate this month will be the appropriations process. Senator Stevens will be working hard to prepare the spending bills for floor action, and we will be scheduling these for floor action throughout the month. In addition, this month we will complete consideration and passage of the Energy bill. Both consideration and passage will be before the August recess. I am committed, along with Chairman Domenici, to pass an energy bill that will enhance our country's national energy security. There are many remaining amendments, as we all know, to debate and dispose of, but I do want to be clear: We must pass a bill as soon as possible to establish a clear national energy policy which will reduce our dependence on foreign oil. Third, we have a lot of remaining work to do on executive nominations, especially judicial nominations. I urge my colleagues again to allow the Senate to work its will on these nominations and give them an up-or-down vote. I will continue to schedule consideration of nominations as they become available with the hope that we can move forward and give the individuals their due process. Advice and consent means allowing Senators an up-or-down vote on the President's nominations. Fourth, today we will begin to address the crisis of medical liability. Prior to the recess we attempted to reach consent to begin consideration of S. 11, the Patients First Act of 2003. We are in desperate need of medical liability reform in this country, and now is the time for us to act. Unfortunately, there was an objection prior to the recess to proceeding to this bill. Today if we are unable to reach that consent, it would be my intent to move to proceed to that bill and file cloture on the motion if that is necessary. If that is the case, the vote would occur on Wednesday of this week. Senator McConnell will be here later this afternoon to discuss the medical malpractice crisis. Also this week we will consider other authorization measures, including the State Department authorization. Chairman Lugar has indicated the bill will be ready for the floor this week. We hope we will be able to complete action on this important bill in a day or two. These are just a few of the issues we will be addressing during this legislative session. A lot of that will be done this week. To get our work done, it is going to take the cooperation of all Senators. We will schedule these items for consideration from Monday through Friday. Having said that, I alert Members they should prepare for full days of voting that includes Mondays and especially Fridays. That includes this Friday. Senators should arrange their schedules accordingly and plan to be here in the Senate each day of the week unless I specifically say we are not having votes. I do want to thank my colleagues for their attention and look forward to work together with them in a collaborative way in what will be a very busy 4 weeks. I yield the floor.

Mr. FRIST

Mr. FRIST. Mr. President, I ask unanimous consent that when the Senate completes its business today, it stand in adjournment until 9:30 a.m., Tuesday, July 8. I further ask that following the prayer and pledge, the morning hour be deemed expired, the Journal of proceedings be approved to date, the time for the two leaders be reserved for their use later in the day, and the Senate then begin a period of morning business until 11:30 a.m., with the time equally divided between the two leaders or their designees; provided that at 11:30 a.m., the Senate proceed to executive session to consider Executive Calendar No. 227, the nomination of David Campbell to be a U.S. District Judge for the District of Arizona, and that the time until 11:45 a.m. be equally divided between the chairman and ranking member of the Judiciary Committee or their designees. I further ask unanimous consent that the Senate recess from 12:30 p.m. to 2:15 p.m. for the weekly party lunches.

Mr. FRIST

Mr. FRIST. Mr. President, I understand that the House companion bill to S. 1 is at the desk, and before the Chair appoints conferees pursuant to the order of June 26, I ask unanimous consent that the title amendment, which is at the desk, be agreed to.

Mr. FRIST

Mr. FRIST. Pursuant to the order of June 27, I ask that the Senate proceed to executive session for the consideration of Calendar No. 132.

Mr. FRIST

Mr. FRIST. Mr. President, this cloture vote will occur Wednesday morning. I will announce, during tomorrow's session, the precise timing of this vote for Wednesday.

Mr. FRIST. Mr. President, I ask unanimous consent that the live quorum, as provided for under rule XXII, be waived.

Mr. FRIST. Mr. President, I now send a cloture motion to the desk on the pending motion.