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July 02, 2003Independence Day for Health Care? Independence Day could take on additional significance if Republican efforts at health care liability reform meet with success beginning next week. These efforts could assure the independence of access to affordable health care for generations to come by reducing the effects of escalating liability costs. On July 7, the United States Senate will begin debate on SB 11 (Frist), appropriately named the “Patients First Act.” On July 15, the Tennessee Senate and House will begin deliberations on our own version of this important initiative, SB 605 (Norris). If the federal legislation passes, it will govern; if not, adoption of the Tennessee legislation is even more imperative. Both bills are designed to protect patients’ access to quality and affordable health care by reducing the effects of excessive liability costs. Both are premised on the understanding that our current civil justice system is adversely affecting patient access to health care services, better patient care, and cost-efficient health care. As stated in Senator Frist’s legislation, the health care liability system is a costly and ineffective mechanism for resolving claims and compensating injured patients, and it is a deterrent to sharing information among health care professionals. This impedes efforts to improve patient safety and quality of care. Like Senator Frist’s initiative, our legislation caps liability for non-economic damages, restricts the recovery of punitive damages and imposes limitations upon attorneys’ contingency fees in order to encourage prompt and efficient resolution of malpractice claims. Some of the reforms proposed in Washington are already in place here in Tennessee, but more reforms are necessary. Senator Frist and I believe these reforms are necessary in order to “(1) improve the availability of health care services in cases in which health care liability actions have been shown to be a factor in the decreased availability of services; (2) reduce the incidence of ‘‘defensive medicine ’’ and lower the cost of health care liability insurance, all of which contribute to the escalation of health care costs; (3) ensure that persons with meritorious health care injury claims receive fair and adequate compensation, including reasonable non-economic damages; (4)improve the fairness and cost-effectiveness of our current health care liability system to resolve disputes over, and provide compensation for, health care liability by reducing uncertainty in the amount of compensation provided to injured individuals; and (5) provide increased sharing of information in the health care system to reduce unintended injury and improve patient care.” Over 75% of Americans now feel that such reforms are warranted and that their independence is threatened by the prospects of rising health care costs as a result of a system out of kilter with reality. As a result, we must improve upon the law so as to safeguard those in need of health care as well as those who have been injured. As the prime sponsor of Tennessee reforms and a member of the Joint Legislative Study Committee which begins deliberations here at home this month, I encourage everyone to engage in this debate by paying close attention to the proceedings in Washington as well as those in Nashville. These reforms are opposed by powerful lobbyists for the Trial Lawyers and are threatened by the status quo. Write your Senators and state legislators. Express your opinions in letters to the editors of your local newspapers. This Independence Day, let us be thankful for our freedoms and hopeful for the freedoms yet to come. Reflections on Republican Budget Reforms
For the first time in recent memory, State expenditures actually decreased according to the Administration. With the notable exception of TennCare, across the board cuts, which most Republicans have called for since I took office, were finally implemented. As a result, we balanced the budget without raising new taxes. The governor calls it “the family budget” because, over time, Republicans forced the State to do what we must to do in our own homes to make ends meet: live within our means. Republican reforms were finally adopted largely because we consistently held the line against increased spending and the unconstitutional income tax. This resulted in candidate Bredesen pledging last year not to support a state income tax which made him indistinguishable from his Republican opponent on fiscal issues. By the time he took office this year, he really had no other choice. This conservative approach to budgeting came none too soon. In a special report by USA Today on June 23, Tennessee’s performance in spending and taxing wisely between 1997 and 2002 ranked “Poor.” Only Mississippi and Montana were worse. The study concludes that states’ fiscal problems had less to do with the economy than the ability of governors and legislators to manage money wisely. Those states which did best did so by cutting their budgets. That is all most Tennessee Republicans ever asked for. Unfortunately, rather than cutting all programs equally, the governor increased spending for TennCare by $350 million in this budget because he needs time to try and fix it. Most Republicans have given the governor, a former health care executive, the benefit of the doubt. But this increase was funded, in large part, by withholding State shared taxes from local governments. As a result, many local governments will lack funding to provide essential services without, in turn, raising property taxes here at home. If local taxes increase in coming weeks, TennCare is largely to blame. Republicans attempted to balance the state budget without raiding local coffers by reducing TennCare’s increase, now a $7 billion annual expenditure, a mere $30 million. If Republicans held a majority in the Senate and House, this could have been accomplished without raising local taxes. But Republicans fell one vote short in the Senate. Although I supported the other cuts, TennCare should not have been spared at the expense of local governments. I voted against the budget because it was wrong for Tennessee to balance its budget on the backs of local taxpayers. In addition, I passed Senate Bill 998, nicknamed “Fix It or Switch It,” which requires the Administration to report to the General Assembly on or before January 15, 2004 whether TennCare is truly viable. If not, what is the plan for converting TennCare to a cost-effective program which fosters, rather than frustrates, access to affordable health care? If TennCare is not tamed, costs will continue to escalate while doctors and hospitals go unpaid, and thousands of Tennesseans will continue to go without health care. Governor Bredesen admits that cuts to other programs are painful; so painful that some Democrat leaders were reported to invoke scripture. “We reap what we sow,” one member reportedly lamented. If we truly reap the discipline to live within our means, including a solution to TennCare, Republicans and right-thinking Democrats might invoke a little scripture of their own one day soon: “Rejoice and be glad in it!”
I want to know what you think and mailed several thousand questionnaires throughout West Tennessee in June to find out. We have been receiving about one hundred written responses daily. I also receive daily internet responses from the same questionnaire posted on my website. If you did not receive my questionnaire by mail but want to weigh in with your opinion, please visit www.marknorris.org and take the interactive survey. The responses should be fully tabulated and results posted next month. Stay tuned! |
