dr. mclaughlin, how about you? >> absolutely no. >> have you ever heard of solving a problem without putting everything on the table? dr. english. >> say that again, please? >> have you ever heard of solving a problem by not putting everything on the table? >> no. >> it is foreign to me. >> the law did actually approve the opportunity for some demonstration programs for medical liability reform but in the law, the plain language of the law says you may not do any demonstration program that includes any limits on non-economic damages. so. the constraints were fairly significant. >> you know, dr. mclaughlin, i want to go back to reducing time for physicians to see their patients. we're reducing reimbursement rates. we're reducing panels. all choreographing hurting the patient, would you agree. >> absolutely. >> and you made the comment that you want to practice medicine your way. you want to individualize that, take your time, how you see fit. individualize the treatments, right? >> yes, sir. >> how do you feel most p

dr. mclaughlin does he have to foot the bill for the e.r. to somebody like that? >> unless dr. london has additional information but i do not believe that emergency room care is free. i believe that the first dollar amount that come to pay any bill need to satisfy the deductible first. regardless of what plan you have. now some plans indeed on the new york state marketplace have a small deductible, but they come with a very high premium. if you're not in the category financially to have a subsidy, it is just a matter of do you pay a higher premium every single month, or do you have a lower premium and thin this immensely high deductible. now, all of this is fine if all you need is preventative care. but if you're ill, that is when the deductible and the large coinsurance amounts are going to kick in. we talk about this as patient first dollar amounts. this is a totally new concept that most patients who currently just had co-payments are now going to have to face, come to grips with and deal with and i don't think this has been talked about s

dr. mclaughlin? >> sir, physicians have always given charity care, love of their heart to people who couldn't afford be it. always did. >> always did. >> and always will continue to do so. but what this has created, sir, is a roadblock of unsurmountable to organizations. the high deductibles that were imposed on these patients is nothing more than them not having insurance. can we understand that? >> dr. novack? >> the gentleman may answer, of course, doctor. >> i agree with you. >> mr. chairman, i know my time has expired, but we have found that collection of ideas on which we can agree, and i agree with my colleagues on the other side of the aisle, we should begin working towards those goals, and we should do that immediately. i yield back. >> i thank the gentleman. we now go to the gentleman from massachusetts for five minutes. >> well, thank you. thank you for your being here today. i wanted to ask, i think it was dr. mclaughlin who made a comment that her patients' policies were -- the insurance

dr. patricia mclaughlin. dr. mclaughlin, thanks for joining us this evening. how has it affected you and patients? >> started out i have a small group policy. and i was given notice it was going to be nonrenewed starting january 1, 2014. i was shock by the that. it's a ppo level plan that had everything. i wasn't missing anything. i was foet anied the letter suggested another plan would be forth coming that would be comparable. i could stay wut had to wait to see what they're going to ofrment a couple weeks letter that plan had in nut work benefits only instead of out of network and in network. so cutoff half of the ability to see people outside of the network there is an epo, epo never traditionally needed refersalss but the pathway network was going to be so much smaller than current network of doctors which meant everyone i currently went to, everyone my employees went to was no longer going to be participating in network only, which meant we can keep our doctor but would have to pay out of our own pocket not going to our deductible, increasing from 2,000se

is notricia mclaughlin small at just in a private isctice and dr. eric novak an orthopedic surgeon with ortho-arizona in phoenix, arizona. i would like to recognize the gentleman from georgia, mr. woodall, to introduce his constituent, dr. english. >> i appreciate the courtesy. we have the great pleasure of having dr. jeffrey english with us. he got his bachelor of science and graduated from dartmouth medical school in 1995, served as chiefy close by resident of neurology and university of maryland in 1999 and to the great pleasure has chosen to call norcross home where he is the director of clinical research at the multiple sclerosis center in atlanta and president of the of docs for patient care. it's with great pleasure that i welcome you today, dr. english. thank you for what you do not only on the committee but for back home. to committee rules, i ask all three of our witnesses to rise to take the oath. lease raise your right hand. do you solemnly swear or affirm the testimony you are about to give would be the truth, the whole truth and nothin

dr. mclaughlin about the various situations that you found yourself in. in some kind of way we have got to balance all of this. congressman tierney was so adamant. a lot of these things could've been solved when this was put together but there was a lot of give and take and a lot of things happened that i think we could have avoided a lot of what we have here now. there are a lot of problems that you are right, we have got to fix this and it's got to be a can-do attitude and not one where we just throw up our hands and say -- because do you know what? the people that suffer are the people you try to help every day. i thank you for all you do and i thank all of you for bringing the passion that you bring to your professions. we understand you are just trying to help people to get them well and keep them well. we really appreciate you. thank you. >> thank you so much. >> thank you wall and again you will have seven days two and traditional statements or other material into the earh and we will now take a short resource resource -- recess for the second pane

mclaughlin m.d. is an ophthalmologist in a private practice in new york city. dr. eric novack m.d. is an orthopedic surgeon with the ortho arizona practice in phoenix, arizona and i would like to recognize the gentleman from georgia mr. woodall to introduce his constituents dr. amos. >> thank you mr. chairman. i appreciate that courtesy. we do have the great pleasure of having dr. jeffrey english with us. he has been a tremendous resource to the georgia delegation. i want to tell you a little bit about his background. he has a bachelor of arts in psychology and -- from boston college in 1991 and graduated from dartmouth medical school in 1995. he served relatively close by as chief resident at the university of maryland to the great pleasure of all georgians has chosen to call at home where he is the director of clinical research at the multiple sclerosis center in atlanta and president of the georgia chapter 4 patient care. it is with great pleasure that i will come dr. english and thank you so much for what you do not just for us on the committee but for everyone back home. >> pu