Although I know there has been
a level of controversy over a recent letter from
my campaign to the legal community, I truly believe
that there are far more areas of public policy
that unite us than there are that divide us. I
wanted to put in writing my thoughts about several
aspects of health care policy, outline a number
of areas where I am working hard on the medical
community’s behalf and address the controversy
But first let me
say that I have always valued my working relationship
and open communication with Metro area physicians.
It is something that is very important to me,
and I want that to continue in the years ahead.
I meet frequently with physicians and, incidentally,
I like to do so at the physician’s office
so I can see the application of Federal rules
and regulations with my own eyes. The recent controversy
might prompt some to think I am “anti-physician”.
Nothing could be further from the truth.
the American Medical Association’s “Federal
Advocacy Agenda” specifically lists me as
voting on the side of physicians four out of five
key measures. That’s one reason
why I have continued to receive support from the
AMA in my congressional race. Also, I believe
it is relevant to point out two things: 1) I serve
on the House Energy and Commerce Committee, which
has primary jurisdiction over many aspects of
the nation’s health care system; and 2)
I am a member of the majority party. Quite simply,
this puts me in a position to help construct a
legislative agenda that will prevail in the U.S.
House of Representatives.
When physicians from
Douglas and Sarpy County give me information,
I pay attention to it. This open communication
is a major reason I supported a doubling of the
budget for NIH as well as cosponsored numerous
bills of importance to the medical community,
including H.R. 1068, the Pancreatic Islet Cell
Act, and H.R. 1622, which changes the payment
mechanism for chemotherapy.
Medicare and Physician Payments
I am a very strong
proponent of the Medicare improvements sought
by the AMA and enacted by Congress last year.
The law includes substantial changes in the way
physicians are treated under the program. For
instance, prior law was going to reduce the Medicare
reimbursement rate by nine percent over the next
two years. We scrapped that cut, and actually
provide an increase in each of calendar year 2004
and 2005. In doing so, we “swung”
the rate issue 18 percent in favor of physicians!
We also wrote into law new protections for physicians
in dealing with overpayments, and took action
to reduce paperwork requirements and unnecessary
One area of the
new law that I take a great deal of pride is the
development of upfront preventive care.
We authorized, beginning in 2005, Medicare coverage
of many new preventive services, including a diabetes
screening test, an initial preventive physical
exam, adult immunizations, an electrocardiogram,
pelvic exam, mammograms, pap smears, and other
Finally, I would
like to address an issue that arose recently—my
position on federally imposed caps on damages.
The issue before the U.S. House in H.R. 5 was
whether Congress should unilaterally mandate a
nationwide cap. The primary reason I opposed the
bill was that I believe this is an issue that
should be left to the states to decide. I don’t
have to tell you the damages that can be done
to states rights when the federal camel gets its
nose under the tent. It is not an overstatement
to warn that federal law has the potential for
overreach that would erase all state laws governing
I do believe
there is a crisis in malpractice insurance rates.
To this end, I drafted an amendment that would
ban punitive damage awards in medical error cases.
I’ve also discussed ways that we might create
a national reinsurance pool for specialties that
have the highest insurance costs. The overall
issue is extremely complicated and is driven by
many factors in addition to jury awards. We need
a comprehensive solution that includes incentives
for reinsurers to re-enter markets (something
they haven’t done as a result of 9/11),
as well as a realization that tort reform will
require all parties to give a little and compromise.
I assure you that I am open to looking at any
reasonable solution to the issue of excessive
increases in medical malpractice insurance premiums.
Thank you for taking
the time to review this material. As I mentioned
previously, I value a good working relationship
with local physicians, and want this open exchange
of ideas to continue in the future. If you have
any questions or comments, please feel free to
contact my campaign headquarters in Omaha.
Member of Congress