Bill Frist

Mr. FRIST

Mr. FRIST. Madam President. Nearly 1,900 men and women have served in this body since its inception in 1789. Yet only a couple dozen stand out in history as leaders who not only defined the times in which they lived, but changed the course of the future. I would include the man we honor today--Senator Jesse Helms--in those select ranks. He will be missed as a friend to us all and a leader for all America. Although one might find it hard to believe, Senator Helms began his career in the media. After World War II, Jesse worked as city editor of the Raleigh Times. Later he became director of news and programs for the Tobacco Radio Network and radio station WRAL in Raleigh. The media also provided Senator Helms' transition into politics and public affairs. In 1952, he directed radio and television for the presidential campaign of Senator Richard Russell of Georgia. One year later, Jesse became executive director of the North Carolina Bankers Association and editor of the Tarheel Banker, which he grew into the largest state banking publication in America. As a journalist, Senator Helms earned the respect of his readers and his peers. From 1960 to 1972, Jesse delivered daily editorials on WRAL- TV, wrote columns that appeared regularly in more than 200 newspapers nationwide, and broadcast on more than 70 radio stations in North Carolina. Jesse received the Freedoms Foundation Award for the best television editorial in America. He won the same award for the best newspaper article. Jesse Helms' arrival in this chamber nearly 30 years ago made history. He was the first Republican elected to the Senate from North Carolina. His star immediately began to rise. At the 1976 Republican National Convention, he was the only Senator to endorse Ronald Reagan for President. And though he asked for his name to be removed from the ballot, he won the support of 99 delegates for the nomination of Vice President of the United States. While in the Senate, Jesse Helms has become one of those unique leaders who combine fierce conservatism with fierce populism. His love for the principles upon which this country was founded is matched only by his love for the people he represents. He has always stood up for the people of North Carolina--for the values they hold dear, for the beauty of their land, and for the work that is their lifeblood. Jesse has also stood up for those of the world who don't enjoy the freedoms and rights that Americans are guaranteed. He stood side-by- side with President Reagan in the battle to win the Cold War. He believed in peace through strength and still does. He also believes in the value and dignity of every human life. I know this first-hand. Jesse and I have worked hard as members of the Foreign Relations Committee to secure hundreds of millions of dollars to save young Africans from the plague of HIV/AIDS. Always one to practice what he preaches, Jesse Helms has served as a deacon and Sunday School teacher and a director of Camp Willow--a Christian youth camp he helped found. He has generously given his time to combat cerebral palsy. And he has spent countless hours with the nearly 100,000 children and young adults who have stopped by his office to shake his hand. Jesse has inspired them all to be better citizens; many have even gone on to serve in public office. I, and all of us in this chamber, will miss having Jesse Helms in the Senate. And America will miss an impassioned leader. But our loss is the gain of his family and the great state of North Carolina to which he will return. I think we all know that Jesse Helms won't just fade away. He'll continue spending time doing what he loves, and we'll continue loving him for it. God bless you, Jesse.

Mr. FRIST

Mr. FRIST. Mr. President, born nearly a century ago, when Mark Twain was alive and Teddy Roosevelt was still President, Strom Thurmond has led a life of public service unmatched in the modern history of America. He has been a friend to all of the more than 400 Senators with whom he has served. And he will forever be a symbol of what one person can accomplish when they live life to the fullest. Strom Thurmond has served in the Senate for all but four of my 50 years of age. Though that is a remarkable accomplishment itself, we should not forget what Strom accomplished before coming to the Senate. He was a teacher, an athletic coach, and a Superintendent of Education. He studied law under his father, Judge J. William Thurmond and became a City Attorney, County Attorney, State Senator, and, eventually, a Circuit Court Judge. Though exempt from serving in the military, Strom, who had already been an army reservist and a commissioned 2nd Lieutenant by the age of 21, volunteered for active duty on the day we entered WWII. As a member of the 82nd Airborne, he parachuted behind enemy lines on D-Day and helped secure the foothold for the Allies to liberate the European continent. For his distinguished service, Strom was awarded five Battle Stars and 18 other decorations, including the Legion of Merit with Oak Leaf Cluster, the Purple Heart, the Bronze Star for Valor, the Belgian Order of the Crown and the French Cross of War. After the war, Strom returned home to South Carolina. He was elected Governor in 1946 and then ran for President of the United States as the States Rights Democratic candidate. Although Harry Truman prevailed, Strom won four states and 39 electoral votes. That tally still stands as the third largest independent electoral vote in U.S. history. Despite not winning the presidency, Strom was determined to serve in Washington. He ran for the Senate in 1954 and became the only candidate elected to Congress by a write-in vote in American history. Strom has been re-elected eight times since. Clearly the people of South Carolina value principle, character and courage in their leaders. Though it has been more difficult in recent years for Strom to make it home to South Carolina, that has not stopped South Carolina from coming to him. And it shouldn't. For decades Strom attended every county fair, handled every constituent request, and sent a congratulatory note to every high school graduate, many of whom came to intern in his office. It has been said that almost 70 percent of South Carolinians have met Strom Thurmond face-to-face. Over the course of his long and distinguished career, Strom Thurmond has been a witness to history. As a young man, he knew people who had seen Andrew Jackson, and he campaigned for the votes of men who fought in the Civil War. He and Herbert Hoover won their first elective office in the same year, 1928. But Strom has more than seen history; he has written it. Not only is he the oldest and long-serving Senator, he has served with about one- fifth of the nearly 2,000 people who have been members of the Senate since 1789. And he is nearly one half the age of the United States Constitution itself. Like the great experiment that is American democracy, Strom Thurmond has certainly faced his trials, both politically and personally. Yet, through it all, he has always held tight to his principles, always upheld his beliefs, and always defended American values at home and abroad. Today we say thanks to this giant of a man not only for the history he has witnessed and written, but for the service his life will inspire for generations to come. God bless our friend, our colleague, and the Senate's Icon of Time, the senior Senator from South Carolina, Strom Thurmond.

Mr. FRIST

Mr. FRIST. Mr. President, fall has come and across the country, students are returning to school facing a public health risk from what many see as a completely benign and essential back-to-school supply, the school backpack. More than 40 million American students carry backpacks to and form school each day. Health experts say that many of our children are hauling around too much weight, and that extra weight can adversely affect their healthy growth and development. Children carrying backpacks that are overloaded or improperly worn are putting themselves at risk for musculoskeletal pain, including back, neck, and shoulder pain, adverse affects on posture and the developing spine and compromised breathing and fatigue. The good news for parents and kids is that many of these problems can be avoided by taking some very simple steps to help lighten the load. And the first step is education, raising awareness among parents, educators and kids about these potential risks and offering solutions to address them. To that end, the American Occupational Therapy Association, AOTA, is sponsoring the first of its kind National School Backpack Awareness Day this week, on Wednesday, September 25. On that day, health professionals will hold events in schools across the country to weigh- in backpack-wearing kids and demonstrate the risks of injury that can result from carrying packs that are worn improperly, or are too heavy. Experts say that students should carry backpacks that weigh no more than 15 percent of their total body weight. Occupational Therapists, thousands of whom work every day in America's schools, will offer simple steps in how to properly pack, select and wear school backpacks. Nashville, TN, Occupational Therapists will be at the Nashville State Technical Community College helping students learn more about the issue. In Knoxville, there will be a backpack weigh-in and Awareness Day event at Pond Gap Elementary School. I am proud to see these communities taking a leadership role on this important public health issue and I encourage other communities to take similar action on this day to help prevent health care problems that can arise. Surely, we can all appreciate the bottom line lesson in this important public health education campaign, an ounce of prevention is worth of a pound of cure.

Mr. FRIST

Mr. FRIST. Madam President, I am pleased to join Senators Bond and Dodd in re-introducing the ``Birth Defects and Developmental Disabilities Prevention Act of 2002''. This bill reauthorizes the National Center on Birth Defects and Developmental Disabilities (NCBDD) at the Centers for Disease Control and Prevention to promote optimal fetal, infant, and child development and prevent birth defects and childhood developmental disabilities. Birth defects are the leading cause of infant mortality in the United States, accounting for more than 20% of all infant deaths. Of the 150,000 babies born with a birth defect in the United States each year, 8000 will die during their first year of life. In addition, birth defects are the fifth-leading cause of years of potential life lost and contribute substantially to childhood morbidity and long-term disability. Congress passed the ``Birth Defects Prevention Act in 1998''--a bill to assist States in developing, implementing, or expanding community- based birth defects tracking systems, programs to prevent birth defects, and activities to improve access to health services for children with birth defects. The authorization for this important legislation for this important legislation expires at the end of this year, and the legislation we are introducing today will strengthen those important programs. In order to educate health professionals and the general public, this legislation requires NCBDD to provide information on the incidence and prevalence of individuals living with birth defects and disabilities, any health disparities, experienced by such individuals, and recommendations for improving the health and wellness and quality of life of such individuals. The Clearinghouse will also contain a summary of recommendations from all birth defects research conferences sponsored by the agency including conferences related to spina bifida. This legislation also clarifies advisory committees, already in existence, that have expertise in birth defects, developmental disabilities, and disabilities and health will be transferred to the National Center for Birth Defects. This piece of legislation also supports a National Spina Bifida Program to prevent and reduce suffering from the nation's most common permanently disabiling birth defect. I ask that this piece of important legislation be reauthorized. I want to thank my colleagues, Senators Bond, Dodd, and others, for the introduction of this initial piece of legislation in 1998 and for their continued initiatives on birth defects and developmental disabilities.

Mr. FRIST

Mr. FRIST. Madam President, I am pleased to join Senators Bond and Dodd in re-introducing the ``Birth Defects and Developmental Disabilities Prevention Act of 2002''. This bill reauthorizes the National Center on Birth Defects and Developmental Disabilities (NCBDD) at the Centers for Disease Control and Prevention to promote optimal fetal, infant, and child development and prevent birth defects and childhood developmental disabilities. Birth defects are the leading cause of infant mortality in the United States, accounting for more than 20% of all infant deaths. Of the 150,000 babies born with a birth defect in the United States each year, 8000 will die during their first year of life. In addition, birth defects are the fifth-leading cause of years of potential life lost and contribute substantially to childhood morbidity and long-term disability. Congress passed the ``Birth Defects Prevention Act in 1998''--a bill to assist States in developing, implementing, or expanding community- based birth defects tracking systems, programs to prevent birth defects, and activities to improve access to health services for children with birth defects. The authorization for this important legislation for this important legislation expires at the end of this year, and the legislation we are introducing today will strengthen those important programs. In order to educate health professionals and the general public, this legislation requires NCBDD to provide information on the incidence and prevalence of individuals living with birth defects and disabilities, any health disparities, experienced by such individuals, and recommendations for improving the health and wellness and quality of life of such individuals. The Clearinghouse will also contain a summary of recommendations from all birth defects research conferences sponsored by the agency including conferences related to spina bifida. This legislation also clarifies advisory committees, already in existence, that have expertise in birth defects, developmental disabilities, and disabilities and health will be transferred to the National Center for Birth Defects. This piece of legislation also supports a National Spina Bifida Program to prevent and reduce suffering from the nation's most common permanently disabiling birth defect. I ask that this piece of important legislation be reauthorized. I want to thank my colleagues, Senators Bond, Dodd, and others, for the introduction of this initial piece of legislation in 1998 and for their continued initiatives on birth defects and developmental disabilities.

Mr. FRIST

Mr. FRIST. Mr. President, I am pleased to join Senators Kennedy, Hutchison, and others in introducing the ``Quality of Care for Individuals with Cancer Act''. This bill represents our next step in the battle against cancer. It is critical to increasing access to timely, quality health care. Cancer is the second leading cause of death among Americans, claiming one life each minute. Most of us know someone who has cancer, or who has died from cancer. One out of every 4 Americans will die from this terrible disease. We have done a tremendous job investing in cancer research in this country. We must now make sure the knowledge gained from those investments is being applied, and that research advancements are translated into improved patient care. If you have cancer, the quality of care you receive should not be affected by where you live, where you get your care, or whether you have health insurance coverage. You should have access to quality care whether you have just been diagnosed with cancer, are a cancer survivor, or are dying from this disease. The care given should take the patient's values and concerns into account and should be provided in a culturally competent manner. Based on a recent Institute of Medicine's report, ``Ensuring Quality Cancer Care'', this bill would coordinate the development and collection of information on quality cancer care using quality measures that examine care from diagnosis through the end-of-life. Clearly, a better system is needed to rapidly identify the results of ongoing research with quality implications and ensure that this is transferred into daily medical practice. Individuals with cancer receive care from a number of specialists during the course of their cancer, and the responsibility for navigating through the system often rests on the individual. Comprehensible and ongoing communication among providers, patients and caregivers is essential to coordinated care. There are two demonstration projects authorized by this legislation to help improve the coordination of care. One demonstration project provides individual case managers to better coordinate care within the health care system or to help get patients into the system. The second attempts to improve coordination between providers and hospitals so that individuals with cancer receive seamless care throughout their course of treatment. While receiving care, some individuals with cancer do not receive care known to be effective for their condition, such as the delivery of palliative care. Much of the suffering from symptoms associated with cancer and its treatment could be alleviated if currently available symptom control measures and other aspects of palliative care were more widely used. This bill authorizes demonstration projects which will provide palliative care at any stage of cancer care and train health care providers in symptom management. The legislation also seeks to help provide better pain and other symptom relief so that individuals with cancer do not suffer the consequences of their disease or treatment. For the nine million Americans living with cancer, this bill provide hope in improving the quality of life for individuals with cancer by translating what is already known to be effective care to all individuals with cancer. For those areas in which we need to investigate, demonstration projects will further our knowledge. I am pleased to introduce this important legislation, and I look forward to its ultimate enactment into law. I want to thank my colleagues, Senators Kennedy, Hutchison, and others, for their work on this bill. I ask that the summary, section-by-section, and list of supporting organizations be printed in the Record.

Mr. FRIST

Mr. FRIST. Madam President, though we would never wish to relive the horror of September 11, 2001, we must dedicate ourselves to appropriately remembering it. That is the task we begin with this first anniversary of that darkest of days, to properly and lastingly honor the sacrifice of the more than 3,000 women, men, and children who perished at the Pentagon, at the World Trade Center, at the crash site of flight 93 in Shanksville, PA. September 11 will be a day of mourning for many years to come. And it should be, for the grief of those who lost loved ones on that day will pass only with their passing. Nothing can wipe away the memory of a friend or a family member taken before their time. The victims of September 11--those who died and the friends and family who survived them--deserve our enduring respect. Though the attacks were carried out in New York, Washington, and Pennsylvania, no American was left untouched by this tragedy. That includes the men and women of my home State of Tennessee. I think of John and Pat Lenoir of Knoxville who lost their son, Rob, when the World Trade Center collapsed. Francis Hall of Knoxville lost her sister-in-law. And Otis and Nancy Tolbert of Brentwood, TN, lost their son when flight 77 crashed into the Pentagon. We keep those Tennesseans in our thoughts and prayers today. It is entirely appropriate that the President and First Lady began their September 11 by attending a church service. I hope Americans all across this country follow their example by spending some part of their day in a house of worship or on bended knee in prayer. Regardless of the God we may worship, faith in a higher power can help heal and explain and console and reassure us today, just as it did a year ago. Though September 11 attacks did bring one of the darkest days in our history, a few rays of light did shine through. Americans rallied to help those in need by waiting hours to give blood, by donating supplies to the rescue effort, by digging deep in their own pockets for the September 11 charities. I am especially proud of the Tennessee Baptist Convention that sent 30 volunteers to prepare food for the rescue workers at the World Trade Center. I am still moved to this day, as we were at the Pentagon a few hours ago, by the presence of members of the Tennessee Task Force One who helped search for survivors and recover the fallen at the Pentagon. America will always remember the men and women who risked their lives to save the lives of others on September 11: Those on the front line, the medical personnel, the firemen, the police officers, all who rushed into harm's way, who forever touched our hearts with their heroism. Their example exists, survives, as an inspiration to us all. It will remain so for generations to come. Britt Brewster, a 12-year-old Tennessee girl, who came up yesterday from Tennessee to participate in the remembrance services said earlier this week: The one good thing [about September 11] was that America started coming together as one. I remember visiting Ground Zero with about 40 of my colleagues from this body a couple days after the attacks. Smoke was still rising from the debris. Almost everything was covered with the fine ash. The only color, other than the workmen's bright yellow hats, was the American flags that hung so proudly posted on the buildings around that World Trade Center site. We should fly our flags on this anniversary and show our common love for country and our fellow countrymen. There has been much debate about what we should teach our children on this first anniversary of the September 11 attacks. I believe they need to know the truth. I had the opportunity to take my wife and my three teenage boys to Ground Zero about 2 months after the attacks. I wanted them to see firsthand the destruction with their very own eyes and remember, long after I am gone and my generation is gone, what evil once did--and, I should add, can do again--to our country. I will take them back to New York. We were just there 5 days ago and saw the rebirth, the vitality of that remarkable city. I also want my sons to see what good can be done, and can always be done, in our country. The Gettysburg Address is considered one of the most powerful pieces of funeral oratory ever delivered on American soil. As Lincoln himself admitted, even he could not dedicate the battlefield beyond what those who fell there had already done. Instead, he urged his audience at the time to dedicate themselves, ``that from these honored dead we take increased devotion to that cause for which they gave the last full measure of devotion.'' The terrorists attacked on September 11 and continue to make deadly threats because they hate our country and everything we represent. The 3,000 women, men, and children who died on that tragic day did so for the same cause as those who fell on the battle green of Lexington, and the forests of Argonne, and on the beaches of Normandy--justice, equality, liberty, democracy. I urge every American to offer their respects to families who lost loved ones, to put those who perished in their prayers, and to show their patriotism by unfurling the American flag. But above all, I hope we will rededicate ourselves to those values, to the values that have been the core of the greatness of our country for more than two and a quarter centuries. Those values may be threatened sooner than we may think. If they are, we will find strength and hope and resolve in remembering, properly and lastingly, September 11, 2001.

Mr. FRIST

Mr. FRIST. Madam President, the only level one trauma center in Las Vegas shuts its doors. Twelve orthopedic surgeons at facilities near Philadelphia resign their practice. Two-thirds of doctors in a small Mississippi city consider leaving for Louisiana. What is forcing our medical community to take such drastic measures? The ``litigation lottery,'' trial lawyers filing too many lawsuits with the hope of winning excessive awards. Medical malpractice litigation, when an injured patient sues a doctor over a medical error, has exploded in the United States. Between 1995 and 2000, the average amount a jury awards a patient rose more than 70 percent to $3.5 million per claim. And more than half of awards now exceed $1 million. Trial lawyers, who are fueling this surge by hand- picking patients whom they believe will win large awards, typically take 30 to 40 percent of the proceeds. Doctors purchase insurance to protect themselves from malpractice lawsuits, but excessive awards have pushed the cost of insurance to unaffordable levels. In 2001, insurance premiums rose 30 percent or more in some States. And for doctors who perform high-risk procedures or practice where trial lawyers have won excessive awards, premiums have risen by as much as 300 percent per year. Many doctors can no longer afford to do the jobs they love. But even more disturbing to doctors, because we swear a sacred and ancient oath to do no harm, is the impact of excessive awards on patient care. High insurance premiums are forcing doctors to move their practices to other States, adjust how they practice medicine, or quit practicing medicine altogether. Trial lawyers may be winning the litigation lottery, but patients are suffering a health care crisis. First, excessive malpractice awards hurt access to health care. When a trauma center closes or specialists resign from a hospital or rural doctors can't deliver babies, patients must travel longer distances to get the care they need. They must also select from a smaller pool of physicians. When minutes, and a doctor's experience, can mean the difference between life and death, access to health care matters. Second, excessive malpractice awards increase the cost of health care. Many doctors are forced to practice defensive medicine. They must order more tests, write more prescriptions, and refer more patients to specialists to protect themselves against lawsuits. A recent Federal report found evidence that reasonable limits on malpractice awards would reduce health care costs by as much as 5 to 9 percent per year. Third, excessive malpractice awards are the single largest barrier to improving patient safety in our country. Doctors and hospitals want desperately to improve patient safety by sharing, analyzing, and learning from medical errors. I have proposed a bill that would let them do that without the fear of being sued for trying to improve patient care. But even the most limited restrictions on lawsuits are unacceptable to some of my Democrat colleagues. They believe trial lawyers should have open access to any medical error reporting system, which would render such a system useless because few doctors or hospitals would participate. We can turn back this growing health care crisis by reforming medical malpractice litigation. Some States have already taken the responsible step of capping awards for noneconomic damages, which are highly subjective, intangible and the major source of mischief for trial lawyers. Rightfully, these States have also preserved awards for economic damages, such as lost wages and medical costs. But most States have done nothing or not enough to fix the problem. The American Medical Association lists 12 States that are now in a health care crisis because of excessive malpractice awards. And 30 more States are nearing crisis, including Tennessee. This is a national problem that will worsen without a national solution. Just prior to the August recess, the Senate debated medical malpractice litigation reform that would have capped trial lawyers' fees. Though I support bolder action that includes limiting awards for noneconomic damages, this bill would have been a good first step. It would have allowed injured patients to keep a greater share of their rightful compensation while reducing the incentive for trial lawyers to pursue excessive awards. Unfortunately, all of my Democrat colleagues voted against this patient-friendly bill, keeping the litigation lottery alive and well. Injured patients have the right to sue for medical malpractice, but trial lawyers do not have the right to force innocent doctors from their livelihoods and throw our health care system into crisis. With millions of uninsured families, increasing health care costs, too many deaths from medical errors, and no prescription drug benefit for seniors, the Senate must show its commitment to turning back the growing health care crisis in our country. Limiting excessive malpractice awards is one solution that concerned public servants, providers, and, most importantly, patients can and should support.

Mr. FRIST

Mr. FRIST. Mr. President, it is a wellspring of pride for the people of Tennessee that Hubert Shuptrine is a native son. Born in Chattanooga in 1936 and graduated from the University of Chattanooga in 1959 with a degree in fine arts painting, Shuptrine is one of the most celebrated American painters and watercolorists of the last several decades. From the Low Country of the Carolinas to the Hill Country of Texas to the Great Smoky Mountains of Tennessee, Hubert Shuptrine's paintings have captured the rustic beauty of the American South. His love for the people of these places--and the places themselves--shines so strongly that one cannot help but share his affection. What lends such power to Shuptrine's paintings is that they are not conjured from his mind, but grounded in truth. He traveled more than 15,000 miles to meet and talk with the people of the South when illustrating his first and highly successful book, Jericho: The South Beheld. With a stroke of light, a sliver of shadow or a strategically placed prop, Shuptrine sketches the life stories of his subjects. They are pure, simple and unrushed people--a former field hand resting on her front porch, a widower centenarian living off his land, a basket weaver practicing her craft. Shuptrine's wife, Phyllis, once said, ``A good portrait is like a biography.'' Clearly Hubert Shuptrine has adhered to this code throughout his career. He is an exceptional biographer not only of people of the South, but the South itself. Though the South has changed irreversibly since Jericho was published nearly 30 years ago, the truth and beauty of the people and places of that time will never be lost. For it has been captured and will be honored in perpetuity by a native son of Tennessee, Hubert Shuptrine.

Mr. FRIST

Mr. FRIST. Mr. President. I rise today to introduce ``The Math and Science Education Excellence Act.'' I have worked with my colleague from Kansas, Senator Roberts, to make sure we do everything possible to give math and science education the attention, funding and assistance it deserves. Today, I introduce a bill to authorize programs at the National Science Foundation that will help achieve that goal. Under the authority of the No Child Left Behind Act, NCLBA, the Department of Education is authorized to implement a Mathematics and Science Partnership Program, a program I am very interested in making sure is a success. That program is designed to improve the academic achievement of students in the areas of math and science. It will encourage States, universities, school districts and schools to work together to: 1. improve the status of math and science teaching and 2. develop more rigorous math and science curricula. The NCLBA authorized $450 million for Fiscal Year 2002 for this program, but only $12.5 million was appropriated for 2002. That level of funding is a huge disappointment to me, and I believe it is a mistake. However, last year, NSG initiated its own Program at a level of $160 million. Because the bulk of the funding for the Math and Science program is at NSF, I believe it is appropriate, even necessary, to authorize the MSP Program at NSF as well. This is not the preferred choice. I would prefer that we fund the program at the Department of Education. In the meantime, this bill will give us an opportunity to re-assert how important this program is. As we all know, the No Child Left Behind Act requires that schools be determined as failing based in part on their math scores. If they are failing, there will be consequences, such as public school choice, supplemental services and eventual reorganization. That means that math teaching and math curriculum are more important than ever. And, by 2007, science assessments will be added to the mix. So I want to be sure that we are getting these funds to our neediest schools. I worry that without more descriptive language, NSF will not focus on awarding grants to those that need it the most. I also worry that the Math and Science Partnership program is not getting the funding it needs. Reading, math's counterpart on the yearly tests, receives over $1 billion in funding. Any many other programs authorized in the No Child Left Behind Act are receiving appropriations that meet, or even exceed the authorization levels. Not the Math and Science program. Despite the importance of math and the fact that schools will be determined as failing based on their math scores, the Math and Science Partnership Program is received a total of only $172.5 million in 2002, with only $12.5 million of those funds targeted to those based on need. $160 million from NSF and $12.5 million from the Department of Education. For 2003, the Senate Appropriations Committee recommends that only $120 million be provided for the MSP program. Why? Apparently, some $30 million in funds is left over from last year's appropriation because NSF did not believe the applications met the rigors the grant program requires. I am very concerned that we are leaving States, schools districts, schools and students confused and bewildered due to the complicated bureaucratic process that has been created. I believe we should make sure that every dollar of the math and science partnership program money is appropriately administered to ensure results. I also believe that we should work toward appropriately funding this initiative. My amendment will accomplish those two goals. My bill would insert the exact Math and Science Partnership language from the No Child Left Behind Act, language which we members of the HELP Committee have already agreed to, with only minor changes. That language requires targeting of the $450 million in funds to those who need it the most, and it also requires accountability. I have also added a section requiring the NSF to provide technical assistance to those eligible applicants that request it. If the quality of the applications is not high, the NSF should help applicants develop high-quality programs. Otherwise, applicants must guess how to improve, forcing math and science education to suffer in the meantime. The bill also authorizes $12 million for NSF to conduct and evaluate research related to the science of learning and teaching math and science. It directs NSF to develop ways to apply, duplicate and scale up the results of such research for use in low-performing elementary and secondary classrooms to improve the teaching and student achievement levels of mathematics and science. This investment will make sure that we find out the best ways to teach math and science. With that knowledge, we will have the building blocks we need to effectively argue for, and demand, more funding for the Math and Science Partnership Program. This bill attempts to make the best out of a not ideal predicament for math and science education. I believe it is the right thing to do, and I respectfully request my fellow Senators support. I ask unanimous consent that the text of the bill be printed in the Record.

Mr. FRIST

Mr. FRIST. Mr. President. I rise today to introduce ``The Math and Science Education Excellence Act.'' I have worked with my colleague from Kansas, Senator Roberts, to make sure we do everything possible to give math and science education the attention, funding and assistance it deserves. Today, I introduce a bill to authorize programs at the National Science Foundation that will help achieve that goal. Under the authority of the No Child Left Behind Act, NCLBA, the Department of Education is authorized to implement a Mathematics and Science Partnership Program, a program I am very interested in making sure is a success. That program is designed to improve the academic achievement of students in the areas of math and science. It will encourage States, universities, school districts and schools to work together to: 1. improve the status of math and science teaching and 2. develop more rigorous math and science curricula. The NCLBA authorized $450 million for Fiscal Year 2002 for this program, but only $12.5 million was appropriated for 2002. That level of funding is a huge disappointment to me, and I believe it is a mistake. However, last year, NSG initiated its own Program at a level of $160 million. Because the bulk of the funding for the Math and Science program is at NSF, I believe it is appropriate, even necessary, to authorize the MSP Program at NSF as well. This is not the preferred choice. I would prefer that we fund the program at the Department of Education. In the meantime, this bill will give us an opportunity to re-assert how important this program is. As we all know, the No Child Left Behind Act requires that schools be determined as failing based in part on their math scores. If they are failing, there will be consequences, such as public school choice, supplemental services and eventual reorganization. That means that math teaching and math curriculum are more important than ever. And, by 2007, science assessments will be added to the mix. So I want to be sure that we are getting these funds to our neediest schools. I worry that without more descriptive language, NSF will not focus on awarding grants to those that need it the most. I also worry that the Math and Science Partnership program is not getting the funding it needs. Reading, math's counterpart on the yearly tests, receives over $1 billion in funding. Any many other programs authorized in the No Child Left Behind Act are receiving appropriations that meet, or even exceed the authorization levels. Not the Math and Science program. Despite the importance of math and the fact that schools will be determined as failing based on their math scores, the Math and Science Partnership Program is received a total of only $172.5 million in 2002, with only $12.5 million of those funds targeted to those based on need. $160 million from NSF and $12.5 million from the Department of Education. For 2003, the Senate Appropriations Committee recommends that only $120 million be provided for the MSP program. Why? Apparently, some $30 million in funds is left over from last year's appropriation because NSF did not believe the applications met the rigors the grant program requires. I am very concerned that we are leaving States, schools districts, schools and students confused and bewildered due to the complicated bureaucratic process that has been created. I believe we should make sure that every dollar of the math and science partnership program money is appropriately administered to ensure results. I also believe that we should work toward appropriately funding this initiative. My amendment will accomplish those two goals. My bill would insert the exact Math and Science Partnership language from the No Child Left Behind Act, language which we members of the HELP Committee have already agreed to, with only minor changes. That language requires targeting of the $450 million in funds to those who need it the most, and it also requires accountability. I have also added a section requiring the NSF to provide technical assistance to those eligible applicants that request it. If the quality of the applications is not high, the NSF should help applicants develop high-quality programs. Otherwise, applicants must guess how to improve, forcing math and science education to suffer in the meantime. The bill also authorizes $12 million for NSF to conduct and evaluate research related to the science of learning and teaching math and science. It directs NSF to develop ways to apply, duplicate and scale up the results of such research for use in low-performing elementary and secondary classrooms to improve the teaching and student achievement levels of mathematics and science. This investment will make sure that we find out the best ways to teach math and science. With that knowledge, we will have the building blocks we need to effectively argue for, and demand, more funding for the Math and Science Partnership Program. This bill attempts to make the best out of a not ideal predicament for math and science education. I believe it is the right thing to do, and I respectfully request my fellow Senators support. I ask unanimous consent that the text of the bill be printed in the Record.

Mr. FRIST

Mr. FRIST. Mr. President, we are about to vote on an amendment that very clearly costs more and covers fewer people than the tripartisan bill we debated last week. I yield the remainder of our time to one of the sponsors of that tripartisan, more comprehensive plan that seniors deserve better than the underlying bill on which we are about to vote. I yield the remainder of our time to the Senator from Louisiana.

Mr. FRIST. Madam President, I yield myself 10 minutes, to be followed by the Senator from Maine, 10 minutes. Madam President, I rise in opposition of the Graham drug Medicare proposal. I will make four points regarding my opposition in the few minutes I will speak. The first point is, the bills we are considering on the Senate floor have not gone through the committee process. That is important for the American people to understand. It makes it incredibly challenging to receive an amendment yesterday such as this and having the opportunity only to read it for the first time. This legislation is very complicated. In looking at the this bill compared to the bill passed by the House of Representatives, the tripartisan proposal or the bi-partisan Hagel- Ensign bill, the major substantive objection I have is that the bill costs more and yet fewer people benefit. We do have huge gaps of coverage. We have huge gaps in terms of being able to look seniors in the eye and say, yes, we understand your problem is affordable access to prescription drugs, and then walk away because they don't fall into the category. There are cliffs and gaps and chasms, and these vacuums exist for that individual who falls into one of these gaps or chasms because we do not cover everybody in the sense of addressing their problem; that is, health care security for prescription drugs. Of all the bills we have considered, this is not really a compromise bill. It is a very different bill that costs more and covers fewer and fewer people. The tripartisan comprehensive plan the Senator from Maine put on the table--and we will hear from her shortly, along with Senators Grassley and Breaux and Jeffords is a much more comprehensive bill that I argue gives more secure comprehensive coverage and helps a broader swathe of people. If you look at individuals with disabilities, it doesn't have these categories of exclusion. Where there are some areas that you do not get as complete coverage, it is gradual, and you do not have these cliffs, these drop-offs. If you make one dollar more, all of a sudden you do not get the coverage. In terms of how many people are covered, it is hard to factor it out. We have about 38 million Medicare beneficiaries, seniors and individuals with disabilities around this country. Of the 38 million, there are an estimated 18 million who are above 200 percent of poverty. We heard yesterday and last night about this drop-off, this cliff. Once you get to 200 percent of the poverty level for an individual or for a couple, all of a sudden you do not get benefits. There is a huge hole, a huge chasm, a gap that is there, this drop-off. Above 200 percent you get a minimum benefit of 5 percent. That does not give me the security to look in somebody's eye and say we are really helping you. We need to make affordable access to prescription drugs, which is our goal, a reality. Only about 2 million of those 18 million will ever qualify for the catastrophic benefit. So you have 18 million above the cutoff level of 200 percent of poverty with very minimal benefit. But people say: Yes, for catastrophic coverage they will be helped. At the end of the day, only 2 million out of the 18 million will fall into that catastrophic category, again leaving essentially no benefit for 16 million seniors today. I think it is important for our seniors to understand. I do not want to leave this body 2 days from now saying we passed prescription drugs, we took care of your problem, you will have affordable access to prescription drugs--which seems to be the implication. It has been said that we cannot leave here on recess without passing a package. This package is a shell, and it does not give seniors affordable access to prescription drugs. If we pass it, we are not being honest going home saying we passed a real prescription drug package. It costs more, covers fewer people than what we have had on the floor, what we have been discussing. If we go back to the Finance Committee, I think we can come up with a very good bill. Under this bill, at least 15 million to 16 million seniors are left behind. That is, they do not get a substantial benefit; they only get that 5-percent discount. Fifteen million to 16 million people we are leaving behind. Second, I think from our standpoint it is irresponsible to pass a bill and pretend we are doing something that we are not really doing when we have alternatives. If we did not have alternatives, we could say this is our best shot, and we can build on it in the future. But, really, the two bills that came to the floor each had different approaches. The initial Graham bill was much more Government run. The tripartisan bill involved the public and private sector, but both of those bills had more comprehensive coverage. For the seniors who are listening, for the dollar value, they had more benefits than the bill before us today. Therefore, we should not, by default, end up passing a bill today just to say that we have passed something. Politically, people might be able to claim a victory saying we passed prescription drugs, but this particular bill never addresses the ``affordable'' problem, affordable prescription drugs. The response to that is we are taking a good first step, and we have to do something. If we do something, maybe we can work on it later. If we knew what that ``later'' was, I would say yes, we should have a one-two punch and come back. I have a great deal of confidence if we pass this, we will not come back and visit this in September or October and put together a truly comprehensive plan. We are not addressing the fundamental problem of seniors not being able to afford lifesaving drugs. The third point I want to make is this bill fails to recognize that prescription drugs are, and need to be, considered a part of the overall modernization of Medicare. Yes, I admit all the bills we have considered over the last 2 weeks have not fully addressed the fact that prescription drugs need to be a part of the full armamentarium of what a physician has to deal with, what a hospital has to deal with, that doctor-patient relationship and outpatient care. We are treating prescription drugs sort of on the outside, as if it is an appendage to Medicare, without in any way addressing the fundamental problems of Medicare. In truth, the sustainability, long- term, of whatever we promise--whether it is acute or long-term or preventive care--has to be part of a more comprehensive approach which we addressed. I mention that because the tripartisan bill, of all the bills we mention on the floor, is the only one that is health care security for our seniors, like the surgeon's knife, like acute care, chronic care, or preventive medicine. Remember, the tripartisan bill costs $370 billion, and the more limited bill we are considering on the floor is even more than that because the tripartisan bill at least reached out and said we understand prescription drugs are a part of overall Medicare. This bill does not address that. It has no element of modernization at all. Thus, I think the bill on the floor, of all the bills we have considered, is the least effective in accomplishing what seniors expect. It does not guarantee seniors comprehensive prescription drug coverage. It locks into place a limited stopgap proposal. Everybody says this is not the answer but this is sort of a stopgap, something to do now. But it locks it in place at a far higher cost than it needs to. The taxpayers are paying for this--the people who are listening to me now. It is, my colleagues, constituents. All over the country, people are paying into this as taxpayers. So we need to give them an effective product as we go forward. The product itself, I think, is insufficient. As I mentioned, it leaves a gaping hole in coverage. This is my final point. We have talked about doughnuts earlier in the debate. All last week we talked about a doughnut, which is a gap of people who simply do not get the benefits that other people get. This has a much larger gap than, again, any other bills; than the tripartisan proposal or the proposal that passed the House of Representatives, for example, several months ago. It fails to provide Medicare beneficiaries with either an effective drug prescription benefit or some of the other much needed improvements that are present in the tripartisan bill. I will close by simply saying that I think at this juncture the most prudent thing to do is to table this bill because of the reasons I have outlined and to recognize we have made huge progress compared to even a year ago. It was 3 years ago that we had the Medicare Commission. It basically proposed a public-private approach. That approach has been built upon by a series of bills. We have made great progress over the last 2 weeks. The Medicare debate is on the floor. People have talked about it. We recognize deficiencies. We recognize some advantages in some of the bills. I think the best thing to do is to go back through regular order that is usually in this body, and that is to go through the Finance Committee. Let that process, based on what we know and what we talked about today, work so we can have that particular debate, and move forward. I will be voting against this bill. I will be voting, if there is a point of order, to table the bill. I will support that, and I encourage my colleagues to do so. I yield 15 minutes to my colleague from Maine.

Mr. FRIST. I yield an additional 2 minutes to the Senator from Maine.

Mr. FRIST. Mr. President, I yield 10 minutes to the Senator from Iowa.

Mr. FRIST. I make a point of order that the Graham amendment No. 4345 violates section 302(f) of the Budget Act.

Mr. FRIST. Mr. President, a point of order will be filed very shortly. In closing, it is important that people recognize the bill is inadequate. Seniors deserve more. A proposal has been discussed, the tripartisan bill, which is a more comprehensive approach for less money. This bill promises less, gives less, fewer benefits, for more money. I urge the defeat of the underlying bill. I yield back the remainder of our time.

Mr. FRIST. Mr. President, has all time expired?

Mr. FRIST. Mr. President, I yield 2\1/2\ minutes to the Senator from Oklahoma.

Mr. FRIST

Mr. FRIST. I thank the Chair. Madam President, I rise in support of the McConnell amendment on medical malpractice to the Greater Access to Affordable Pharmaceuticals Act. It goes to the heart, I believe, of an issue that has reached crisis proportions in the United States. Much of the argument and debate on Friday and a little bit yesterday and today centered on how best to frame this debate. Our opponents to the McConnell amendment have tried to frame this as a debate focused on corrupt insurance companies and HMOs. What is absolutely critical for my colleagues and the American people to understand is that this debate is not about insurance companies. This debate is about patients, patients who are suffering today and, even more important, unless we act on this crisis, will be hurt in the future. It is about patients versus skyrocketing medical liability insurance premiums that, in large part, are driven by the current medical liability system. This amendment strikes right at the heart of that problem. Why is this debate important? I go back to patients. How do patients suffer because of these skyrocketing insurance premiums? They suffer in two ways: No. 1, lack of access to health care. If in the future you are a patient, you will see a decrease in access when you want to go to a physician, such as an obstetrician or a neurosurgeon or an orthopedic surgeon. They have all seen these skyrocketing premiums, and these doctors are not going to be there. Why? Because they happen to live in Mississippi where their premiums are $50,000 or $100,000 or in Florida where an obstetrician premium might be $150,000 or $200,000. They might decide, A, to pack it up and leave and go to another State or, B, to stop practicing or, C--and this is what we see happening all over the country--to stop delivering babies. If your doctor delivered your first baby and you want him to deliver your second baby, you had better call far in advance. Because of these skyrocketing premiums, many physicians are leaving that specialty. In addition we saw what happened in Nevada where the trauma surgeons basically said, we cannot stay in business, we cannot keep delivering these services, because malpractice premiums are too high. They were actually forced to close down shop for a period of time. Thank goodness it was just for a few days. I mention the impact on doctors because this is important. For example, if one is an obstetrician and he pays $200,000 a year for his insurance premiums, as in Florida, and he delivers 100 babies, which is the average for an obstetrician in Florida delivers, that means for every baby the doctor delivers there is a $2,000 tax or premium. Now, one might say that this is the worry of the doctor. Well, the doctor can leave. He can switch specialities. He can relocate or retire, early retirement, none of which is very satisfactory. But if a doctor is going to stay in practice, ultimately the doctor is going to pass the cost on to the patient. Who else will pay it? It has to be passed on to the patient. Americans are watching this debate and they hear the ranting and raving against the bad insurance companies. Let's go back to the effect of the problem, which is on that individual patient. Then let's look at the root cause, which is this runaway tort liability system, which this amendment takes the first step at fixing. Patients are hurting in two ways. First, they suffer from a lack of access to care. Specialist are leaving areas, and doctors are refusing to deliver babies. The second way patients suffer is the overall cost of defensive medicine. Ask your physician right now: Do you practice defensive medicine? According to a recent Harris poll, 76 percent, or three- fourths, of physicians believe concern for medical liability litigation has hurt their ability to provide quality care in recent years. Eighty percent of physicians say they ordered more tests than they thought were medically necessary because they worried about malpractice liability. It is called defensive medicine. It is something the consumer does not see, the patient does not see, but America pays for it. How much? Fifteen, 20, 30, 40, 50--about $50 billion. I close by stating my strong support for the McConnell amendment and look forward to continued debate during the course of this afternoon.

Mr. FRIST

Mr. FRIST. First, I want to go back to the theme that I introduced last Friday: This is not about insurance companies or injured patients but about patients broadly. The debate boils down to patients broadly; to the American people versus a broken system of runaway, skyrocketing premiums secondary to the trial lawyers. As I paint the picture, look at the skyrocketing medical premiums which we know are out there. They have an impact that is directly translated to access of health care. This is important to everyone listening to me today because they want access to health care, and affordable access to health care. What is happening is that the skyrocketing costs, coupled with these runaway jury awards, have an impact on physicians in the following way. As the Senator from Mississippi said a few minutes ago, physicians are leaving parts of the country. They are relocating. They are stopping certain riskier procedures, such as delivering babies. Because of these skyrocketing premiums, obstetricians are having to stop delivering babies and neurosurgeons are beginning to limit their practices. We will hear shortly about trauma centers closing in Nevada and elsewhere. Trauma centers provide highly specialized care, and they are actually closing because of these skyrocketing premiums. We also talked a little yesterday about defensive medicine. It increases costs the system overall, but these costs also translate down to how much you pay every time you go see a doctor or pay an insurance premium. Ask your physician about defensive medicine. Eighty percent of physicians practice defensive medicine to the tune of billions of dollars. Patients are hurt in terms of poor access to health care and in terms of greater costs to them. Let me just close, by asking the following: Who do you believe? Is it the insurance companies? Is it the trial lawyers? I will simply say, go back and ask somebody you trust for your health care. Ask your doctor who is telling the truth about the impact of skyrocketing medical malpractice costs; ask your doctors why physicians are leaving States to practice in other States where there is some sort of control on these runaway costs. Ask your doctor why physicians are retiring early or refusing to see certain patients. Ask your doctor why obstetricians are refusing to take new patients, or adjusting their practice just to practice gynecology and not obstetrics. Ask your doctor why trauma centers are closing today because of these skyrocketing premiums. Ask your doctor whether legal reform in the area of medical malpractice is good for patients. I do not care about the insurance companies. They can come or go; they can deny business. The people I care about are the patients, who need access to better care. To better understand this debate ask your doctor, somebody you trust. Call them on the phone today, and I guarantee the answer they will give you is that the judicial system today is out of control and must be reformed. That is what the McConnell amendment does. To summarize, States across the country are experiencing a health care liability crisis. Medical liability insurance premiums are skyrocketing as medical liability claims and damage awards are exploding. This problem is not limited to just a few States or a few areas of the country. It is nationwide, and it is getting worse. The end result of this national crisis is simple: patients suffer. Patients suffer because in many areas because their access to care is in grave danger due to rising medical liability insurance premiums. Doctors are being forced to leave their practices, to stop performing high risks procedures and to drop vital services. Specialists are leaving certain areas or simply retiring. Women suffer the most. One out of 10 OB/GYNs no longer delivers babies because of the high cost of liability insurance. In addition, emergency departments are losing staff and scaling back certain services. This can literally be a life or death problem. The problem is so sever that, according to the AMA, there is a crisis in 12 States where patient access to care is now seriously threatened And there are 30 more States that are near crisis, including my home State of Tennessee. Patients also suffer because of the large costs of defensive medicine. To avoid situations in which a contingency fee attorney can claim injury occurred because certain tests were not performed, doctors engage in ``defensive medicine'' by performing testes and prescribing medicines that are not necessary for health reasons. This costs our economy billions. As a doctor I know this problem is real. I don't need to know all the facts and figures because I have heard from many of my colleagues from across the country who are concerned about their liability insurance. I have heard from many who are seriously considering leaving an area or dropping a service because of the liability problem. They don't want to leave or change their practice, but the are being forced to do so. My colleagues are demanding action by Congress to address this crisis in order to help their patients and to continue to provide quality health care. So we are we in this crisis? Why are malpractice premiums skyrocketing? Why is patient access in jeopardy? Why are trauma centers closing? Why are OB/GYNs refusing to deliver babies? Why are maternity wards shutting down? The answer is simple--medial malpractice suits are out of control. Between 1995 and 2000 the average jury award jumped more than 70 percent to $3.5 million, and more than half of all jury awards today top $1 million. However, payouts aren't the only problem. Simply Defending a malpractice claim costs on average over $20,000, whether or not a doctor or hospital is at fault. Of course, this litigation is having a major impact on medical liability premiums. In 2001, physicians in many states saw rates raised by 30 percent or more and in some areas in some specialities, malpractice insurance is rising by as much as 300 percent per year. In New York and Florida obstetricians, gynecologists and surgeons pay more than $100,000 for $1 million in coverage. Soon, the annual premium which these doctors pay could reach $200,000. In my home State of Tennessee--a State that is not considered in crisis by th AMA--premiums rose 17.3 percent last year and are rising 15-17 percent this year. It should be no surprise that these premium increases are causing this serious health care access problems across the country. We know what must be done--intelligent and reasonable tort reform. Such reform will help solve this problem and, most importantly, help patients. Sensible reform will provide for fair and equitable compensation for those negligently injured and stabilize the insurance marketplace which will help maintain patients' access to quality health care. Experience at the state level clearly shows the dramatic benefit of tort reform. California tort reform, the Medical Injury and Compensation Refom Act, or MICRA, which became law in the mid 1970s, is the most obvious example of what works. California doctors and patients have been spared the medical liability crisis that other States are facing. In fact, California currently has some of the lowest medical malpractice insurance premiums in the country. This is why I strongly support this amendment offered by Senator McConnell. Though this amendment does not include all the measures that I think are necessary to address this problem, it is a good step in the right direction. We know that sensible tort reform works. It holds down rising health care costs and helps maintain access to quality health care. We must act now to protect patients and their accessibility to quality health care before the problem gets worse. I encourage my colleagues to vote for this important amendment. I reserve the balance of my time.

Mr. FRIST

Mr. FRIST. Mr. President, I rise today to thank my colleagues for the confirmation of Julia Smith Gibbons to the U.S. Court of Appeals for the Sixth Circuit. I am also grateful to President Bush for his nomination of this outstanding judge whose distinguished life is an example of the American dream. Raised in Pulaski, TN, Judge Gibbons has been a trailblazer for women in the legal profession, and exemplifies in both her professional and personal life the character that makes us a great nation--active in her church and community, a supportive and loving wife to her husband, Bill, for 29 years, and a proud mother of two wonderful children, Carey and Will. A product of small town America and the solid values that her family instilled in her, as valedictorian of her senior class at Giles County High School, Julia was obviously poised to accomplish great things. With an outstanding record of achievement at Vanderbilt University and the University of Virginia Law School, Judge Gibbons headed home to Tennessee to begin her legal career. She served then-Governor Lamar Alexander as his legal advisor, and in 1981, she became the first female trial judge of a court of record in Tennessee. President Reagan recognized her talent and skill, and just 2 years later, in 1983, she was confirmed by the Senate as a U.S. District Judge in the Western District of Tennessee. At that time, Julia became the first female Federal judge in Tennessee, and was the youngest person on the Federal bench in the country, and the second youngest in the Nation's history ever appointed to a district court judgeship. Despite her tender years, her legal acumen and human touch soon made her one of the brightest stars in our Federal judicial system. Judge Gibbons is known for being bright, industrious, thorough, even- handed and someone who truly loves the law. She is everything anyone could want in a judge, and will continue to serve our country with distinction on the Sixth Circuit.

Mr. FRIST

Mr. FRIST. Mr. President, I have a time constraint. I have been on the floor since last night waiting to make my opening statement. I would be happy to yield 3 minutes, if the Senator has to make an airplane or something.

Mr. FRIST. How much time has been used by each side?

Mr. FRIST. Mr. President, I ask the Senator from Kentucky to allow me to enter three sentences in the Record, and then I will close. First, I thank the Senator for his comments. This does give us an opportunity to point to the fact that this is a national crisis that has to be addressed. We have an obligation to address this crisis. Dr. Frank Boehm, who is a good friend of mine, writes a newspaper article in the Nashville Tennessean. Though I do not have one of his articles, he keeps a really good feel of what is going on around the State of Tennessee and around the country and is also one of the preeminent high-risk obstetrical doctors in the United States of America. I communicated with him the other day. I close with two or three sentences of what he said. He sees a lot of these high-risk cases coming through and reviews a lot of cases. He says: What this has taught me is that doctors, hospitals and nurses are being sued in large numbers, in large part because of the possibility of a settlement or trial judgment of a large amount of money. Then he talks about some of the things we can do, many of which are in the underlying McConnell amendment. He closes with this: Doctors need tort reform and so do our patients. With many physicians leaving States to practice elsewhere, or just closing up shop, patients are suffering from a lack of access to medical care in many parts of our country. That was in an e-mail in response to my question of what is the lay of the land. I thank the Chair.