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HEALTH CARE REFORM (Part 3) JOINT HEARINGS BEFORE THE SUBCOMMITTEE ON HEALTH AND THE ENVIRONMENT AND THE SUBCOMMITTEE ON COMMERCE, CONSUMER PROTECTION, AND COMPETITIVENESS OFTHE COMMITTEE ON ENERGY AND COMMERCE HOUSE OF REPRESENTATIVES ONE HUNDRED THIRD CONGRESS FIRST SESSION NOVEMBER 1993—PROPOSED NATIONAL HEALTH BOARD 2, NOVEMBER 9, 1993—INSURANCE MARKET ISSUES NOVEMBER 10, 1993—MEDICAL MALPRACTICE Serial No. 103-84 Printed for the use of the Committee on Energy and Commerce HEALTH CARE REFORM (Part 3) JOINT HEARINGS BEFORE THE SUBCOMMITTEE ON HEALTH AND THE ENVIRONMENT AND THE SUBCOMMITTEE ON COMMERCE, CONSUMER PROTECTION, AND COMPETITIVENESS OFTHE COMMITTEE ON ENERGY AND COMMERCE HOUSE OF REPRESENTATIVES ONE HUNDRED THIRD CONGRESS FIRST SESSION NOVEMBER 2, 1993—PROPOSED NATIONAL HEALTH BOARD NOVEMBER 9, 1993—INSURANCE MARKET ISSUES NOVEMBER 10, 1993—MEDICAL MALPRACTICE Serial No. 103-84 Printed for the use of the Committee on Energy and Commerce U.S. GOVERNMENT PRINTING OFFICE 78-105 WASHINGTON i 1994 ForsalebytheU.S.GovernmentPrintingOffice SuperintendentofDocuments,CongressionalSalesOffice,Washington,DC 20402 ISBN 0-16-044269-9 COMMITTEE ON ENERGY AND COMMERCE JOHN D. DINGELL, Michigan, Chairman HENRYA. WAXMAN, California CARLOS J. MOORHEAD, California PHILIP R. SHARP, Indiana THOMAS J. BLILEY, Jr., Virginia EDWARD J. MARKEY, Massachusetts JACK FIELDS, Texas AL SWIFT, Washington MICHAEL G. OXLEY, Ohio CARDISS COLLINS, Illinois MICHAEL BILIRAKIS, Florida MIKE SYNAR, Oklahoma DAN SCHAEFER, Colorado W.J. "BILLY" TAUZIN, Louisiana JOE BARTON, Texas RON WYDEN, Oregon ALEX MCMILLAN, North Carolina RALPH M. HALL, Texas J, DENNIS HASTERT, Illinois BILL RICHARDSON, New Mexico FRED UPTON, Michigan JIM SLATTERY, Kansas CLIFF STEARNS, Florida JOHN BRYANT, Texas BILL PAXON, New York RICK BOUCHER, Virginia PAUL E. GILLMOR, Ohio JIM COOPER, Tennessee SCOTT KLUG, Wisconsin J. ROY ROWLAND, Georgia GARYA. FRANKS, Connecticut THOMAS J. MANTON, NewYork JAMES C. GREENWOOD, Pennsylvania EDOLPHUS TOWNS, NewYork MICHAEL D. CRAPO, Idaho GERRY E. STUDDS, Massachusetts RICHARD H. LEHMAN, California FCRRAAINGKAPAWLALSOHNIEN,GJTr.O,NN,eTwexJaesrsey LYNN SCHENK, California SHERROD BROWN, Ohio MIKE KREIDLER, Washington MARJORIE MARGOLIES-MEZVTNSKY, Pennsylvania BLANCHE M. LAMBERT, Arkansas Alan J. Roth, StaffDirector and ChiefCounsel Dennis B. Fttzgibbons, Deputy StaffDirector Margaret A Durbin, Minority ChiefCounsel and StaffDirector Subcommittee on Health and the Environment HENRYA. WAXMAN, California, Chairman MIKE SYNAR, Oklahoma THOMAS J. BLILEY, Jr, Virginia RON WYDEN, Oregon MICHAEL BILIRAKIS, Florida RALPH M. HALL, Texas ALEX MCMILLAN, North Carolina BILL RICHARDSON, New Mexico J. DENNIS HASTERT, Illinois JOHN BRYANT, Texas FRED UPTON, Michigan J. ROY ROWLAND, Georgia BILL PAXON, New York EDOLPHUS TOWNS, NewYork SCOTT KLUG, Wisconsin GERRY E. STUDDS, Massachusetts GARYA FRANKS, Connecticut JIM SLATTERY, Kansas JAMES C. GREENWOOD, Pennsylvania JIM COOPER, Tennessee CARLOS J. MOORHEAD, California FCRRAAINGKAPAWLALSOHNIEN,GJTr.O,NN,eTwexJaesrsey (Ex Officio) SHERROD BROWN, Ohio MIKE KREIDLER, Washington JOHN D. DINGELL, Michigan (Ex Officio) Karen Nelson, StaffDirector Michael M. Hash, Counsel Andreas G. Schneider, Counsel Ruth J. Katz, Counsel William Schultz, Counsel Howard Cohen, Minority Counsel Mary M. McGrane, Minority Counsel (ID Ill Subcommittee on Commerce, Consumer Protection, and Competitiveness CARDISS COLLINS, Illinois, Chairwoman EDOLPHUS TOWNS, NewYork CLIFF STEARNS, Florida JIM SLATTERY, Kansas ALEX MCMILLAN, North Carolina J. ROY ROWLAND, Georgia BILL PAXON, New York THOMAS J. MANTON, New York JAMES C. GREENWOOD, Pennsylvania RICHARD H. LEHMAN, California CARLOS J. MOORHEAD, California FRANK PALLONE, Jr., NewJersey (Ex Officio) JOHN D. DINGELL, Michigan (Ex Officio) David Schooler, StaffDirector/ChiefCounsel Bradford Ross Kane, Counsel Mary-Moore Hamrick, Minority Counsel