Washington, DC – Congressman John D. Dingell (D-MI15) spoke to the annual legislative conference of the American College of Cardiology in Washington, DC this morning.  Below is a copy of his remarks as prepared for delivery.

“Thank you for inviting me here this morning. It is always good to be among friends, and the American College of Cardiologists have been long-time friends of mine. I especially want to thank Dr. Doug Weaver for the kind introduction. He is a fine doctor and great friend. I want to thank Dr. Jack Lewin, president of the American College of Cardiology for his leadership and all of the staff at the American College of Cardiology, especially Nick Morse, for organizing today’s event.

“Our friendship throughout the years has been a natural one because we both believe that our American health care system is made up of the finest professionals in the world. We have always believed that all patients deserve high quality, affordable care and that physicians should be rewarded for putting their patients first.

“This past year has been an exciting one for me and for people who care about our nation’s health care system. We achieved something that I have been working on for a number of years.  For years our people and our doctors have been victims of insurance companies that focus solely on profit; oftentimes neglecting health quality.  The new health care law does a number of good things to address this concern. No longer will people face discrimination because of a pre-existing condition, no longer will lifetime caps lock people out of care, and in a few weeks it will be illegal for an insurance company to drop people someone who gets sick.

This new law has already helped small businesses provide coverage to their workers, reduced the cost of medicines for seniors who fall in the Medicare prescription drug coverage gap, allowed companies to keep insuring their early retirees, and given people with pre-existing conditions a place to purchase health insurance.
 
“These reforms have been a long time in the making and they will benefit a great deal of American people. Yet, as we know, the health care reform law is not perfect. No piece of legislation ever is. The last perfect law was handed down to the Israelites on stone tablets at the base of Mr. Sinai and it was written by the fingers of God. 

“The work we do in Congress is evolutionary. Our duty is to pass the best legislation possible and continually improve it. So as we move into the Fall and beyond there is more to do.  We will have to make changes to the health reform law we passed – tweaks, fixes, and improvements.  But fundamentally, the law is strong and we will make it even stronger over time.
           
“I can’t stand up here today and predict what health care issues Congress will take up next. I often say that I am a legislator, not a fortune teller. However, I do know that one of the first items on my agenda, and one I know ranks highly on yours as well, is permanently reforming the Sustainable Growth Rate or SGR. For ten years we have been kicking the can down the road, waiting for another day to make tough decisions and solve the problem. Failure to act is unfair to physicians, who deserve adequate, consistent compensation for the care they provide, and most importantly to patients, who deserve the right to enjoy uninterrupted access to their doctors.  The harsh reality is that failure to act is also a drag on the federal budget.  Due to our failure to fix this problem permanently the price tag has grown each year.  In 2005, the cost of fixing the problem was $48 Billion.  Last year—just four years later—the cost was $210 Billion.  We can no longer kick the can down the road—that is fiscally irresponsible.

“I authored legislation that would provide a permanent fix to the current SGR formula, H.R. 3961, the ‘Medicare Physician Payment Reform Act.’  Last November, the House passed this bill and sent it to the Senate. Too often the Senate is the place where good legislation goes to die. And my friends, that happened with this bill almost a year ago.

“As Congress gathers back this week, I will continue to urge my colleagues, both Republicans and Democrats in both Chambers to utilize the time between now and November to find a solution. We must permanently fix this problem to ensure our seniors and military service members and their families will have access to the same doctors they have today.

“I also intend to continue to work with my colleague Charlie Gonzalez to continue fix the Medicare Physician Fee schedule so that you and your colleagues are not cut unfairly due to a flawed payment schedule study.  I know that this is something that you are very concerned about and I share your concerns.

“Another unresolved issue that Congress needs to address is medical malpractice. There is much passion on each side of this issue. However I think we can and must find a third way solution.

“On March 5, 2009, the President hosted a White House Forum on Health Reform to officially kick off the health care reform debate. At this forum I raised my desire to include medical malpractice reform as part of our broader healthcare efforts. I said then, and still believe now, that reducing defensive medicine is a cost saving measure. Despite the rhetoric on each side, facts show that medical malpractice premiums continue to be one of the highest practice expenses for some physicians, and fears of medical malpractice claims lead doctors to practice defensive medicine or even limit some procedures. Just last week, Health Affairs published a study showing that medical liability added $55.6 billion to the cost of health care in 2006. Furthermore, $45.6 billion of that total cost was attributed to defensive medicine by doctors who ordered unnecessary procedures, treatments and tests in order to protect themselves from lawsuits.

“The new health care reform law made commendable strides that begin addressing this issue. Through new grants states will have the flexibility to experiment with innovative ways to reduce defensive medicine. Even prior to the enactment of the law, the Obama Administration showed its commitment to reform by launching the Patient Safety and Medical Liability initiative to increase patient safety, foster better communication between physicians and patients, and reduced liability premiums.  I applaud this initial step because there is a lot we can learn from institutions across the country who have decided to lead the way in medical liability reform.

“For example, in my district, the University of Michigan Health Care system reduced malpractice claims by 55 percent between 1996 and 2006 with their policy of full disclosure and compensation for medical claims. Not only did malpractice claims drop, but U of M also found a 61 percent decrease in spending on legal defense costs, and have witnessed a change in culture that puts honesty and patient safety first. This is one example of a common sense solution that can benefit patients and doctors.

“These policies are welcome advances, but are not enough.  We must continue to work toward careful, balanced and targeted legislation that will serve the interests of both physicians and their patients, not medical malpractice insurance companies.
           
“Let me be clear, I am not, and have never been in favor of caps on malpractice damages. I believe these caps are unfair to patients who have been wrongfully harmed. However, there are steps we can make that put patients and doctors first, and reduces the runaway costs associated with defensive medicine.

“In 2005, I introduced the “Medical Malpractice and Insurance Reform Act of 2005.” This bill would:

• Weed out frivolous lawsuits and stabilize our court system while protecting the rights of patients and doctors;
• Create an independent commission to examine every aspect of the current insurance crisis, propose additional solutions, and make recommendations to avoid any future malpractice insurance crisis;
• Create a new administration within the Department of Health and Human Services to collect data about medical malpractice insurance markets that are not currently centrally collected; and
• Require malpractice insurance companies to pass along savings from the legislation directly to healthcare providers.

“I think that it is time we dust off this bill and hope to work with you and other interested parties on developing common sense solutions to this problem.

“Let me conclude today by saying the passage of the Affordable Care Act was one of my proudest moments in Congress. However, it would be unwise to think that our work is complete. We will need your help and partnership to make it better.   Where there are legitimate concerns with implementation, I want to be the first to know.  The promise of the new law will only be realized by us working constructively together.

“Thank you again for inviting me to be with you this morning. I look forward to your questions.”