THE PRESIDENT: Thank you all. Please be seated. Thanks for
coming, and thanks for the warm welcome -- inside. (Laughter.) It's
great to be back in Scranton, Pennsylvania. (Applause.) Home of a
lot of really fine people and a great university.
And I want to thank the University of
Scranton -- (applause.) I want to thank the University of Scranton
for the hospitality. I want to thank Father Joe McShane for opening
up this wonderful facility for me, and a lot of members of the
congressional delegation have come, and the great Secretary of
Health and Human Services, Tommy Thompson. (Applause.)
I appreciate you all putting up with us, and giving me a chance
to talk about a significant problem which faces America. And that
problem is the fact that our medical liability system is broken, and
therefore, a lot of Americans don't have access to affordable health
care. And I'm here to declare in Pennsylvania I intend to work with
Congress to do something about it and fix the problem. (Applause.)
And we're going to need your help. Democracy can respond. People
in Washington tend to respond when the people speak. (Laughter.) So
I'm going to spend a little time today encouraging you and those who
may be watching on TV to start speaking on your behalf, to make sure
that you can afford health care in America. (Applause.)
I'm traveling today with some mighty fine folks. One person
decided to go back to Washington to represent Pennsylvania's
interest on the Senate floor. He flew up with me. I talked to him
about this issue, and that's Senator Arlen Specter. I want to thank
him for his friendship. (Applause.) It looks like they're finally
getting organized in the United States Senate. (Applause.) And they
might start voting on the appropriations bill for '03, which would
be helpful. (Laughter.)
I also was traveling with Jim Greenwood. I'm honored that Jim was
on the plane. Jim was a sponsor in the House of Representatives of
the legislation which I'm going to talk to you about today and which
I hope I'm able to sign into law this year, to help the doctors and
patients in the state of Pennsylvania. I appreciate you. (Applause.)
Paul Kanjorski is here, as well, the member of the United States
House of Representatives. Paul, I'm honored you are here. The issue
we're talking today about is not a Republican issue, it's not a
Democrat issue; it's an issue which affects people from all walks of
life. And it's an issue which must be solved. (Applause.)
A man who used to represent Scranton is Don Sherwood. I
appreciate Don and his friendship. Thank you for coming. (Applause.)
With us, as well, is two other fine members of the congressional
delegation from Pennsylvania, Todd Platts and Pat Toomey, and I want
to thank you guys for being here today. (Applause.)
I'm honored that the Mayor of Scranton, Chris Doherty, is here
with us. Mr. Mayor, thank you. (Applause.) He was standing out there
in the cold, waiting for Air Force One. That's beyond the call of
duty, I want you to know. (Laughter.) But thank you, sir. I
appreciate so very much the Attorney General of the State of
Pennsylvania, my friend, Mike Fisher. I'm glad you're here, Mike.
(Applause.) John Perzel is here, from -- representing the House of
Delegates, along with the senators and members of the House from
this part of Pennsylvania. I'm honored you guys are here. Thank you
for coming. Thank you for your interest in this issue. (Applause.)
Today when I arrived, I met Ed Gilmartin. He's what we call a USA
Freedom Corps greeter. He is a volunteer with the Goodwill
Industries of Northeastern Pennsylvania. I want to thank Ed for
coming. I want to thank him for working with Goodwill. He is a
reminder that while one of us can't do everything to help heal the
hurt of America, each of us can do something to help make somebody's
life in your community a better place. (Applause.) And that, as we
continue our struggle against people who are evil who would want to
hurt America, that we can do so not only through the use of our
great military, but we can do so by doing some good in our
communities, in order to fight evil. Each of us can do some good by
loving a neighbor just like you'd like to be loved yourself.
See, we've got some big problems in this country. I'm here to
talk about one problem, but we've got some others. One is, how best
to secure the peace. And one way to secure the peace is never to
forget what happened to us on September the 11th, and hunt the
killers down one by one and bring them to justice, which is what
America is going to do. (Applause.)
We will continue to confront problems before they become acute.
We understand that the world was changed on September the 11th.
Oceans no longer protect us from threats that may mass overseas. And
that's why I've been clear about my desire to keep the peace by
confronting Mr. Saddam Hussein. It's his choice to make. It's up to
Mr. Saddam Hussein to do what the entire world has asked him to do.
The world overwhelmingly, through the U.N. Security Council, said,
Mr. Saddam Hussein, disarm for the name of peace. It's his choice to
make. So far, the evidence hasn't been very good that he is
disarming. And time is running out. At some point in time, the
United States' patience will run out. In the name of peace, if he
does not disarm, I will lead a coalition of the willing to disarm
Saddam Hussein. (Applause.)
We will deal with those problems overseas, and we will deal with
the problems we have at home, as well. We've got an economy that is
not as strong as it should be. And therefore, I've proposed to
Congress ways to strengthen the economy, starting with this
principle: It is best to let Americans have more of their own money,
if you're worried about economic vitality. (Applause.)
If you want people to find work, if you're worried about somebody
looking for a job, like I am, the best way to encourage economic
growth is to let people have more of their own money. And one of the
lessons that I keep trying to explain to Washington and, of course,
these members don't need to hear it is that the money we spend in
Washington is not the government's money; it's the people's money.
(Applause.)
I look forward to working with Congress. I look forward to
working with Congress to create an environment in which the small
businesses grow to be big businesses, in which the entrepreneurial
spirit is strong, and, most importantly, in which people who are
looking for a job can find work. (Applause.)
But the problem I want to talk today is the problem with our
health care system. I hope you're as proud of our health care system
as I am. I mean, we're great at what we do. (Applause.) We've got
great doctors in America. (Applause.) Incredibly skilled,
well-trained, compassionate people who care deeply for their
patients. We've got great nurses in America. (Applause.) People who
love their patients. We've got fine hospitals, fine researchers.
We're on the leading edge of technological change in this country.
We make new discoveries all the time. We develop new cures and,
therefore, we develop new hopes for people who are sick. We're good
at what we do. And I'm proud of the health care system of America.
(Applause.)
But we've got some problems. And one of my jobs is to talk
plainly about the problems, and encourage people to find solutions
to the problems and then get them to act. We've got a problem
because too many of our citizens go without health care. That's why
I proposed refundable tax credits to empower people to be able to
have the capacity to get into the marketplace to purchase health
care.
We've got a lot of people who go to emergency rooms for primary
care, which strains our emergency rooms. It makes it hard on the
community hospitals. That's why I'm for community health centers,
realistic, smart ways to make sure people can get primary health
care who don't have it.
Our seniors need to have a reformed Medicare plan which includes
prescription drugs. (Applause.) We've got a system that's stuck in
the past. Medicare is stuck. Medicine has become modern, and
Medicare hadn't. And it seems like to me a good place for Congress
to start is to take a look at their own health care system. They've
got choice in the system. Congressmen and senators and their staffs
can pick and choose the plan that meets them best. It seems to me a
good principle for our seniors, to trust our seniors to make the
right decisions for them. (Applause.)
And medical care is expensive. Out of $100 spent in this country,
$11 goes to pay for health care. The costs are rising at the fastest
rate in nearly a decade. I mean, that's a problem. Most costs in our
economy are pretty well under control; inflation is low. But that's
not the case in health care. And we need to do something about it,
before people get hurt.
Health care costs rise for a lot of reasons. Research is costly.
Technologies cost money, and they're expensive. And some of the
costs are necessary. But there are some costs that are unnecessary
as far as I'm concerned. And the problem of those unnecessary costs
don't start in the waiting room, or the operating room, they're in
the courtroom. (Applause.) We're a litigious society; everybody is
suing, it seems like. There are too many lawsuits in America, and
there are too many lawsuits filed against doctors and hospitals
without merit. (Applause.)
And one thing the American people must understand is, even though
the lawsuits are junk lawsuits and they have no basis, they're still
expensive. They're expensive to fight. It costs money to fight off a
junk lawsuit. And oftentimes, in order to avoid litigation, and
oftentimes, to cut their costs, docs and, therefore, the companies
that insure them just settle. See, so even though there's no merit,
in order just to get rid of the thing, they just say, okay, let's
just pay you. We'll get you out of the way. Instead of maybe
suffering the consequences of a lousy jury and a lousy verdict, just
pay them off. That is expensive to the system when it happens time
and time and time again, like it's happening in America today.
(Applause.)
And what's happening is these rates for insurance are going out
of sight. And doctors need insurance to practice. Today I met with a
lot of great health-givers and healers, decent people, compassionate
Americans who love their patients. These are docs -- I met with some
patients, as well -- talking about the effects of this litigious
society we have. And I heard stories about people not being able to
pay their premiums. See, that means that health care is no longer
accessible to too many of our citizens. When a doc can't pay the
premiums and, therefore, can't practice, somebody is going without
health care. It's strains the system.
So what happens is, doctors say, well, gosh, I can't afford it
here in Pennsylvania, I'm moving. I'll just take my heart and my
skills to another community where I can afford it. But when that
happens, somebody hurts. Somebody doesn't have the care. Some mom
fixing to have a baby wonders out loud -- when she wonders out loud
whether or not the doc is going to be there to deliver the baby,
it's a -- we heard a story, by the way, about that -- it's a sad
situation. There's a lot of uncertainty in our society. Lawsuits run
up the costs for you, the patient. But they also create a sense of
uncertainty in America for people who need the stability of good
care.
I had a chance to, when I talked to the docs, to talk about
people who literally had tears in their eyes when they described
their situation. Debra DeAngelo and her husband are leaving Scranton
to go to Hershey. They wanted to stay here in Scranton, they were
raised in Scranton. I met one of Debra's patients who really needs
her to be in Scranton. They chose so because they can get their
insurance there and they can't here.
This insurance issue is creating a problem in our communities all
across America. People are having to move. People who don't want to
move have to move in order to stay in business to be able to do
their job.
Jack Brooks is a respected pathologist at the University of
Pennsylvania Hospital. He was there today. He went to Buffalo. He
moved back to his state, but he was turned down by three insurers
when he came back to Pennsylvania. The fourth insurer's quote was
just too high, he couldn't afford it. Jack Brooks has never had a
claim filed against him. He's one of your leading docs here in the
state of Pennsylvania. He's one of your best assets. He's never been
to the courthouse. And yet, because the system is broken, he
couldn't afford to be in Pennsylvania. Fortunately, he got some
insurance through a hospital; he couldn't do it on his own. You've
got a problem here in this state. (Applause.)
Greg Przybylski was here. He's a brain doctor. He has been moving
from Pennsylvania to Illinois to New Jersey because the costs were
too high. He can't stay in business. He can't do what he was trained
to do and loves to do, which is to treat patients. He talked about
when he was living in Chicago, he talked about a patient of his who
had incredible complications. The guy couldn't find help in
Pennsylvania, so the man drove all the way out to Chicago to be
treated by Greg. That says a lot about Greg. It says a lot about his
patients. And unfortunately it says something bad about the health
care system, when liability costs are such that you can't get the
kind of care that you need in Pennsylvania.
You're not alone, though. It's not just your state that's got a
problem. We heard from an OB/GYN in the state of Florida about how
she couldn't get insured. And in Nevada, pregnant women sometimes
have to leave the state to find a doctor. One woman called more than
50 local doctors and couldn't find one to serve her. So she's going
to go to Utah to have her baby.
I was down in Mississippi recently to talk about this issue.
There's a doc and his wife who's also a doctor, who came from up
north down to Mississippi in the Delta region of that state. And the
Delta region has got a lot of people who hurt, a lot of people who
are needy, a lot of people who need health care. And they went, not
to build a giant portfolio of wealth; they went because they got
great hearts. They heard a calling. They heard he would have
attributed it to the Almighty. Having watched him, I would have
attributed it to the Almighty, too. He has got a fantastic heart to
him. I could see that he was inspired. He told me he's leaving the
Delta because the trial lawyers ran him out. He couldn't practice
medicine without getting sued.
Something's wrong with the system. And a broken system like that,
first and foremost, hurts the patients and the people of America.
(Applause.)
Twenty percent of hospitals nationwide have had to cut down on
certain services -- on delivering babies, or neurosurgery, or
cardiovascular surgery, or orthopedic surgery. That's a fact. So the
problem is not only for Pennsylvania, it's a problem for our
country.
And there's another cost driver. And if you're worried about
getting sued all the time, then there is the natural tendency to
practice what they call defensive medicine. In other words, you
order tests that someone may not need, to protect yourself in a
court of law. And that's costly, and that's one of the main reasons
why costs are going up. These lawsuits have got a lot of effects on
our country, and we've just got to understand that.
This is an incredibly important issue for states. I obviously
hope the state of Pennsylvania is able to address it. That can
happen in the statehouse. When I got to Washington, I said, that's
an important issue for the states. And then it didn't take me long
to realize, this is an important issue for the federal government,
too, and I'll tell you why. (Applause.) The direct cost of
malpractice insurance and the indirect cost from defensive medicine
raise the federal government's health care cost by at least $28
billion a year. Malpractice, defensive practice of medicine affects
Medicare, Medicaid, veterans' health, government employee costs. It
affects the federal government. Therefore, it is a federal issue.
(Applause.)
It is a national problem that needs a national solution.
(Applause.) And here it is -- first, let me just say this as clearly
as I can -- we want our judicial system to work. People who have got
a claim, a legitimate claim, must have a hearing in our courts.
Somebody who has suffered at the hand of a lousy doc must be
protected. And they deserve a court that is uncluttered by frivolous
and junk lawsuits. If they prove damages, they should be able to
recover the cost of their care and recovery and lost wages and
economic losses for the rest of their life. That's fair. That is
reasonable. And that is necessary for us to have confidence in the
medical system and in the judicial system. (Applause.)
Yet, for the sake of affordable and accessible health care in
America, we must have a limit on what they call non-economic
damages. (Applause.) And I propose a cap of $250,000. (Applause.)
Otherwise, if not, excessive jury awards, like those in
Pennsylvania, and those I was just -- one was just described to me
-- today a guy held up a full-page ad in your newspaper paid for by
the excessive jury award. (Laughter and applause.) Excessive jury
awards will continue to drive up insurance costs, will put good
doctors out of business or run them out of your community, and will
hurt communities like Scranton, Pennsylvania. That's a fact.
(Applause.) And that's why we need a cap on non-economic damages,
and that's why we need a cap on punitive damages, as well.
(Applause.)
As I mentioned to you -- and it's important for our citizens to
understand -- it is the fear of unlimited non-economic damages and
punitive damages that cause docs and the insurance carriers to
unnecessarily settle these cases. See, you can pretty well blackmail
a doctor into settlement if you continue to throw lawsuit after
lawsuit, and the system looks like a giant lottery. (Applause.)
Thank you.
There needs to be other reforms, as well. A lot of times, these
lawyers will sue everybody in sight in order to try to get
something. In cases where more than one person is responsible for a
patient's injuries, we need to assign blame fairly. We need joint
and several liability reform in our medical liability system.
(Applause.)
We need to make sure that doctors can take care of their patients
without fear that their advice will be used against them some day.
It's hard to believe a system (applause). You hear a lot about the
doctor-patient relationship -- it's an incredibly important
relationship, in order to make sure we have a health care system
that functions well. And yet imagine a system where docs can't share
information amongst each other, much less talk to your patient, for
fear that what they say will be used them -- in court one day.
The system is not balanced, if that's the case. The system is not
fair. The system doesn't need to have a relationship with the doc
and the patient for fear of what is said will be used by a lawyer to
sue them. That's why we need these reforms, for the good of the
country.
We got the bill passed out of the House, thanks to Jim and the
members of the delegation here. And I want to thank you for your
leadership and your vote. (Applause.) And the Senate didn't act on
it, so we've got to start over. And I'm ready to start over.
(Applause.) And the time is getting worse. That's what people have
got to understand up there in Washington or over there in Washington
down there in Washington, whatever. (Laughter.) Thought I was in
Crawford for a minute. (Laughter and applause.)
And this is I repeat, this is a national problem and we just
cannot allow a bunch of needless partisanship to prevent a good,
solid solution from going forward. (Applause.) And let me say one
other thing. This problem won't be solved by just throwing money at
the problem. This problem will be solved by getting at the source of
the problem, which are the frivolous lawsuits. (Applause.)
If you're looking for solutions in Pennsylvania, look at states
which have done a good job of helping the patient out. California is
one example. More than 25 years ago, they passed a law that caps
damages from malpractice suits. And the law has worked.
Let me tell you a startling statistic. Reports from Philadelphia
say that juries there have awarded more in malpractice damages than
the entire state of California did over the last three years. That
says two things. California's law is what people in your statehouse
ought to look at, and you've got a problem in Pennsylvania.
(Applause.) There was a good news story in Mississippi. I went down
there and -- it wasn't because of me, it was because the doctors and
the citizens understand the cost of a trial system gone array and
they got themselves a law. And they got a medical liability law.
They put caps, real caps. Guess what happened? In some counties, the
malpractice claims rose dramatically before the law came into
effect. (Laughter.) Now, what does that tell you about the system?
It tells you the system is less about justice and more about
something that looks like the lottery, is what it looks like to me.
(Applause.) And with the plaintiffs bar getting as much as 40
percent of any verdict, sometimes there's only one winner in the
lottery. (Applause.)
We need reform. You need reform in Pennsylvania, and we need
reform all across America, and we need a law coming out of the
United States Congress. (Applause.) It's a law that recognizes the
centerpiece of good health care is to worry about your patient, the
American people. It's a law that will recognize that an affordable
and accessible health care system can best be had if we limit the
caps -- put caps on non-economic and punitive damages. That's what I
understands. (Applause.)
Congress needs to act on this law. Congress needs to listen to
the people and not make excuses as to why they can't get something
done. I believe we'll get something out of the House. I believe
we'll get us a good law out of the House. And then the Senate must
not fail its responsibilities to the American people again.
(Applause.)
And you can help. Every state's got them a couple of senators.
(Laughter.) And they need to hear from you. I consider your two
senators allies, but they need to hear from you. Every state, people
who are concerned in every state about whether or not they're going
to have affordable health care, or health care at all, need to
contact the people that represent them. See, democracy can work.
Democracy makes a difference. When the people speak, the folks in
Washington, D.C. listen. (Applause.) And I'm here to ask you to join
in this important cause, for the sake of people you care about --
your loved ones and your neighbors and the people in your
communities.
No, we've got a lot of problems facing America. We've got the
responsibility to make the world more peaceful. We have the
responsibility to make sure our homeland is secure. We've got the
responsibility to make sure every child is educated. We have a
responsibility to make sure our health care systems work. We've got
a lot of problems. But I'm going to tell you something about this
country. In my mind, there is no doubt that we won't solve these
problems, because this is the greatest nation, full of the finest
people, on the face of the Earth.
Thank you for coming. May God bless. Thank you all.