dr. hoven is from kentucky. dr. weinstein is from iowa.kentucky is one of the four states that constitutionally prohibit limits on damages, but there are other states,arizona, thnnsylvania, wyming, including trauma centerh provided such excellent care to our colleague, gabby giffords, are , the gentleman from arizona, m franks, for his opening statement and then we'll go to the ranking member of the constitutional law subcommittee. >> well, thank you, mr. chairman. mr. chairman, the medical liability litigation system in the united states, i think, by all accounts is broken and in desperate need of reform. the current system is as ineffective a mechanism for adjudicating medical liability claims as it can be, whh leads to increased health care costs, unfair and unequal awards for victims of medical malpractice and recuduced access to health care for all americans. unfortunately the massive health care overhaul that president obama signed into law last year did not meaningfully address medical liability reform. thus we are here today to exa

so we look forward to your testimony and we'll begin with dr. hoven. >> thank you, and good morning. chairman smith, ranking member conyers and members of the committee on the udiciary, as stated, i am dr. ardis hoven, chair of the american medical association board of trustees and a practicing internal medicine physician and infectious disease specialist in lexington, kentucky.nkto talk a important issue. this morning i will share with you results from ama studies that prove how costly and how often unfair our medical liability system is to patients and physicians. most importantly i will talk about a solution. that solution is a package of medical liability reforms based on reforms that have already been proven effective in states like california, texas, and michigan. our current medical liability system hasece ineangrriolysm dreny mecoumg titi a onend nocomidage as at brg instability to the liability insurance market. it is also an extremely inefficient mechanism for compensating patientsarmedby gligen wre cost cots and attorn fees ten csume a subs

dr. hoven is from kentucky. dr. weinstein is from iowa. kentucky is one of the four states that constitutionally prohibit limits on mages, but there are other states, arizona, pennsylvania, wyoming, including the trauma center that provided such excellent care to our colleague, gabby giffords, are all, i think under some danger presented by some of the trends that we're expecting in hr-5. i think it's something we ought to consider. i close with just a comment about the real costs of medical malpractice claims. there are only a fraction of the real costs, and i end on this note. the sixth largest cause of death in the united states of america medically are malpractice cases. so i hope that as this discuson rolls out this morning, we will be considering what we do with the hundreds of thousands of people that could be adversely affected whose liv time costs, even though they're innocent and the case is supported by the court and judgments are entered but with a $250,000 cap, as many of us know on all the hearings we have had prior to now, t

as has been pointed out by dr. hoven, in medical school you're trained to take a history, do a physical examination and try and put this puzzle together. occasionally you'll need one test, a lab test, or imaging study, and then you will take an orderly progression, but the climate of fear that exists from the medical standpoint is such, you need to keep taking that progression, that orderly progression, to the very end from the beginning, because should you miss something, your life and your ability to practice medicine and your craft is over. so that's the assurance behavior. avoidance behavior is most medical students come out of medical school, in our school, over $100,000 in debt, so when they choose a career, they come out of our orthopedic surgery residency able to take care of anybody who is brought in off the highway who has had a traumatic injury and put them together again, but the majority of them don't want to do that. they don't want to cover the emergency room because that's a high risk environment. so you

dr. hoven is from kentucky. dr. weinstein is from iowa. kentucky is one of the four states that constitutionally prohibit limits on damages, but there are other states, arizona, pennsylvania, wyoming, including the trauma center that provided such excellent care to our colleague, gabby giffords, are all, i think under some danger presented by some of the trends that we're expecting in hr-5. i think it's something we ought to consider. i close with just a comment about the real costs of medical malpractice claims. there are only a fraction of the real costs, and i end on this note. the sixth largest cause of death in the united states of america medically are malpractice cases. so i hope that as this discussion rolls out this morning, we will be considering what we do with the hundreds of thousands of people that could be adversely affected whose live time costs, even though they're innocent and the case is supported by the court and judgments are entered but with a $250,000 cap, as many of us know on all the hearings we have had prior to n

weinstein and dr. hoven have said this and i want to make sure you are aware, also, there are certain professions in the medical field that have stopped practicing because they can't see enough patients in order to cover their insurance cost. just the cost alone, not because they have done anything wrong, but they cannot see enough patients to cov their malpractice insurance cost. >> well, i hope that also you're aware that since 2006, we have been in a soft insurance market. that's why you don't hear any longer about doctors picketing on state legislatures and capitals andrauma centers, et cetera, that we did in the early part of the 200s when we were in a hard insurance market, when rates were going up 100%, 200% for doctors. this is a cyclical industry. this has happened in the past 30 years when rates have shot up like this. to believe the legal system has anything to do with it, you would have to believe juries engineered large awards in 1975, then stopped for ten years, then did it again from 1986 to 1

dr. hoven is from kentucky. dr.erk istein is from iowa, and kentucky prohits limits on damage, but there's other states, arizona, pennsylvania, wyoming thatrided sh mpany re t o colleague, gabby giffords, are all under some danger by some of the treandz that we're -- trends that we're expecting in hr5 and i think it's something we ought to consider. i close with just a comment about the real cost of medical malpractice claims. there are only a fraction of the real cost, and i end on this note. the sixth largest cause of death in the united states of america medically are malpractice cases. i hope that as this discussion rolls out this morning, we will be considering what we do with the hundreds of thousands of people that could be adversely affected whose lifetime cos evenhough ty e innocent and are supported by the court and judgments are entered, but with a $250,000 cap as much of us know on all the hearings we've had prior to now that this would be very min mall indeed -- minimal indeed, and i thank you for the t