Judd Gregg

Mr. GREGG

Mr. GREGG. Mr. President, I ask unanimous consent that in addition to the 4 minutes she would be receiving from the Senator from West Virginia, the Senator from Maine receive 5 additional minutes in morning business.

Mr. GREGG

Mr. GREGG. Mr. President, I send an amendment to the desk and ask for its immediate consideration.

Mr. GREGG. Mr. President, I ask unanimous consent that reading of the amendment be dispensed with.

Mr. GREGG. Mr. President, this amendment goes to one of the critical issues in the Kennedy health care bill that we have been debating for the last few days, which is the fact that the bill dramatically expands lawsuits in this country. Our Nation is already far too litigious; 2.2 percent of our gross national product goes into lawsuits every year. That is literally hundreds of billions of dollars every year absorbed in our legal system--dollars that could be used much more productively. Compared to other nations in the world, we are the most litigious by far. For example, Japan only uses about .8 percent of its gross national product for lawsuits. Canada, our neighbor, uses about .5 percent of its gross national product for lawsuits. These lawsuits that have, for years, been used against individuals and manufacturers accomplish some good, but in many instances they end up chilling events, creating greater costs for consumers and causing such things as research to be retarded, especially in the area of health care. This is a sensitive issue because things such as the development of new devices and the need for doctors to practice defensive medicine are issues that are highlighted and aggressively expanded by the expensive use of lawsuits. Just this week, for example, we saw a $4 billion judgment--$4 billion--against one manufacturer in this country. That type of judgment against a medical manufacturer, for example, would end up being passed on to the consumers through an increase in premiums and an increase in the cost of insurance. We are as a society simply too litigious. In many areas we as a society--as a government--have decided that lawsuits should be not cut off but at least curtailed to some degree. However, the other side of the aisle has come forward with a bill which would dramatically expand the number of lawsuits available in this country. It would essentially be the ``Kennedy Annuity for Attorneys Act'' rather than a health care bill. This bill, as proposed by the other side, would create the opportunity for 48 million more incidents of lawsuits involving 48 million more individuals, which could then be multiplied in a geometric progression. Let's just take one situation. Right here, we have the example of how 137 different doctors might treat one simple type of medical problem, ``uncomplicated urinary tract infection.'' There are 82 different treatments from 137 different treating physicians. If one of these doctors picked a treatment which didn't work, under the Kennedy bill that would immediately open a brand new lawsuit against a variety of different individuals, including the employer, the HMO, and the insurer. That lawsuit could be multiplied literally by hundreds of different treatments and hundreds of different opportunities, because this bill dramatically expands the opportunity for lawsuits. Another example of the expansion of lawsuit opportunity under this bill is this chart. All these different blue lines are new regulatory actions which are available under the Kennedy bill. Fifty-six new causes of action are created under this bill. It is truly an explosion of opportunity for attorneys to bring lawsuits. There would be a whole new business enterprise created in this country, and it would be a massive enterprise, the purpose of which would be to bring lawsuits under the Kennedy bill. And the practical implications of this are that the cost of health care in this country would go up dramatically. The Congressional Budget Office has estimated that this bill, the Kennedy bill, because of the lawsuit language which allows attorneys to go out and sue in a variety of different areas--which right now they do not have the opportunity to sue in--would increase the cost of premiums by 1.4 percent. What does that mean? That means that approximately 600,000 Americans would be thrown off the insurance rolls. The practical effect of this expansion in lawsuits is that you would see a dramatic expansion in the cost of health care in this country and an equally dramatic expansion in the number of uninsured in this country. In addition, the cost of insurance for doctors would go up dramatically. Under a study done by the doctors' insurance agents--not necessarily the HMO insurance agents or the health plan insurance agents but, rather, the doctors--it is estimated that the premiums on the errors and omissions policies of doctors would go up somewhere between 8 and 20 percent relative to the ERISA part of their insurance. This means we would see a massive expansion of defensive medicine being practiced. We already know that defensive medicine is practiced excessively in this country, which means procedures undertaken not because the doctor believes they have to be undertaken but they are undertaken to protect a doctor from a lawyer. We would see a massive expansion of this defensive medicine by doctors. What does that do? That drives up the cost of medicine, and it does very little to improve the quality of care. Equally important, what we would see is a deterioration in the availability of doctors to practice specialties, which are unique and needed in rural areas--especially OB/GYN--which we have already seen driven out of many rural areas in this country because of the cost of the error and omissions policies. An 8 to 20 percent increase in the cost of those policies would have a devastating impact on an area of medicine which is already underrepresented in the rural parts of this country. Six-hundred thousand fewer insured people, and what do we get for this expansion in lawsuits? What does the consumer get for this huge expansion in lawsuits? They get a lot more attorneys. There is no question about that. They get a lot more wealthy attorneys. There is no question about that. They will get a lot more attorneys who will be able to contribute to the Democratic National Committee. There is no question about that. The trial lawyers love this Kennedy bill. They are enthusiastic for this bill. If there is a basic beneficiary for the Kennedy bill, it is the trial lawyers in this country. That is what I call this bill. It is the ``attorneys' annuity bill'' rather than the Patients' Bill of Rights. What do the consumers get when they get involved in these lawsuits? They will get very little. Will they get greater care? No. They will have to go to court to get care under this bill. A lawsuit has to be brought. Do they get better results? Absolutely not. The attorneys get 54 percent of the recovery. That leaves the litigants with a combined 46 percent after this, one-half being an economic loss and one-half being compensation for pain and suffering. It makes very little sense when you realize that the only winners under the Kennedy bill are actually the attorneys in the expansion of lawsuits that will occur as a result of the bill. So where does that bring us? We have come up with a better idea in our bill. We say that rather than creating a brand new opportunity to create all sorts of new lawsuits and add a lot of new attorneys to the American culture, who really add very little in the way of productivity--or better medicine, for that matter--let's let doctors take a look at what doctors are deciding for patients. Under our bill, a patient, rather than having to go to court to have their concerns addressed, gets to have their concerns addressed by, first, a doctor in the specialty dealing with the type of problem the patient has within the clinic or the group by which the person is being served. That doctor is independent. That doctor makes a decision: Did that patient have the right care or did that patient have the wrong care? Or should that patient get more care? If the patient isn't comfortable with that decision, then the patient can go outside the clinic, outside the insurance group, and have another doctor, who is appointed after having been prequalified by a certified either State or Federal agency, and have another doctor review that patient's care. If that doctor decides that the patient needs some other type of care--something that the clinic or the interests group did not decide that the patient should have--then that is binding. It is binding on the insurance group. There is an independent review at two different points, one inside and one outside, done by doctors who have a binding decision on the patient. If the patient again is uncomfortable with that decision, then the patient can bring a suit. But it is limited as to amount of damages, and it is limited to the cost of the event. The practical approach they have put forward is to try to get the patient care, and get the patient good care and efficient care quickly, and make sure they have gotten fair treatment and they have had a review by the appropriate doctors. As a result, we reduce the cost of health care. As a result, we keep more people insured. As a result, we allow more people to participate in health insurance in this country. As a result, I admit that we do not create as many opportunities for attorneys to bring lawsuits. That is absolutely right. We do not create a bill that basically underwrites the legal profession in this country. That is absolutely right. We assist patients in getting care. That is a big difference between these two bills. The Democratic bill, the ``Attorneys' Annuity Act,'' the ``Kennedy Patients' Bill of Rights,'' is essentially a bill to promote attorneys. Our bill is a bill to promote health care. Mr. President, I reserve the remainder of my time.

Mr. GREGG. I simply note ERISA does not cover 123 million Americans, so the Senator from Illinois is incorrect. I yield to the Senator from Iowa 10 minutes.

Mr. GREGG

Mr. GREGG. Mr. President, I ask unanimous consent that the Committee on Small Business be authorized to meet during the session of the Senate on Thursday, July 15, 1999, to consider the Committee's budget and to markup pending legislation. The meeting will begin at 9:00 a.m. in room 428A of the Russell Senate Office Building.

Mr. GREGG. Mr. President, I ask unanimous consent that the Select Committee on Intelligence be authorized to meet during the session of the Senate on Thursday, July 15, 1999 at 2:00 p.m. to hold a closed hearing on intelligence matters.

Mr. GREGG. Mr. President, I ask unanimous consent that the Senate Committee on Commerce, Science, and Transportation be authorized to meet on Thursday, July 15, 1999 at 9:30 a.m. on pending committee business.

Mr. GREGG. Mr. President, I ask unanimous consent that the Special Committee on the Year 2000 Technology Problem be permitted to meet on July 15, 1999 at 9:30 a.m. for the purpose of conducting a hearing.

Mr. GREGG. Mr. President, I ask unanimous consent that the Committee on Energy and Natural Resources be granted permission to meet during the session of the Senate on Thursday, July 15, for purposes of conducting a full committee hearing which is scheduled to begin at 9:30 a.m. The purpose of this hearing is to receive testimony on S. 161, the Power Marketing Administration Reform Act of 1999; S. 282, the Transition to Competition in the Electric Industry Act; S. 516, the Electric Utility Restructuring Empowerment and Competitiveness Act of 1999; S. 1047, the Comprehensive Electricity Competition Act; S. 1273, a bill to amend the Federal Power Act to facilitate the transition to more competitive and efficient electric power markets, and for other purposes; and S. 1284, a bill to amend the Federal Power Act to ensure that no state may establish, maintain or enforce on behalf of any electric utility an exclusive right to sell electric energy or otherwise unduly discriminate against any customer who seeks to purchase electric energy in interstate commerce from any supplier.

Mr. GREGG. Mr. President, I ask unanimous consent that the Government Affairs Committee be permitted to meet on Thursday, July 15, 1999 at 5:00 p.m. for a business meeting to consider pending Committee business.

Mr. GREGG. Mr. President, I ask unanimous consent that the Senate Committee on Indian Affairs be authorized to meet during the session of the Senate on Thursday, July 15, 1999 at 3:30 p.m. to approve the Committee's budget for the 106th Congress. The meeting will be held in room 485, Russell Senate Building.

Mr. GREGG. Mr. President, I ask unanimous consent that the Committee on the Judiciary be authorized to meet for an executive business meeting, during the session of the Senate on Thursday, July 15, 1999, in S216 of the Capitol.

Mr. GREGG. Mr. President, I ask unanimous consent that the Committee on Rules and Administration be authorized to meet during the session of the Senate on Thursday, July 15, 1999 at 9:30 a.m. to mark-up a Committee funding resolution.

Mr. GREGG

Mr. GREGG. I can respond on our time relative to this amendment. I will do it then.

Mr. GREGG. Will the Senator yield for a question prior to yielding back his time?

Mr. GREGG

Mr. GREGG. Would the Senator yield me 10 seconds? Because a misstatement was made.

Mr. GREGG. So there is an option under your proposal where plans would have a choice because that is what the language says?

Mr. GREGG. Mr. President, I have a question for the Senator from North Carolina which is in reference to the Kennedy bill, section 133, subsection (1)(ii), on page 67: If an applicable authority permits-- That will be the State authority-- more than one entity to qualify as a qualified external appeals entity with respect to a group health plan or health insurer issuer, then the plan or issuer may select among such qualified entities the applicable plan. So basically if the State picks two or three different reviewers, under your plan, then the plan gets to choose; isn't that correct?

Mr. GREGG. I am reading from S. 6. That is the bill that was laid down. That is the bill we are debating.

Mr. GREGG. Will the Senator yield for a question?

Mr. GREGG. As I understand it, by repealing the underlying amendment, which would limit the cost increase to 1 percent and would say, in the alternative, if 100,000 people are knocked off the rolls of insured, the bill will not go forward. If we repeal that and those 100,000 people are knocked off the rolls, they are not going to have any insurance for mastectomies; right?

Mr. GREGG. Basically, the proposal of the Senator from Virginia, supported by Senator Kennedy, uninsures potentially 100,000 women from any mastectomy coverage as a result of their amendment or any other coverage.

Mr. GREGG. Of those 2 million people, we can assume potentially half would be women. So we have approximately 1 million women who would not have insurance as a result of this amendment being put forward on the other side.

Mr. GREGG. I, therefore, take it in the Kennedy plan, when it says, ``the plan or issuer may select among such qualified entities,'' that that language is not operative, that that does not exist, that that language is a nonfactor. Let's get serious. This is what your bill says. It says the plans can be selected from the qualified entities. You can pick two or three plans, that the States have chosen to qualify two or three plans, and the people pick the plans. So you are totally inconsistent with your argument.