THE PRESIDENT: Thanks for that warm welcome, and thanks for coming
out today. I want to thank you all for fighting through the rain --
it's part of my drought relief program. (Laughter.) I do want to
thank you all for coming. I want to thank all your fellow citizens for
lining the road and being so gracious in their hospitality. I love
coming to North Carolina. It's a fabulous state, full of fabulous
people. I'm honored to be here. (Applause.)
And I'm glad my friend, Tommy Thompson came with me. He was the
governor of the state of Wisconsin, and then I convinced him to come to
Washington to head up the Department of Health and Human Services. I
did so because I understand he knows health issues, he knows welfare
issues, he knows a good system when he sees one and a system that needs
to be reformed when he sees one. And I'm glad that Tommy came to
Washington. He's doing a heck of a job on behalf of the American
people, and I want to thank you, Tommy. (Applause.)
I want to thank Richard Budd and all the folks here at High Point
University for giving me a chance to come and discuss some important
issues that face our nation. It's a beautiful campus. The gymnasium
could use a little air-conditioning. (Laughter and applause.) We're
trying to keep the hot air down to a minimum. (Laughter.) But we're
thrilled to be here on this fine campus.
I also want to thank Jeff Miller of the High Point Regional Health
System for -- (applause) -- we just had a fantastic and very
interesting discussion about problems that affect patients --
patients in North Carolina, health care patients in Nevada, problems
that affect our docs. And I want to talk about some of that in a
minute. But we just had a great discussion. I want to thank all the
doctors and my fellow Americans who were there to share with me their
stories, some of which I will share with you in a minute.
I appreciate Don Palmisano, who is the head of the --
President-elect of the American Medical Association out of New Orleans,
Louisiana, who flew in for this event. I want to thank you for being
here, Don, and I want to thank you for your support on the initiative,
which I'm fixing to talk about.
I also want to thank the Mayors of some of the communities here.
We've got the Mayor of High Point, the Mayor of Greensboro and the
Mayor of Thomasville. I appreciate all three Mayors coming.
(Applause.) I want to thank my friend, Elizabeth Dole, for coming over
today to say hello. I appreciate you being here. (Applause.)
I want to thank members of the North Carolina health and medical
community, all you who worry about your fellow Americans and who work
hard to provide good, quality health care. Thank you for coming here
today. (Applause.)
Every time I come to a community I like to herald some of the
heroes of the community. And today, when I landed in Air Force One,
there to greet me was a citizen named Jane Lambert. She's a -- she's
been volunteering here in this community for 50 years. She has been
working hard to make people's lives better. It didn't require a
government law saying, Jane, you will help people in need. It required
a good heart.
Jane has worked with Girl Scouts, she's worked through her church
to bring meals to people who need food. She is the kind of person I
call a soldier in the army of compassion. The truth of the matter is,
the reason I like to introduce the Jane Lamberts of the world is
because the great strength of America lies in the hearts and souls of
our fellow citizens who love (applause). So I want to thank Jane.
I think Jane is here. Where are you, Jane? Thank you for coming.
Thank you for your work. (Applause.) Thank you for setting such a
fine example, 50 years of service.
You know, I believe out of the evil done to America is going to
come some good. And part of the good is for people to understand that
serving something greater than yourself in life is a part of being a
complete American. And Jane shows us what that means.
The security of our country is on the minds of a lot of our
citizens. I want to talk a little bit about the security of America.
It first starts with the homeland security. You hear a lot of talk
about the President working with the Congress to set up the Department
of Homeland Security, and we are, we're working hard on that. I just
want to make sure that Congress understands that when we do create this
department, I've got to have the ability to manage the department in a
way to make the homeland more secure. I readily concede I didn't run
for office saying, vote for me, I promise to make government bigger.
So I'm not interested in something big, I'm interested in something
that works. (Applause.)
The number one priority of our government is to protect the
American people. We live in a new era. We're under the threat of
cold-blooded killers who hate America and hate our freedom. So our top
priority, in all levels of government, has got to be to protect
America. That's what we've got to do. I see some of our first
responders here, our police and EMS and firefighters. I want to thank
you for the work you do. (Applause.)
We've got work to do in Washington. You just need to know that
we've got a lot of good people, people who work for all levels of
government, working overtime, working hard, to chase down any kind of
lead that we get, any kind of hint. And we're following up on it.
Protecting our homeland is our most important priority. But the best
way to protect the homeland is to hunt the killers down one by one and
bring them to justice, and that's what this government is going to do.
(Applause.)
And I know this great state houses a lot of our military. And on
behalf of a grateful nation, I say thanks to those who wear our uniform
and to those who support those who wear our uniform. (Applause.)
And you need to know we're making pretty good progress. It's a
different kind of war. It's hard to measure the results of this war
based upon the old way of thinking. It used to be you could see tanks
moving across a plain and if the tanks made it to destination A it was
successful. This isn't the kind of war we're under. We're facing
international criminals who hide in caves, send youngsters to their
death, and think they can escape the long arm of justice of America.
But they're not going to. No matter how long it takes, no matter how
long it takes, this country will prevail. (Applause.)
And the reason why is we love freedom. We love the values our
country stands for. Anybody who wants to take our freedoms away is
going to find a determined and tough and patient nation.
Secondly, a lot of people in this country are worried about the
economy. They're worried about their job. I want you to know that I
believe the economy is fundamentally strong. Our economy is growing.
Inflation is low. We've got lower taxes which help people keep their
own money. And when you have your own money, it means you've got more
money to spend. And when you spend that money for a good and service,
it means somebody is going to provide a good or service for you. And
as they provide a good or service, it means somebody is more likely to
be able to find work.
We've got the fundamentals for economic growth are strong.
Employment is stabilizing. It looks like I'm going to have a bill on
my desk very soon which will bring reforms to our corporate sector,
which will mean that there will be accountability for chief executive
officers, and accountability for those who count the numbers to make
sure that our investors and employees across America feel confident in
what they're being told from corporate America. (Applause.)
It's a good piece of legislation. I look forward to signing it.
In the meantime, you need to know that this administration will
investigate, will haul in, and will prosecute any CEO which breaks the
law. (Applause.)
The foundation for growth is there. But one of the things I think
we understand is that without health security, there's no economic
security. If we're not confident about our health care system, we
won't be confident about the future of our country. And we've got a
problem. Right now, rising health care costs are undermining the
availability of health care, of medical care not only here in North
Carolina, but throughout our country. And the rising costs were
forcing too many people to go without, and that's not right, that is a
problem. And we need to address it soon rather than late.
As Tommy just told us, the report he put out from the Department of
Health and Human Services shows that our badly broken medical liability
system is responsible for higher costs for patients, for lower quality
of care, and for decreased access. And I worry about it. I worry
about it in big town America and I worry about it for small town
America.
I don't appreciate the fact that we see a health care system that
is broken and riddled with bad -- bad law and we're not moving. And so
one of the reasons I've come to North Carolina today is to lay down
what I think we need to get done and call upon the Congress to act as
quickly as possible to help us solve these problems. (Applause.)
We're working hard to give more and more Americans access to
quality care, and here are some of the initiatives. America's seniors
need an improved Medicare system which includes prescription drug
benefits. (Applause.) And a system which trusts our seniors to make
the right decision for themselves. (Applause.)
Medicare has worked in the past. Today, it is outmoded. It is
antiquated. It is a great idea that needs to be modernized. And we're
making progress. The House passed a bill, the Senate is squabbling
about one right now. I think they can get something done. I hope I
can report to the American people that we've finally begun to modernize
Medicare to include prescription drug benefits for all seniors.
(Applause.)
Secondly, we need to allow small business owners to pull insurance
risk across jurisdictional boundaries. A restaurant in Raleigh, North
Carolina, ought to be allowed to pool the risk with a restaurant in
Crawford, Texas, so that the small business owner and his or her
employees can have affordable health care insurance. (Applause.)
We need personal health accounts to let workers pay smaller monthly
premiums and save money for their medical costs. In other words, we've
got to trust patients, we've got to trust the American people with
their own money, to make their own decisions that best suit them for
medical care. (Applause.)
And too many Americans are uninsured; I understand that. And
that's why I called upon Congress to enact tax credits to enable the
uninsured to buy the health care coverage they need, and at the same
time, to expand what we call community health centers to provide
quality care for low-income Americans. You see, we've got to make
sure, for the efficiency of the system, that those poor folks who do
not have health care get health care, but not in the emergency rooms
all across America. The most efficient way to provide health care --
(applause) -- is in community health centers.
We're also, as you well know, getting a lot of health coverage to
low-income Americans, to Medicaid and uninsured children through
Children's Health Insurance Programs. And we're working hard to make
sure health care is available, quality health care is accessible. Yet,
any progress being made is being undermined, dramatically undermined by
rising health care costs.
And one of the main reasons that costs are rising is a broken
liability system. And that's what I want to talk about today, what we
ought to do about it. First, too many lawsuits filed against American
doctors are being filed that have no merit. Too many lawsuits filed
against our doctors have no merit. But since it costs so much for
doctors to defend themselves, they often settle cases, even though they
have not committed a medical error.
And the unpredictability of our liability system means that even
frivolous cases, even what we call junk lawsuits, carry the risk of
enormous verdicts. In either case, health care costs rise for all of
us. And you just need to know that.
Another cost driver is that the fear of even baseless lawsuits
causes good doctors to order excessive tests and procedures and
treatments. It's called defensive medicine. If you think you're going
to get sued, you do everything you possibly can to prevent the trial
lawyer from coming after you. Unfortunately, that costs patients a lot
of money.
Health care costs are up because docs are worried about getting
sued and, therefore, oftentimes prescribe unnecessary and costly
treatments. Even when legitimate cases go to trial, the current system
often doesn't serve the patient. Legal procedures are slow; it takes a
long time. They can be very wasteful. And sometimes the lawyers take
up to 40 percent of the verdict -- 40 percent. And while patients
injured by a doctor's malpractice deserve fair compensation, there are
too many cases of grossly excessive jury awards. And you know what I'm
talking about. You hear them all the time these days. Massive numbers
laid out there.
The thing that Americans have got to understand is every one of us
pay for those awards. Those excessive jury awards cost us all money,
and it's part of why rising -- why there's rising costs in the health
care system.
Some insurers are now dropping medical liability coverage for
doctors. Because of the system, insurers no longer insure docs. And
they're hiking premiums, as well. In your state of North Carolina, as
well as eight other states, at least two companies raised liability
insurance premiums more than 30 percent this year. You pay; you pay
either as a patient or you pay as a taxpayer. Higher and higher --
because, the reason you pay as a taxpayer is because your government is
paying a lot of health care bills.
Higher and higher insurance premiums make it nearly impossible for
a lot of doctors to practice medicine. And if docs don't practice
medicine, it's hard to have good health care. Without insurance, they
cannot afford to treat patients. Without insurance, the trust between
doctor and their patients becomes a broken trust.
Today I mentioned I had a discussion with some of the medical care
providers and patients. There was a doctor here from Nevada. I don't
know if you've been reading about what's taking place in Nevada, but
they've got a real problem. As a matter of fact, an entire trauma
center shut down because of medical malpractice.
The fellow's name is Dr. Shelby Wilbourn, OB/GYN in Las Vegas. He
had never been sued. He had never had a claim filed against him. Yet
this year's insurance premium went from $33,000 to $108,000. The
system needs to be fixed. This poor fellow who had borrowed money to
get out of medical school faced a choice. Does he want to run up a
bunch of debt because somebody has threatened a lawsuit on him, or does
he want to continue to practice his love, which is helping people,
healing people? And so at the end of the month he's closing his
practice in Nevada and he's moving to Maine, because the cost of doing
business are about a quarter of what they were in Nevada.
The trial lawyers, suit after suit after suit, have driven this
good man out of Nevada. But more significantly, there are hundreds of
patients who will miss his care.
Jill and Chet Barnes are with us. Jill is a student teacher and
her husband is a fireman actually, the fireman is not here; Jill is
here. They live near Las Vegas where her doctor left his practice in
the state of Nevada because of high malpractice insurance rates. She's
eight weeks pregnant. She talks about the inability to find a doc.
That's got to be really frightening for a young mom not to be able to
find a doctor with whom she can consult.
She said that she found one doctor, but there's a limit to the
number of deliveries this doctor can agree to take because of
skyrocketing medical malpractice premiums. She now is driving to
Arizona for an hour and a half she's a teacher, and she's driving to
Arizona to get her prenatal care. And she's worried. The medical
system is hurting because of a lot of lawsuits driving up the cost of
business. It's also making it hard for a lot of Americans to find
quality care.
Lauri Peel had trouble finding a doc when she moved to Raleigh,
because a lot of the practices were full. Then she ran into Dr.
Schmitt. He's a nice fellow, OB/GYN, he agreed to take her on as a
patient. They got a wonderful relationship. He helped her a lot. He
decided recently to go to Virginia, because of the high liability
premiums here in North Carolina. He said it's no longer fun to
practice medicine here. Not just here, it's no longer fun to practice
medicine when there's a constant threat of a lawsuit hanging over your
head. (Applause.) Lauri has to find a new doctor she can trust.
Lauri's looking for a doc right now. Yet another compelling, real life
story about what's taking place all across the country.
Fear of lawsuits is awful -- also stifling innovation and the
improvement of health care, which means sometimes patients aren't
getting the best care possible. Here's why: If a hospital and a
doctor share information about how they can serve their patients
better, under the current systems, lawyers can use those discussions
and that information to file lawsuits. If you sit down to decide how
best to improve the practice, that becomes a piece of evidence in a
lawsuit. And therefore, a lot of good folks, like the good folks at
High Point Regional Health System, think long and hard about making
changes.
I met with Paula Szypko today. She's a fine doctor. They've been
warned any time they write anything down about improving the health
care in this town, it can be given to lawyers who are fishing for
lawsuits. And that's not right, it's just not right. The system is
broken. It puts a burden on taxpayers, and we need to do something
about it.
People say, well, is it a federal responsibility? Should the
federal government act on this problem? And the answer is, yes. And I
tell you one clear reason why, besides my deep concern for our fellow
citizens and whether or not they can find health care. The federal
government uses taxpayers' money to fund health care programs --
Medicare, Medicaid, children's health care, veterans' health care,
military health care. And any time a frivolous lawsuit drives up the
cost of health care, it affects the taxpayers. It is a federal issue.
(Applause.)
It is estimated that frivolous lawsuits drive up the cost of
government health programs by over $25 billion every year. It's a
national problem that requires a national solution. And it is my honor
to come here today to describe what I think that solution is. The
federal government ought to set a minimum federal standard to reform
the medical liability system. That's what we ought to do. (Applause.)
We must, of course, protect any injured patient's right to a fair
trial and fair compensation, including full compensation for economic
damages. Anybody who goes into court and wins their case ought to get
full economic damages. At the same time, we must prevent excessive
awards that drive up costs, encourage frivolous lawsuits, and promote
drawn-out legal proceedings. And that is why we need a reasonable
federal limit on non-economic damages awarded in medical liability
lawsuits, and the reasonable limit in my judgment ought to be
$250,000. (Applause.)
And we need a cap or a reasonable limit on what they call punitive
damages. Doctors ought not -- ought to be judged based upon clear
misconduct. And our federal government ought to put a cap on punitive
damages, as well.
And finally, it's important to understand that in many cases, the
current system forces doctors to pay damages for harm they do not
cause. And, therefore, we need what was called joint and several
liability reform in Washington, D.C., as well. (Applause.)
And finally, this law ought to include the ability for doctors to
evaluate and hospitals to evaluate their practices so they can approve
care without having the discussions discoverable for lawsuits.
(Applause.) I mean, what we've got to focus on in America what
we've got to focus on is what's best for the patients. And what's best
for patients is affordable health care. (Applause.)
We can get this job done. In California, when they had a problem
with their medical malpractice insurance premiums, they put a law in
place, and it worked. This is a reasonable law. This says that what
we want is quality health care, not rich trial lawyers. What we want
is people to feel comfortable with their system. (Applause.) People
who are injured ought to be able to take their case to court; no
question about it. But we've got to understand that frivolous lawsuits
clog our courts and deny people with legitimate claims.
Doctors who practice bad medicine ought to be held accountable; no
question about it. It's important for the system that they be held
accountable. But what we need is a system that doesn't drive people
out of medicine, and doesn't hurt patients. And the federal government
needs to act and the Congress needs to get a bill to me before they go
home next this late fall. A bill that will protect the American
patients from medical malpractice. (Applause.)
I believe that when we pass this law, the system will be much
better and people will feel more secure. And that's what I'm
interested in. I want the homeland to be secure; I want our fellow
citizens to feel economically secure; I want the health care systems to
continue to be the best in the world.
You know, I like to remind my fellow citizens of this: When the
enemy hit us, they thought they must have thought they were hitting
a weak nation. Speaking about lawsuits, they probably thought all we
would do was file a lawsuit. (Laughter.) They didn't understand
America, did they? They didn't understand when it comes to defending
freedom, we're plenty tough. But what they didn't also understand is
that out of this evil done to our country we believe can come some
good.
See, one of the interesting things that's happening in this country
is that people understand that to be a patriotic citizen no longer
means putting your hand over your heart -- and by the way, saying, "one
nation, under God". (Applause.) Thank you. But being a patriot
means you're willing to help a neighbor in need, to serve something
greater than yourself in life. That's what a patriot is.
You know, I was out at the airplane today, and I met the dad of a
young boy and girl whose wife, Sandy, was on Flight 93. And Phil was
there, and I appreciate him being there. And it just reminded me,
seeing Phil Bradshaw, that the country understands that when you serve
something greater than yourself in life, it's a part of being a great
citizen. Obviously, these citizens made the ultimate sacrifice of
personal responsibility, taking an airplane into the ground to save
somebody's life. But I believe that out of the evil done to America is
going to come some incredible good, as people realize that serving
something greater than yourself in life is a noble calling and
important part of being an American.
So today, as I want to thank you again for coming, I hope that if
you see somebody in need, you'll help them. If you find a child that
can't read, help them read. If you know a shut-in who needs somebody
to love them, tell him you love him. If you're a mom or a dad, love
your children with all your heart and all your soul. It's a -- this
country has got problems, but we're going to solve them, because we're
the greatest country on the face of the Earth. Thanks for coming. God
bless.