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Rep. Deal Lays Out Ambitious Health Care Agenda

JUNE 9, 2005 -- The chairman of the House Energy and Commerce Health Subcommittee laid out an ambitious legislative agenda for his panel on Thursday, citing Medicaid, medical malpractice, and patient safety as priorities.

Rep. Nathan Deal, R-Ga., said he anticipates an early September markup in his committee on a package of changes to the Medicaid program in order to meet the committee's responsibility under the fiscal 2006 congressional budget resolution (H Con Res 95) to cut $14.8 billion over five years, including anticipated savings of $10 billion from Medicaid.

Deal said he hopes the overhaul will authorize pilot programs to allow a limited number of states "to take it to the next level" and experiment with even more wide-ranging reforms than might be adopted in the current session of Congress.

He also aims to include "cash and counseling" language that would empower beneficiaries individually "to use their money and make choices with regard to their health care."

The overhaul plan also might include Medicaid health savings accounts "that would take it to a further personal involvement level." The accounts allot to individuals sums of money from which they pay for certain health care expenses and allow them to keep what they don't spend.

A former trial lawyer, Deal acknowledged the emotional toll medical malpractice can take on patients, but emphasized the need for an overhaul of the way such cases are handled. The House passed a bill last Congress that would have capped non-economic damages in malpractice lawsuits at $250,000, and Deal said he wanted to move legislation again this Congress. He said that he didn't expect the House version to be the final language of a malpractice bill, but wanted to work with the Senate, where the legislation has been stalled, to come up with a compromise.

He pointed to recent changes in Georgia law that provide for a higher cap and allow physicians to apologize and not have the apology used against them at trial. Republicans pressing for malpractice award caps argue that high awards are driving up prices of health care because of insurance costs and the practice of defensive medicine.

One way to get at the malpractice problem, Deal said, was to get legislation through Congress that aims to reduce medical errors in the first place. Both chambers last year passed versions of legislation that would establish databases of medical errors to track trends and avoid mistakes in the future. A conference meeting never took place in the 108th, and Deal said there are "hopeful signs the legislation can come forward before August."

Deal spoke at a health care conference sponsored by Congressional Quarterly.

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