SENATOR PAT ROBERTS

Home State: Kansas

TESTIMONY

I would like to thank you all for joining us today to discuss an issue of great importance to the state of health care in this country. The Bipartisan Patient Protection Act of 2001 sponsored by Senators John McCain and Edward Kennedy attempts to tackle many issues concerning many players in the health care system including providers, patients, and insurers. The issue that we will be discussing today, health plan liability, is an important one and has implications for all players and stakeholders in the health care industry.

I must say that there are some provisions in this legislation that concern me because of the possible effects that a patient*s power of suing will have on my constituency. Now, I am all for patient*s rights and believe that aggrieved patients should be recompensed. However, I am against legislation that will encourage frivolous and unnecessary legislation.

As a public servant from the state of Kansas, I have been focusing on rural health care and making sure that my constituents living in rural locations have access to quality health services. Over thirty percent of the Kansas population lives in rural areas. And thirty percent of Kansans are families bringing up children. In addition, farming is an important industry in Kansas and employs many of my constituents. As a member of the Agriculture, Nutrition, and Forestry Committee, I understand how difficult it is for farmers, the self-employed, and small employers to obtain insurance. So, I am cautious of any piece of legislation that can make health insurance even harder to obtain. My job is to look out for the people that I represent including workers, farmers, families, health care providers, etc.

There are several questions and issues that I would like clarified today. I am mostly worried about the additional health care costs that can stem from increased litigation against health plans. The proposal does not place limits on damage awarded in state courts and none in federal courts and from research that I have reviewed, this can lead to an increase of costs and liability of insurance plans and employers. We have all already heard about double-digit percentage increases in premiums this year and it would be impossible for small employers in Kansas to afford even higher cost increases. Small employers are already struggling to offer health coverage to their employees and it seems that this act could lead to more small employers and even medium-sized ones dropping the option of health coverage.

This in my opinion would exacerbate the problem of the uninsured. Small, rural hospitals and providers as well as the uninsured will be negatively affected. Some people in Kansas already have to make a thirty-minute drive to the hospital and the possibility of losing any kind of coverage that they have will serve as a disincentive to seek health care. Small hospitals have already suffered from Medicare and Medicaid reimbursement cuts. Lower rates from health plans would be an even harder blow.

Another unsettling issue is that this proposal of Kennedy and McCain would allow patients to bring cases to state and federal courts. To my understanding, state courts will hear cases on disputes over medical judgments and federal courts will hear cases over contractual disputes. As a proponent of small government, this should be handled on only one level in my opinion. President Bush has suggested that cases only be heard in federal courts. Naysayers have said that Bush just wants to move claims to federal courts because they tend to be more "defendant-friendly" and doing so would impose a lower damages claim. I honestly believe that hearing cases in federal courts only, will lead to less variability among decisions and rewards.

We should look at putting a bigger emphasis on exhausting the appeals process before a case goes to court. Slow and costly legislation to patients, insurers, employers, and taxpayers should be a last resort. Of course expensive litigation and the resulting rise in health care costs would only make it more difficult for Americans to afford health care coverage in the first place. Business interests should also be protected. Employers should be shielded from lawsuits. I agree with President Bush that a decision should be made first by an independent medical review board not associated with the health plan in question. And if the review decides that a patient was wrongly denied needed medical care, the patient should be allowed to take the case to federal court.

Today, I hope that we all can fully discuss the reverberations of the liability provisions in this legislation. I have put forth my thoughts on this issue. Hopefully, we can all compromise in the future and develop something that will protect patients as well as not damage employers and health plan providers. I definitely want to ensure that doctors are allowed to make proper medical decisions without being restrained. However, the interests of all involved must be considered.

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