Phil Roe

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Mr. Chairman, I have an amendment at the desk.

Mr. ROE of Tennessee. Mr. Chairman, I yield myself such time as I may consume. Mr. Chairman, medical malpractice lawsuits in this country have gotten out of hand, which is hurting both providers and patients. Something must be done. I have spent 31 years practicing medicine in Tennessee before coming to Congress. In that time, I saw my medical malpractice insurance premiums increase from $4,000 a year to over $50,000 a year, by the time I left practice. Why were the premiums so expensive? My practice group took everyone: private insurance, Medicare, Medicaid, TRICARE, and the uninsured. Some practices limit their patient populations, but when you are in rural Appalachia, you take all comers. The reality is, when you are taking care of patients with elevated risk, you get more frequent negative outcomes, increasing your risk for lawsuits, and this creates an issue for patient access to care. Finally, right when I was leaving practice in 2008, Governor Haslam signed into law some of the best reforms we have in Tennessee, in the Tennessee Medical Malpractice Act, which created a 60-day notice statute and a certificate of good faith certifying a case has merit before it can be filed. In 2011, Governor Haslam then signed the Tennessee Civil Justice Act into law, which contained a restriction on who could testify as an expert witness in medical malpractice litigation. Too often, physicians practicing medicine are pitted in litigation against a professional witness who has gone to medical school but specialized in a different field and wasn't even licensed to practice in their State or a contiguous State. Mr. Chairman, that is absolutely wrong. The fact is, these changes work. In Tennessee, we saw medical malpractice premiums reduced from 2009 to 2014 by between 25 and 40 percent, depending on the specialty. OBs saw average premiums reduced from over $52,000 to just over $33,000; neurosurgeons saw average premiums reduced from $49,000 to $35,000; cardiovascular surgeons saw their premiums go down from $44,000 to $31,000. There were other changes that were put into place that helped, including caps, but the fact was, this change had a major impact. My amendment follows Tennessee's law and strengthens the changes contained in the underlying text of the bill, H.R. 1215, by adding further restrictions to those individuals who would qualify as an expert witness for medical malpractice litigation. My amendment limits who can be called as an expert witness, not only by the individual's professional accreditation, but also by his or her geographic location. The fact is, as Tennessee's law proved, we needed medical professionals from the area where the incident in question occurred to testify as an expert, not a foreign jurisdiction hundreds of thousands of miles away. If that proves to be impossible, the court can waive this requirement if a witness that fits these criteria is otherwise unavailable. Mr. Chairman, no one knows the people or healthcare providers in an area better than the people and healthcare providers in that area. Whether testifying for the plaintiff or defendant, it is important that those individuals called as experts really know the people in the area and aren't simply flown in from a faraway place just to get a paycheck. We all want improved quality and lower costs of care. Reforming the litigation process is a step in the right direction. Mr. Chairman, I encourage Members to support my amendment, and I reserve the balance of my time.

Mr. ROE of Tennessee. Mr. Chairman, where the subsidies were going in our State were to the lawyers, since they got over 60 percent of any medical malpractice settlement. The poor patients got less than forty cents on the dollar. Mr. Chairman, I yield 1 minute to the gentleman from Iowa (Mr. King).

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Mr. Speaker, I rise today in support of H.R. 2353, the Strengthening Career and Technical Education for the 21st Century Act, which reauthorizes the Carl D. Perkins Career and Technical Education Act. Mr. Speaker, it's estimated that the U.S. spends $1.6 trillion dollars on human capital development each year. That includes spending on K-12 education, post-secondary education, and employer-based training. In spite of all that spending, fewer than half of Americans ages 25 to 64 have completed a credential beyond high school. All over my district I hear from employers about the need for workers with the right skills. Career and technical education is one way to do this. I am pleased this legislation encourages states to utilize work-based learning, but I would also note that I think we can further strengthen it by encouraging apprenticeships, both registered and unregistered. As our nation continues to transition itself from analog to digital, so must our workforce. Apprenticeships are needed not only in traditional trades, but also in emerging fields like advanced manufacturing and the technology sector. President Trump demonstrated his commitment to this workforce development model in a speech last week, and I look forward to working on this model with the Chairwoman. With these important reforms, we can help ensure the labor force of tomorrow has the skills it needs.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Mr. Speaker, I am proud once again to rise and join in commemorating June 20, 2017, as American Eagle Day and to celebrate the recovery and restoration of the bald eagle, the national symbol of the United States. On June 20, 1782, the eagle was designated as the national symbol of the U.S. by the Founding Fathers at the Second Continental Congress. The bald eagle is the central image of the Great Seal of the United States and is displayed in the official seal of many branches and departments of the Federal Government. The bald eagle is an inspiring symbol of freedom and the democracy of the United States. Since the founding of the Nation, the image, meaning, and symbolism of the eagle have played a significant role in art, music, history, commerce, literature, architecture, and culture of the United States. The bald eagle's habitat exists only in North America. I hope my colleagues will join me in celebrating June 20, 2017, as American Eagle Day, which marks the recovery and restoration of the bald eagle.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Mr. Speaker, I rise today in support of H.R. 2372, the Veterans Equal Treatment Ensures Relief and Access Now, or VETERAN, Act, which I am proud to sponsor along with Congressman Sam Johnson from Texas and a number of our colleagues. The VETERAN Act would codify an existing Internal Revenue Service regulation, allowing a veteran who is eligible for but not enrolled in the Department of Veterans Affairs healthcare system to use a tax credit to purchase health insurance. Language that would have codified that regulation in law was removed from a draft version of the American Health Care Act in 2017 earlier this year to comply with Senate rules. While the removal of that language from the version of the bill that ultimately passed the House in no way changed existing regulation or a veteran's eligibility to receive a tax credit pursuant to it, it did form a basis for politically charged assertions that the American Health Care Act would harm veterans. First, congressional intent is clear. Second, I am confident that the IRS would interpret the relevant language of the American Health Care Act in the same manner as it did similar language in the Affordable Care Act under the President Obama administration. Nevertheless, I am glad that the passage of the VETERAN Act today will, once and for all, put an end to posturing over this issue and codify Congress' expectation that veterans who are eligible for but not enrolled in the VA healthcare system may continue to receive applicable tax credits to purchase health insurance. Mr. Speaker, I urge all of my colleagues to support the passage of the VETERAN Act today.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Mr. Speaker, I thank Mr. Walker for yielding. I would like to associate my remarks with Mr. Hudson, Dr. Wenstrup, Mr. Franks, and my good friend Diane Black. I am a concealed carry permit holder--full disclosure--and what Mr. Franks said: I am an OB/GYN doctor by training. I have delivered 5,000 babies in my lifetime, and every single one of them I view as valuable. I have watched these young people that I have delivered grow up and become very productive citizens not only in my community, but around the country. Mr. Speaker, 44 years ago, I was a young soldier in southeast Asia. When we came home from the military, we were advised not to wear our uniforms when we traveled because of basically what was going on in the country: the opposition to the Vietnam war. That left a very deep, indelible mark on me, and I thought that is no way we should be treating our men and women who protected us and gave us the freedoms that we have and live by to this day. When I got the privilege of being elected--when I retired from my medical practice in northeast Tennessee and ran for Congress and was fortunate enough to win--I was asked to be on the Veterans' Affairs Committee, which I have served on for the past 8 years. We know that 3 years ago there was a scandal in Phoenix, Arizona. Then we realized it was not just Phoenix, Arizona. It was all across the country where veterans were not being served, and, actually, veterans were dying while they were waiting for care at a VA. That is as wrong as it gets. So, what we elected to do in our committee, when we discovered this, was to try to get some legislation up that actually did something about this. And one of the things that touched me--I watched late into the evening, like many of you all probably around the country and in this gallery watched--was the election results. It was around 3 or 3:30 in the morning when then President-elect Trump gave his election speech. Very shortly into it, not a minute or two into that speech, he mentioned our veterans. And it really, really encouraged me because I think he is an administration that is very sincere in improving care. And, Mr. Speaker, it is not money. When I came here in 2009, you, the taxpayers, were spending about $97 billion on VA care, on benefits, and on cemeteries. Today, that number is going to be $186 billion. We have gone from 260,000 employees in the VA to over 360,000 employees. There is enough money and personnel to take care of the problems. When the President was sworn in and he selected his Secretary of the VA, Dr. David Shulkin--I believe is now the man for the job--he was approved 100-0 by the Senate. Dr. Shulkin said: The first thing I need is accountability legislation that allows me to terminate bad employees. At the VA, the vast majority--and many of them are personal friends of mine that I have worked with in healthcare--are good people taking the very best care they can of veterans. But there are some bad apples there, and they cannot be terminated. It almost could not happen, Mr. Speaker. So what this legislation does is it protects the whistleblowers who call these people out. It provides due process rights for employees so that they don't have those trampled on, but it allows the Secretary to terminate these bad apples and, hopefully, improve the morale of the entire VA. This is only phase one. We also have passed out of this body and over to the Senate--I want to thank our Senate colleagues, Senator Isakson; Senator Rubio, who is a lead sponsor in the Senate; and Senator Tester, the minority leader. I also want to thank the minority leader on our side of the aisle, Sergeant Major Walz, who worked hand in hand. This was a bipartisan bill, which is how legislation should be passed. We passed it in the House and it went to the Senate. They reformed the bill. It came back, and we now await the President's signature. We are also doing repeals reform. We passed that out of here. We have, now, 470,000 backlog claims of veterans waiting for their appeals. Hopefully, we are going to address this problem. The Secretary, we have just extended the Choice Program for veterans who want to choose care outside of the VA, and also a new electronic health system. So we have a lot of work to do. It is a true privilege to do what I get to do, which is to help the 21 million men and women who have served this country, who allow us to be free. I thank the gentleman for the privilege to be down here tonight to share this with the American people.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Mr. Speaker, I yield 2 minutes to the gentleman from Florida (Mr. Mast), a combat-wounded veteran, Bronze Star winner, Purple Heart winner, Defense Meritorious Service and Army Commendation Medal winner.

Mr. ROE of Tennessee. Mr. Speaker, I thank Congressman Mast for those kind words and words spoken for every American veteran. Mr. Speaker, I yield 1 minute to the gentleman from Pennsylvania (Mr. Fitzpatrick).

Mr. ROE of Tennessee. Mr. Speaker, I yield myself such time as I may consume. Today is a proud day, I think, for this Nation. The United States of America does more for its veterans than all other nations in the world combined; and I don't think that, on some days, that is even enough for these heroes that have served us and many of whom have spoken this afternoon. I want to express my appreciation to the minority and the majority staff, and to Sergeant Major Walz for walking hand in hand. As he said, this was not an easy process. There were a lot of difficult issues that we both dealt with. I also want to thank our friends on the Senate side who also went through the same process and brought a bill to the floor that we can all, I think, enthusiastically support. The Secretary said when he was first chosen--and I might add, 100-0, Secretary Shulkin was a bipartisan agreement in the Senate. I think he is a leader to transform the VA. He asked for accountability. He said: I cannot do my job as Secretary if I don't have this piece of legislation. So he was very supportive, along with President Trump, so we gave him that. We also protected due process rights for the employees who work for the VA--a very important issue. Whistleblower protections. We could not do our job, Mr. Speaker, if we did not have these whistleblowers. There are 350,000 employees, 154 medical centers, and over 800 outpatient clinics. There is no way that we could monitor that without their help. So their protections are there. Mr. Speaker, I want to encourage both sides of the aisle to support S. 1094, and I yield back the balance of my time.

Mr. ROE of Tennessee. Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman from Puerto Rico (Miss Gonzalez-Colon), a new member of our committee, who is doing a great job.

Mr. ROE of Tennessee. Mr. Speaker, how much time do I have remaining?

Mr. ROE of Tennessee. Mr. Speaker, I yield 2 minutes to the gentleman from Maine (Mr. Poliquin), my good friend and a member of the Veterans' Affairs Committee.

Mr. ROE of Tennessee. Mr. Speaker, I yield 1 minute to the gentleman from Florida (Mr. Dunn), a veteran and a member of the committee, to speak on this issue.

Mr. ROE of Tennessee. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from Florida (Mr. Rutherford), a member of our committee and, for many years, who was in the process of protecting us in law enforcement.

Mr. ROE of Tennessee. Mr. Speaker, I yield 2 minutes to the gentleman from Michigan (Mr. Bergman), the Oversight and Investigations Subcommittee chair and a lieutenant general in the Marine Corps.

Mr. ROE of Tennessee. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, this is a historic day. You and many Members of this body are well aware that bringing real accountability to the Department of Veterans Affairs has been a goal of mine and many of my colleagues for many years. That is why I am proud to rise today to support S. 1094, which passed the United States Senate last week via voice vote. This bill is heavily modeled off of my bill, H.R. 1259, which passed out of the House with bipartisan support earlier this Congress, and I am proud to have worked with Senators Isakson, Tester, and Rubio to craft this vital piece of legislation. The Department of Veterans Affairs Accountability and Whistleblower Protection Act of 2017 would provide the Secretary of the Department of Veterans Affairs with yet another tool to instill accountability at VA by giving him the authority to expeditiously remove, demote, or suspend any VA employee for poor performance or misconduct while still preserving an employee's rights to due process. This bill would create an expedited procedure for all VA employees to respond and appeal to proposed removals, demotions, and suspensions for performance or misconduct, or in the case of title 38 employees, which are our healthcare providers, for a question involving direct patient care or clinical competence. The prenotification and response process would have to be completed within 15 business days, and the employee would be entitled to an expedited appeal to the Merit Systems Protection Board where the first step at the administrative judge level would be limited to 180 days. Additionally, either party would be able to appeal the administrative judge's decision to the full MSPB and would be provided the opportunity for limited judicial review. This bill would also provide improved protections for whistleblowers by creating a new office and an Assistant Secretary position specifically for accountability and whistleblowers. It would allow the Secretary to reduce an employee's Federal pension if they are convicted of a felony that influenced their job at VA. It would provide the Secretary with the authority to recoup a bonus provided to an employee who engaged in misconduct or malfeasance prior to receiving the bonus, and would allow the Secretary to recoup any relocation expenses that were authorized for a VA employee only through the employee's ill- gotten means, such as fraud, waste, or malfeasance. Lastly, it would also provide the Secretary with the direct hiring authority he has been asking for so that he can hire medical center directors and VISN directors in a more expedited manner and fill the leadership vacancies across VA. Mr. Speaker, as I have always said, I agree with all of my colleagues that the vast majority of VA employees--many of whom I know personally and call friends--are hardworking public servants who are dedicated to providing quality healthcare and benefits for veterans. But for far too long, the failures of bad actors have tarnished the good name of all VA employees. Unfortunately, despite the tireless efforts of our courageous whistleblowers, the extensive reporting on a lack of accountability by the media and the outrage of the American public, we still see far too many instances of VA employees not living up to the standards America expects. Most importantly, they are not living up to the standards that the men and women who have served this great Nation deserve. This isn't a political issue. This is a veterans' issue. I can't imagine how any Member of this body can defend not standing for veterans to vote for this bipartisan legislation. The lack of accountability isn't specific to any one area of the Department. It is systemic. In the last few years, the committee discovered an instance of a VA nurse scrubbing in drunk for a veteran's surgery--I found that unbelievable--and a care support specialist in the agency's drug and addiction program taking a recovering addict to a crack house to buy him drugs and a prostitute, a VA medical center clerk participating in an armed robbery, and a practitioner watching pornography at work while they were supposedly treating a patient. What is more, it has been proven that some senior managers have retaliated against whistleblowers, costing VA and, in turn, taxpayers hundreds of thousands of dollars in restitution. All of these acts in and of themselves are egregious, but they are just the tip of the iceberg. They have one thing in common: none of these employees were held accountable in a reasonable timeframe, if at all. There are many factors that contribute to this failure, but an antiquated civil service system and a complicated grievance process have left VA unwilling--and sometimes just unable--to jump through the many hoops to do what is right. This is not an issue unique to VA. Too often it is nearly impossible to remove a poorly performing government employee. Officials on both sides of the aisle have expressed their concern about the current process to remove or discipline subpar employees. Just last year, Mr. Speaker, VA's then-Deputy Secretary Sloan Gibson sat before our committee and admitted that it was too difficult to fire a substandard VA employee. Further, the Government Accountability Office studied the government's ability to hold low-performing employees accountable and found that it took 6 months to a year on average, and sometimes significantly longer, to fire a poorly performing government employee-- 6 months to a year. I have heard concerns that the bill will hurt the Department's ability to recruit and retain good employees. I don't buy this argument as every employee I speak to tells me the exact opposite. Good employees want to work in an environment where they know everyone can be held accountable for their actions. I believe the current status quo hurts the morale of the employees who are doing the right thing each and every day. This is the same for employees of the Department who are veterans. I know that some have said that this would hurt veterans who are employed at the VA since they make up a large percentage of our VA employees. But as a veteran myself and as my fellow veterans here today would agree, we don't serve, whether in uniform or civilian clothes, because we prioritize our individual protection. The mission always comes first, and at VA, the mission is our veterans. Veterans want to work alongside colleagues they know are working hard for the men and women who they served alongside. Mr. Speaker, before I close, I want to acknowledge some individuals who have made this bill become a reality. First and foremost, I want to thank the 18 veterans groups representing millions of veterans and their families who are supporting this bill and real accountability at the VA. Many of them are in the gallery today, and I can't thank them enough for all they have done and all they continue to do for our Nation's heroes. Many of these groups took a courageous stand in support of VA accountability, even when it wasn't a politically popular idea. And I especially want to thank Concerned Veterans for America, The American Legion, and Paralyzed Veterans of America for being some of our earliest and staunchest supporters. I also want to thank someone who, this Congress, has been with us from day one, and that is the Secretary of the Department of Veterans Affairs, Dr. David Shulkin. We have worked with Secretary Shulkin and his team to draft the bill that is before us today, and I am thankful for his and President Trump's support. President Trump and Secretary Shulkin have endorsed this legislation, not because they want to punish or make it harder to recruit employees, but because they see this change is needed if the Secretary is going to meet the President's goal of truly reforming the VA. I also want to thank the bipartisan group of Senators who we worked with in crafting this bill, including Senator Isakson; Senator Tester; and the primary sponsor, Senator Rubio. Senator Rubio and his staff have been with me every step of the way, and I am thankful for his and his staff's efforts over the years. I also want to thank a good friend of mine, Ranking Member Walz, and his staff for their support and leadership. They have been fantastic. I also want to thank Speaker Ryan and Majority Leader McCarthy and their staffs for helping us bring this bill to the floor. Lastly, I would like to single out former Veterans' Affairs Committee Chairman Jeff Miller, a good friend, great leader of this committee, and my chairman for 6 years. His leadership got the ball rolling on this issue, which led to House-passed legislation twice last Congress and kept the spotlight on accountability issues at VA through his dogged oversight. Finally, I would like to thank my staff, and especially the professional and communications staff of the House Committee on Veterans' Affairs, for their years of hard work on this issue. Mr. Speaker, today, we have a bipartisan, bicameral bill that makes meaningful change to VA's civil service system, while maintaining due process rights. Today, we have the opportunity to make real and lasting changes to a broken system. Today, we can stand together with veterans against the status quo that has failed them for far too long. They deserve better. I hope all of you will join me, and the 18 veterans organizations that support this legislation, to do what is right and send this bill to the President's desk. Mr. Speaker, I reserve the balance of my time.

Mr. ROE of Tennessee. Mr. Speaker, I yield 1 minute to the gentleman from California (Mr. McCarthy), the majority leader.

Mr. ROE of Tennessee. Mr. Speaker, on that I demand the yeas and nays.

Mr. ROE of Tennessee. Mr. Speaker, I thank my friend from California (Mr. Takano) for his support. I yield 2 minutes to the gentleman from Florida (Mr. Bilirakis), my good friend and vice chair of the Veterans' Affairs Committee.

Mr. ROE of Tennessee. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from Colorado (Mr. Coffman), an Army and Marine veteran deployed to Iraq.

Mr. ROE of Tennessee. Mr. Speaker, pursuant to House Resolution 378, I call up the bill (S. 1094) to amend title 38, United States Code, to improve the accountability of employees of the Department of Veterans Affairs, and for other purposes, and ask for its immediate consideration.

Mr. ROE of Tennessee. Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days to revise and extend their remarks and include extraneous material on S. 1094.

Mr. ROE of Tennessee. Mr. Speaker, I yield 2 minutes to the gentleman from Texas (Mr. Arrington), chairman of the Economic Opportunity Subcommittee.

Mr. ROE of Tennessee. Mr. Speaker, I yield 1 minute to the gentleman from Indiana (Mr. Messer), my good friend who I have served with for 6 years on the Education and the Workforce Comittee.