U.S. Senate Majority Leader Optimistic, Despite Challenges as 2004 Unfolds

Bill Frist

He came to Washington, D.C. with a background steeped in medicine.

U.S. Senate Majority Leader and Tennessee Republican Bill Frist has known first-hand the impact of the nation’s medical malpractice crisis and how it can paralyze the entire business sector, from insurers to doctors.

Born and raised in Nashville, Frist graduated in 1974 from Princeton University. In 1978 he graduated with honors from Harvard Medical School and spent the next seven years in surgical training at Massachusetts General Hospital, Southampton General Hospital, in England, and Stanford University Medical Center. He is board certified in both general surgery and heart surgery.

In 1985 Frist joined the faculty at Vanderbilt University Medical Center where he founded and subsequently directed the multi-disciplinary Vanderbilt Transplant Center, which under his leadership became a nationally renowned center of multi-organ transplantation. A heart and lung surgeon, he performed more than 150 heart and lung transplant procedures, including the first successful combined heart-lung transplant in the Southeast.

Frist was first elected to the U.S. Senate on Nov. 8, 1994. In 2000, he was elected to a second term in the United States Senate by the largest margin ever received by a candidate for statewide election in the history of Tennessee.

Frist recently set time aside to do an e-mail interview with Insurance Journal to discuss the med-mal crisis and where he sees the nation going in the New Year. Below is the conversation with the two-term senator from the Volunteer State.

Insurance Journal: As we head into 2004, how do you see the medical malpractice situation in Tennessee, given that the American Medical Association had listed the state as one of 25 showing some problem signs?

Sen. Frist: Though we have not reached the crisis stage, the situation is bad in Tennessee and it is getting worse. In fact, over the past three years insurance premiums in Tennessee have gone up roughly 60 percent. This type of growth simply cannot be sustained in the long term. More importantly, I hear from my former colleagues throughout the state on a regular basis about the negative effect excessive litigation is already having on their ability to deliver quality health care. Like the rest of the country, obstetrics has been hit particularly hard with many physicians in the state either dropping the service or considering doing so. If we don’t act soon, Tennessee may join the other states where expectant mothers often have a hard time merely finding a doctor. High malpractice insurance premiums are forcing doctors across the nation and Tennessee to face an unbearable choice – to provide care while putting themselves and their practices at risk to financially crippling lawsuits, or to limit care and sometimes abandon their practices. In the end, it is the patient who suffers.

IJ: With 19 states listed as being in ‘crisis mode’ by the AMA, do you see things getting worse before they get better?

Sen. Frist: In 2002, only 12 states were in crisis according to the AMA so the problem is steadily growing. Because the problem is a result of excessive litigation, I don’t see the situation dramatically improving until Congress passes comprehensive medical-liability reform. The good news is that Congress is starting to hear the voices of patients and physicians. Last year, the House of Representatives passed reform and, as Majority Leader, I have made medical liability reform a top priority for the Senate. Last July we brought medical liability reform to the floor of the Senate for the first time ever as its own bill. Unfortunately, the measure – the Patients First Act – was blocked by opponents who filibustered the mere consideration of the bill. However, this was just the first attempt at this important issue. We will bring reform up again this year, and I encourage physicians and patients who have been affected by the crisis to continue to contact their senators.

IJ: Has the Senate, House, White House, etc. looked to California and the five other states that passed a version of tort reform as a model states should go by?

Sen. Frist: Yes. The bill that passed the House last year and the Patients First Act are based on California’s successful model which proves that comprehensive reform works. California passed its medical liability reform measure – MICRA – in the 1970’s and the results have been dramatic. For example, total liability premiums grew in California 182 percent from 1976 to 2001 compared with 569 percent for the rest of the country. Not surprising, California’s doctors and patients have been spared the nightmare facing other states.

IJ: How has your background in medicine helped you in the medical malpractice debate?

Editor’s note: To see the full interview, read the Feb. 9 issue of Insurance Journal.