skip to main contentskip to popular page linksskip to main navigation links
photo of Mike Capuano Michael E. Capuano representing the 7th district of Massachusetts in the U.S. House of Representatives Go to the House of Representatives homepage
Like Mike on Facebook Visit Mike's video channel on YouTube Like Mike on Facebook

 

 My Schedule My Voting Record District Maps Register To Vote FAQ Site Map e-Updates


11,853 subscribers
HR 5: Protecting Access to Health Care Act

RECENT VOTES

Health Care

This week the House considered H.R. 5: Protecting Access to Health Care Act. This legislation repeals the Independent Payment Advisory Board (IPAB) and pays for that repeal by placing arbitrary caps on medical malpractice claims.

Although I oppose IPAB, I could not vote for this bill because of the medical malpractice provisions attached to it.

Regular readers of this newsletter know that I am a strong supporter of health care reform and voted for the Affordable Care Act in March of 2010. You may also recall that I had a number of concerns about certain aspects of that bill, particularly with regard to the ways it would impact Massachusetts. One of my concerns had to do with the creation of an Independent Payment Advisory Board (IPAB).

IPAB was created to set Medicare reimbursement rates. Traditionally, Medicare payments are based on many factors including efficiency, complexity of medical issues, cost of living in different regions, and, crucially for Massachusetts, whether the provider also bears costs associated with medical education for the future doctors and engages in medical research. Some argue that Medicare should focus ONLY on cost containment without regard for all the other factors that affect the cost of care and that have been traditionally considered. The IPAB was proposed by those who favor a bottom-line only approach to Medicare. The idea is to empower an appointed board to make cuts that an elected official would not support — and this is the basis of my concern.

Supporters of IPAB argue that Congressional authority is not undermined because IPAB cuts can be stopped with a majority vote of both the House and Senate. But the members of IPAB are appointed by the President. Clearly, any President is likely to support suggestions from his or her own appointees and would veto Congressional action against the appointed board. Therefore, it would require the vote of two thirds of Congress to override the proposals of IPAB. This reality underlies my greatest concern: there may be future Presidents who do not support Medicare or the Affordable Care Act as I do.

Despite my serious concerns over IPAB, I felt that I had to vote against HR 5 and here’s why. H.R. 5 also contains medical malpractice legislation that pre-empts state law in all 50 states by capping all non-economic medical malpractice damages at $250,000 whenever a patient is harmed as a result of any health care related action, including problems with medical devices and drugs or mistakes made by doctors or hospital staff. Punitive damages are permitted only with proof that someone acted “with malicious intent to injure claimant” or “deliberately failed to act to prevent unnecessary injury claimant was substantially certain to suffer.” They are also capped at $250,000.

H.R. 5 fails to take into account the level of seriousness of medical errors committed. Even the most egregious cases, such as a transplant patient dying because he or she received an organ with the wrong blood type, are subject to a cap. Interestingly, this bill does not cap economic damages, which are determined based on the lifetime earning potential of the patient. This is troubling and, I believe, unfair because, for example, if two people suffered the exact same medical malpractice, the CEO of a major company would receive much more in economic damages than a bank teller with six young children left behind. A lower wage earner suffering from serious injuries would not require less costly medical care, yet that person would receive far less than a higher wage earner with identical injuries. There is no question that reasonable malpractice reform is needed, but this unfair bill is not the answer.

The bill also establishes a three-year statute of limitations on all “health care lawsuits”. So if a suspected medical malpractice incident does not manifest itself for three years and one day, that patient has no recourse. And the scope of H.R. 5 is far too broad because it applies not just to medical malpractice cases but to all “health care lawsuits”. As a result it shields entities like insurance companies, drug companies and HMOs by also making them subject to the $250,000 caps.

I think it’s worth noting that I am one of 15 Democrats (including Barney Frank) who supported Health Care Reform and who also became co-sponsors of the original, bipartisan bill that would have simply repealed IPAB (H.R. 452). I am certain that a clean IPAB repeal bill would have received several dozen votes from good, solid, progressive Democrats and most of the Massachusetts delegation.

After the addition of a divisive and overly broad proposal to deny most people the ability to seek reasonable compensation for malpractice, only two of the original Democratic co-sponsors voted for H.R. 5. I am personally offended that we were denied a clean vote on an important issue on which there had been broad bipartisan agreement. I voted NO on HR 5 and the entire vote is recorded below:

  YEA NAY PRESENT NOT VOTING
REPUBLICAN

216

10

4

11

DEMOCRAT

7

171

0

12

TOTAL

223

181

4

23

MASSACHUSETTS
DELEGATION

0

10

0

0



11,853 subscribers

 

 

 

NEWS & MULTIMEDIA

 

Bill Search

Search Congress.gov for legislative information.

Tip: enter bill numbers without spaces, i.e. "h.res.26" or "hres26"

 

Helpful Links

 

Home | About | Biography | Contact | Issues | Links | News | Schedules | Services

E-Updates | Site Map | Privacy Policy | Accessibility

110 First Street
Cambridge, MA 02141
P: (617) 621-6208
F: (617) 621-8628
Hours

Roxbury Community College
Campus Library
Room 211
Boston
Hours

Stetson Hall
Room 124
6 South Main Street
Randolph
Hours

  Constituent Services Click to close menu
  Casework and Assistance
  Citizenship/Naturalization
  Immigration Casework
  Grants and Federal Domestic Assistance
  Presidential Greetings
  Flags
  Tours
  Washington, D.C. Attractions
  U.S. Service Academy Nominations
  Internships
  FAQs
  Media Center Click to close menu
  e-Updates
  Press
  Recent Votes
  Video and Audio
  Photos
  Legislative Work Click to close menu
  Issues
  Recent Votes
  Voting Record
  Sponsored Legislation
  Earmark Requests
  Committees and Caucuses
  Ethics Task Force
  Schedules Click to close menu
  My Schedule
  House Floor Summary
  Weekly House Schedule
  Annual House Calendar
  Weekly Senate Schedule
  Our District Click to close menu
  Maps
  Cities
  Demographics
  The 7th District Over the Years
  Nobel Prize Winners
  Interesting facts about Massachusetts
  Massachusetts Links
  Links Click to close menu
  Massachusetts Links
    State Government
    About the 7th District
    Arts, Culture and Attractions
    Chambers of Commerce
    Colleges and Universities
    Exploring Massachusetts
    Hospitals and Health Organizations
    Newspapers
    Sports

  Federal Government Links
    USA.gov - Official Government Portal
    Legislative Branch
    Executive Branch
    Judicial Branch
    Federal Agencies
    Kids' Pages
    Register to Vote
    Washington, D.C. Attractions
    Business Opportunities with the Government
  Contact Click to close menu
  District Office
  Washington, D.C. Office
  Office Hours Program
  Community Meetings
  E-mail Me