I want to thank Prosperity UK for organising this conference and in particular, Lord Hill of Oareford, Sir Paul Marshall and Alex Hickman who have been the dynamos who have ensured that today can occur.And they, like the team that run Prosperity UK, are determined to bring together individuals from across the political spectrum to develop policies for Britain’s future outside the European Union (EU). Their committee is composed of both those who argued that we should Leave the EU and also those who believed that we should Remain But they are united by the belief that, whatever positions individuals may have been adopted in the past it’s important that all of us now focus on the opportunities of the future.And in choosing today to focus on agriculture, fisheries, food and the environmental more broadly, I believe, that Prosperity UK and the people in this room have identified a critical range of areas where Britain has the potential to be an innovator, generating increased prosperity and setting new global gold standards in sustainability.I want to set out, in a second, where I believe some of those opportunities specifically lie.But first I wanted to say a little about how important it is to me in this Government that when we explore the opportunities of life outside the EU we ensure the hopes and fears of those who voted to Remain are woven into our thinking. And into our actions.No decision in our nation’s history has enjoyed such a strong popular mandate as the decision to leave the European Union. 17.4 million people voted to take back control of this country’s trade, taxes and laws.But more than sixteen million of our fellow citizens voted to Remain. And there is a special responsibility on those of us who argued for a Leave vote and who are charged with implementing it, to ensure that the underlying reasons why so many people voted to Remain are respected.Many people voted to Remain because they understandably feared the economic consequences of leaving. There were warnings that a vote to Leave would trigger an immediate recession and precipitate job losses.Others chose Remain because they feared a Leave vote was somehow a vote to turn inwards and backwards. It was a vote for narrower horizons rather than a truly global Britain.Others were concerned that a vote to Leave would strengthen the hands of separatists particularly in Scotland or others who wished to pursue an even more populist political platform.And, critically, there were many that felt that during the time we have been in the European Union there have been undoubted advances in how we treat each other, and the planet, which have been enshrined in law and underpinned by regulation, and all that would be put potentially at risk by a vote to Leave.All of those concerns – for economic justice, cultural open-ness, social harmony and environmental enhancement – are critically important.And that is why I am glad that, since the referendum result, this Government has ensured that progress has been made in all of those areas.Since the referendum, Britain has recorded the best employment figures in its history, with more than 32.1 million people in work. Employment is just 66.5% in the Eurozone, compared to 74.1% in the UK.And for those in work, particularly at the bottom end of the income spectrum, wages have been rising. As the OBR pointed out this week, there has been a 7% real terms increase in pay for the poorest.More jobs for working people and better-paid jobs for working people I believe contributes to greater economic justice.All this has been underpinned by a shift in our economy towards export-led growth, away from what I believe to be an over-reliance on domestic consumer demand in the past.In the last 12 months exports have risen by £64.5 billion – that’s a rise of 11.5%.Our service sector continues to thrive with exports up by 10.1% and exports of goods have risen even faster by 12.6% to £344.5 billion, and the manufacturing sector in particular has been making a significant contribution to this growth.So far then, the decision to leave the EU, far from precipitating recession, harming food security or hitting working people in the pocket, has promoted economic progress.And it has also, I believe, had a beneficial political effect.Since the British people voted to leave the EU, support for separatist parties and separation itself has declined. Most notably of course in Scotland.The decline in support for separation in Scotland stands in contrast to the increased support for secession in Catalonia and the growing regional tensions that we’ve seen in Italy in their election campaign.And indeed it is not just support for separatist movements which has declined in Britain since the referendum.Support for populist parties has also collapsed. The United Kingdom Independence Party is now a ghost political movement, like the Luddites or the Whigs, and no populist party of the right, or of the radical fringe, is taking its place.Again, by way of contrast, the recent electoral success of the Five Star Movement in Italy, the Alternative for Deutschland in Germany, the Front National in France shows that almost alone in Europe, Britain does not have either a burgeoning populist party in parliament or making progress in the polls.The ebbing in support for populist parties in the UK has also been accompanied by a warmer and more welcoming approach by the British people to issues such as immigration.The most recent polling on migration showed that the UK was the country in the EU with the most welcoming attitudes towards migrants from outside the EU. We are the most open, global, nation in Europe.And that is reflected in university admissions with the number of foreign students applying to study in the UK increasing.In 2018 there were 7,300 more applicants from overseas, with 43,500 applications from EU students alone – an increase from the year before.Applications from some EU nations such as Croatia, Finland, Germany, Spain, Poland and Portugal have continued to rise in the last few years by as much as 30%.The continuing popularity of our world-leading universities with foreign students is a win-win all round. It’s a wonderful example of British soft power, it makes universities themselves more diverse, it generates earnings for the UK economy, and the fees from foreign students can help keep our own costs down.So, as well as serving economic justice, Brexit, if we make the right decisions, can serve social justice too.The great progressive prize of a green BrexitBut more than that, Brexit, with the right decisions, can enhance our natural environment.Which is why I am so delighted by the range of speakers, and indeed the breadth of issues, at today’s conference. The potential for progressive change is huge.But that change can only be made real if we utilise the talents of everyone who cares about the natural world.I am very well aware that for many who care deeply about the environment, our membership of the EU coincided with both increased awareness of environmental concerns and improved mechanisms to safeguard the natural world.And as I mentioned earlier, leaving the EU, for many, appeared to put those gains at risk, or at the very least raise a question over the prospect of continued progress.And it’s because I appreciate the strength of those concerns that we in Defra have moved as quickly as we can to affirm that not only will there be no abandonment of the environmental principles that we’ve adopted in our time in the EU but indeed we aim to strengthen environmental protection measures and to create new mechanisms to incentivise environmental improvement.That is why we’re consulting on how to introduce a new environmental protection body and it’s why we’ve outlined policies for the natural world in our 25-Year Environment Plan that, in some cases, are more ambitious than any required by EU membership.I recognise that some of the ambitions outlined in the Plan will need legislative under-pinning. And while I can’t say now what will be in future Queens’ Speeches I can state clearly that if we are to honour our pledge to leave the environment in a better state than we inherited it we must also leave the statute book in a better state than we inherited it.And in advance of any major legislation, we’re also determined to show at Defra that we’re making progress as rapidly as possible towards meeting the goals that we’ve set for ourselves in our Environment Plan.That’s why we’re planning to go further in dealing with the pollution caused by single use plastics, and building on our plastic bag and plastic microbeads bans.I am also determined, as I reminded today by the House of Commons, that the UK must do more to clean up our air. I want to create stronger incentives for us to do so, and I will set out our proposals in a clean air strategy later this Spring.Because to be frank, as again the House of Commons has reminded us today, we’ve been too slow to act on what is a major public health scandal.Again, we’ll being saying more in coming weeks, but we all know that we have to do more to restrict diesel use, to protect urban centres from pollution, to change how some of us heat our homes and we also need to reform aspects of agriculture and industry to ensure our air is properly breathable.A strong economy needs a healthy environmentIn acting in this way, I believe that this Government is being true, actually, to the best Conservative traditions. It was Disraeli’s Government that recognised improving public health depended on passing enlightened environmental legislation. His administration introduced laws to safeguard our rivers. The great third Marquis of Salisbury’s Government introduced laws on housing, Macmillan’s introduced laws on Air Quality and Margaret Thatcher’s on a range of environmental issues, all of which reflected a profound appreciation of the inter-dependence of a healthy environment, a healthy population and a flourishing economy.I recognise that it’s a stock in trade of some political commentary that you can only really pursue environmental goods at the expense of consumers or business. There are some who say that you can pursue greenery or prosperity but you can’t put a premium on both.Indeed that was the line doggedly asserted by the BBC’s Nick Robinson when he interviewed me on the Today Programme for the launch of our 25 Year Environment Plan.But, even when that case is prosecuted with all the vigour and talent of a Nick Robinson, I believe, and I believe that history shows, that it’s a false dichotomy.The truth, as governments have long understood, is that you cannot sustain economic growth if you erode the natural capital on which all human flourishing depends.And, in parallel, sustainable economic growth will generate the income we all then can invest in future, further environmental enhancement.It has been economic growth – free market-inspired, capitalist-generated and business-driven – that has helped us to secure cleaner rivers, cleaner and less carbon-intensive energy and to protect natural habitats in the world’s wealthiest nations.And unfortunately history tells us that centralised state control, socialist management, and the absence of effective price signals and functioning markets, and indeed the expropriation of private property and collectivisation have led, not just to economic misery but also to environmental degradation. The example of Mao’s China, Soviet Russia and Maduro’s Venezuela, shows that that path leads to poisoned soils and contaminated rivers, toxic air and wrecked habitats.Indeed the economic policies pursued by the leaders of the Bolivarian Revolution in Venezuela – Hugo Chavez and Nicholas Maduro – who have such enthusiastic fans here in the UK, naming no names – those policies have involved the grotesquely profligate exploitation of fossil fuel reserves in a manner that has been both economically foolish and environmentally reckless. And that has been accompanied by the immiseration of the nation’s population, provoking not just the migration of millions of refugees but also the devastation of that country’s rural economy.So poor, and hungry, have Venezuela’s citizens become under Chavez and Maduro that they were driven to eat the animals in Caracas zoo to keep alive. As a metaphor for how economic failure drives the destruction of the natural world, it is both all too fitting and heart-breaking.A post-Brexit long-term economic planBut while open and enlightened market economies have done a demonstrably better job in delivering environmental goods than closed command economies, we’ve also got to be honest about where our economic thinking has been deficient in recent years.Just as growth in the first decade of this century was over-reliant on debt, on borrowing that we expected the next generation to pay for, so growth over many decades has been over-reliant on exploiting finite natural resources whose depletion inevitably leaves future generations poorer.As a Conservative, someone who believes in the careful husbanding of resources, both financial and environmental, and as someone who also believes in the principle of stewardship, the idea that we must hand on our inheritance to the next generation in an enhanced state, I believe we have a responsibility to ensure that our economic model prices in those valuable principles. In other words we have to have truly sustainable economic growth.That is why I am such an enthusiast for the idea of natural capital, pioneered by the brilliant economist Dieter Helm, from whom you will be hearing later this morning.Dieter developed the idea, the concept of Natural capital accounting, which aims to measure every natural asset – from freshwater to the oceans, oil and gas stocks to fish stocks, woodland to peat – and record how those assets are changing over time, both in physical and financial terms.The UK was the first country in the world to establish an independent Natural Capital Committee to advise the Government on how to manage and enhance our natural wealth and that committee has been playing a critical role in the formulation and implementation of our 25 Year Environment Plan. The insights of the Natural Capital Committee have ensured that this government recognised that natural capital is as fundamental to our health and prosperity in our future as our human capital or physical capital.Of course it’s important to note that natural capital is just one tool we can use to deliver on our environmental gains. Not everything that we cherish in the natural world can be given a monetary value. We don’t want to protect and restore the environment simply because of its economic value, but because of our moral duty and our emotional attachment. But still, natural capital remains a powerful tool for all of us who care about the natural environment and prosperity in the future to ensure that we take our responsibilities towards the environment seriously, and we can be held accountable for our actions.So as we design the economic and environmental policies that will guide Britain after Brexit our aim will be to ensure we incentivise investment in physical, human and, above all, natural capital.CAP reformThe prosperity of our economy, and in particular our food economy, depends on us developing a truly sustainable approach for the future, and in particular towards our landscape.So as we escape from the Common Agricultural Policy and develop our own domestic farming policy we have to move away from our current system, which lacks effective incentives for long-term-thinking, to one that promotes investment in our shared future.That will mean we pay farmers to improve the quality and fertility of their soil, that means we want to reverse the trends of the past which have led to compaction and run-off, and which have polluted our rivers and choked our fish.Supporting those who practice min or no-till cultivation in agriculture is not only better for our rivers and watercourses, it will also help to control and reduced carbon emissions, it will reduce demand for chemical inputs and it will provide a richer habitat for insects and invertebrates.And we should indeed, as we revise our policy towards our land and embed natural capital thinking in our approach, move to provide better support for our farmers and land managers who maintain, restore, or create precious habitats for wildlife. Whether it’s supporting those who’re protecting curlews on moorland or who’re ensuring the health of sphagnum moss in blanket bog, the stewards of precious natural assets which Britain has a special role in conserving, need improved support in the future, and that will be at the heart of our environmental, agricultural and economic policy post-Brexit.FisheriesAnd as well as reforming the Common Agricultural Policy to reward those who provide habitats on land, leaving the EU also provides us with an opportunity to escape the Common Fisheries Policy and replace it with an approach to managing our marine environment which puts conservation and sustainability at the heart of our approach towards our own territorial waters.Effective reform in all these areas will of course depend on also enabling the right sort of technological and scientific breakthroughs. And freedom to innovate in these policy areas should I hope also provide new opportunities for the burgeoning growth and environmental entrepreneurship that we see in Britain. From the appropriate surveillance of fishing activity to the use of artificial intelligence to improve farm animal health, we can demonstrate how we can increase both natural capital on land and at sea and also boost national productivity.AgritechThere is, I am delighted to say, a continued and intense interest in British environmental technology and innovation because we excel in agritech and supporting innovation inf green finance. There were more than 58,000 tech start-ups in the UK in 2017 and more venture capital invested in technology in London than in Germany, France, Spain and Ireland combined.A new business starts every 75 seconds, and many have the potential to change how we define prosperity and how we enhance natural capital. New companies like Saturn Bioponics are leading the way with new modular growing systems that allow farmers to increase crop density while making harvesting cleaner and easier, reducing labour costs by up to 50% and producing an almost 100% saleable yield. Overall, Saturn Bioponics have shown that investment in their technology will be paid back between 1-4 years through increased profitability.And Government, critically, has a positive role to play in helping to enable this sort of innovation.Just this week an investment of £90 million from the Industrial Strategy Challenge Fund was directed towards the Transforming Food Production programme. Investments like this will I believe help to support a technology and data-driven transformation for UK farmers, UK land managers and those who work on or with our environment.By supporting farmers with the initial investment we can help their businesses to not only become more productive and to generate more growth, and indeed to provide more high-skilled jobs, we can also drive more high-value export opportunities, and critically we can also ensure that our environment becomes more resilient and even better guardians of our natural environment.Across the UK there is a wealth of innovative start-ups redefining what it means to be a farmer or a land manager, and how to farm effectively and sustainably. One company, Hummingbird Technologies uses crop mapping to identify problems in drainage, compaction, nutrition, weeds and pests before they become devastating, and it can pre-emptively detect the presence of particular diseases like potato blight and blackgrass.It is also the case that our universities like Harper Adams who have been collaborating with a number of tech companies, have helped to lead the charge in developments in agronomy and agritech, and in particular the world has been paying attention to the way in which Harper Adams through its Hands Free Hectare project has shown the way for a more efficient and environmentally sensitive approach towards agriculture.I believe that we can also, as well as demonstrating global leadership in all these areas, also demonstrate it in our approach towards resource efficiency and the treatment of waste. We all know that we need to reduce our reliance on plastic and in particular make sure the incentives are there to move away from the use of virgin products so we all use more recycled material. I recognise that we need to reform the existing producer responsibility scheme, we need to impose appropriate costs on those whose products leave a heavier environmental footprint and we then need to use the money generated from that to invest in dramatically improved recycling facilities in this country.In the same spirit, we also need to encourage movement away from diesel and petrol cars towards ultra-low emission vehicles such as those Sir James Dyson is developing. And we also should build on the work that’s being done to develop autonomous vehicles in the future. Their development could help us to further reduce the adverse environmental impact of our current approach towards urban transport.Global leadershipI believe that Britain has the potential now to demonstrate global leadership in all these and more areas.And there are opportunities on the months ahead for us to demonstrate, alongside, other nations, our determination to do more for our planet.At the forthcoming Commonwealth Heads of Government meeting, and with Canada’s Presidency of the G7, we can play our part to extend protection to more of the world’s oceans.At the Illegal Wildlife Trade Summit in London this autumn we can take decisive steps to safeguard biodiversity worldwide, and indeed we can, in the months ahead, develop new approaches to measuring, valuing, and enhancing biodiversity worldwide.We can also ensure in the trade agreements that we hope to sign and indeed in the economic partnership that we plan to forge with the EU, that natural capital is protected, that the natural world will be respected and that the highest ethical and environmental standards are upheld.ConclusionA commitment to the highest environmental standards in everything we do doesn’t involve any long-term economic sacrifice. Quite the opposite. We will only succeed in the world as a food exporter, a centre for tourism, a hub for technology investment and an incubator for wider innovation on the basis that we are an economy and society where quality, integrity, sustainability and a commitment to long-term relationships are guaranteed. We need to build an economy and a society which continually promotes incentives to virtue.There are great prizes for our resourceful, resilient, remarkable nation in the years ahead – and I hope, with the help of all the people gathered here for this conference, that we can succeed in the years ahead in building something special in this our green and pleasant land.Thank you.
Edinburgh’s Cuckoo’s Bakery has come up with its own version of the Scottish independence referendum – a cupcake poll.Customers can buy Yes, No or Undecided raspberry and white chocolate cupcakes, priced at £2.50, with the weekly results published on the bakery’s Facebook and Twitter sites.In the first week of sales last week, the results were 29% yes, 51% no and 20% undecided.Owner Graham Savage said staff had been briefed to be on the look-out for supporters from both sides bulk-buying cupcakes.He said: “Hopefully we’ll bring a bit of fun to the debate which has been heating up recently.”
<a href=”https://www.youtube.com/watch?v=lCKtDE5ofUw” rel=”nofollow” target=”_blank”> <img src=”https://img.youtube.com/vi/lCKtDE5ofUw/0.jpg” alt=”0″ title=”How To Choose The Correct Channel Type For Your Video Content ” /> </a> Republicans must accept a broader definition of their party, finding a way to embrace young voters, women, African-Americans, Hispanics, Asians, and environmentalists, if they are to avoid repeating the losses of the 2012 election, panelists said Tuesday during an Institute of Politics (IOP) forum at the Harvard Kennedy School.“Our tone was wrong in recent years,” said Karen Hughes, a top aide to former President George W. Bush and author of the phrase “compassionate conservatism” for her former boss. “Conservative philosophy can be optimistic and hopeful.”But Ana Navarro, national Hispanic co-chair for John Huntsman’s 2012 presidential campaign, was more blunt: “We had bad outreach, a bad message, and bad messengers. We should make 2012 a manual of what not to do.”For progress, Navarro said the party must shift from its perceived resistance to change on issues. “Young people feel deeply about gay marriage, access to contraception, and they also care about the environment,” she said. “There are any number of issues we missed out on without changing our position.”The prescriptions for improvement ranged widely but hewed to a theme of inclusion and dynamism.Kerry Healey ’82, a former Massachusetts lieutenant governor, said there is a tangible sign of a brighter future in the commonwealth with Gabriel Gomez, a former Navy Seal and Harvard Business School graduate who may run for the U.S. Senate seat that John Kerry vacated to become secretary of state. “We’ll have a wonderful candidate who will represent the new face of the Republican Party in the Northeast,” said Healey, a top adviser to Mitt Romney’s recent presidential campaign.Healey, who was secretary of the Harvard Republicans as an undergraduate in 1978 — when the club numbered 12 members compared with the current 100 — was also an IOP fellow in spring ’07. She said the party has to be more accepting, and must rebuff attempts to subject each member to a litmus test of approved conservatism.“If you consider yourself a conservative, we think you’re a conservative,” she said. The party likewise needs to find a way to welcome moderate Washington officeholders, whose ranks are diminishing to the point of extinction with recent departures from Congress.“There has been a glass ceiling in our party for many years above which they could not rise,” said Healey, currently a state committeewoman to the national party. “We need to come together not under a big tent but as a coalition of conservatives,” to create “a winning strategy to bring us back.”Several panelists, including Ron Christie, a White House adviser to the younger Bush and an IOP fellow in 2011, said the party has to improve its use of technology to reach people and get out the vote.Navarro, a CNN contributor who also was an adviser on Hispanic issues to John McCain’s 2008 presidential campaign, quipped: “We seem to have a lot of nerds in the Republican Party, but not enough geeks.”What is truly unsustainable, said John Murray, a former aide to House Majority Leader Eric Cantor who now heads a super PAC to promote conservative candidates and policies, is the amount of money being spent on losing candidates.“We invest a lot of money in guys who can’t win,” said Murray, who heads the Young Guns Network, which was started by Cantor. “If you are going to engage in a House race, you need to find someone who fits his district,” he said. “I cannot go to the people who put up the money and say I blew the budget on a guy who had no chance of winning.”The problem, he said, is that funders are intent on furthering their political agendas and back candidates who share them even if they are not in winnable races. The Young Guns are taking a different approach by vetting promising candidates rather than supporting whoever feels entitled to run because it’s his or her turn. “We have begun to systematically look at people who look different.”A member of the audience who has been active in the Harvard Republican Club asked why Republicans are scarce in faculties on elite campuses.Christie, who has served as an adjunct professor at the George Washington University’s Graduate School of Political Management, took the point and expanded on it, saying, “We need to get involved in academia and deal with the hostility that is out there.”The Future of the Republican Party Watch the full panel discussion from the Institute of Politics
The FMA’s proposed amendment is titled “The medical liability claimant’s compensation amendment.” The ballot summary states: “Proposes to amend the State Constitution to provide that an injured claimant who enters into a contingency fee agreement with an attorney in a claim for medical liability is entitled to no less than 70 percent of the first $250,000.00 in all damages received by the claimant, and 90 percent of damages in excess of $250,000.00, exclusive of reasonable and customary costs and regardless of the number of defendants. This amendment is intended to be self-executing.”Justice Fred Lewis noted the ballot summary doesn’t reflect “that citizens of Florida may not be able to obtain counsel and have access to court because you’re going to limit it in such a fashion that no one will become involved in these kinds of cases, which is really the underlying purpose here, it seems.”Grimes responded: “I submit that’s an argument that could be made. But on a facial assertion of that, I don’t think it would be such that would be cognizable in this case.”Grimes said the amendment would benefit clients because it will allow them to keep more of the recovery.But Chief Justice Anstead said it also could be argued that it doesn’t benefit claimants at all “because now they may not be able to find counsel to represent them in these cases because of this compensation limitation. Is that not an alternative argument?”“I think it is an argument that you could present to the voters if it gets on the ballot,” Grimes said.Buddy Jacobs, representing the Bar’s Trial Lawyers Section — which is made up of both plaintiff and defense lawyers — said the amendment is “almost seductive” in the way it is worded.“We are on behalf of claimants; we want to make sure claimants get this amount of money and that amount of money,” Jacobs said. “But still you’re restricting the rights of the claimants or the persons who are the victims of malpractice; you’re restricting their rights to pay lawyers. Well, the folks that aren’t here today are going to see this on the ballot, and they’re going to say, ‘Well gosh, this is wonderful.’ It is almost seductive, says we are going to guarantee people to have these kinds of percentages and recovery. Doesn’t talk about whether they can pay their lawyer, hire their lawyer, or how much they get paid.”Mills contended the amendment violates the single subject provision and that the ballot and title are substantially misleading.“I don’t think there is any dispute that this amendment supercedes and affects totally for the future the area of medical malpractice and perhaps other things.. . ,” Mills said. “It also has effects in areas such as, potentially, comparative liability, joint and several liability. There are some broad potential impacts. The most important impact is I think the impact on the court.”Mills said the most dangerous precedent would be for the court to approve an amendment which has declared itself self-executing because Art. V, Sec. I, states that the courts operate the judiciary. Academy, FMA square off over amendmentsMark D. Killian Managing EditorThe Florida Supreme Court heard oral arguments in what Justice Barbara Pariente described as “tit for tat” proposed constitutional amendments being advanced by the Academy of Florida Trial Lawyers and the Florida Medical Association.The academy has proposed three amendments, being sponsored by its political committee Floridians for Patient Protection. One would revoke the license of any doctor who loses three malpractice or disciplinary judgments; the second would give patients access to confidential peer reviews and adverse incident reports (which now are immune even from subpoenas); and the third would require doctors to charge the same rate for the same services for all patients.Working through its political committee – Citizens for a Fair Share – the FMA’s proposed amendment would limit how much money lawyers can make in a medical liability case.Over two days of arguments June 7-8, the court reviewed each of the four amendments to ensure that they do not contain more than one subject, and that the ballot title and summary accurately reflect the content of the amendment.Late on the second day of arguments, Justice Pariente marveled that the lawyers involved advanced the same arguments on consecutive days, depending on whose amendment was before the court. Each side represented their amendments as simple and straightforward while characterizing the other’s as ambiguous or misleading.“I am having trouble distinguishing the argument today from the argument yesterday, as far as this seems like four amendments that are going to perhaps cause a great deal of litigation if they are passed,” Pariente said.Three Strikes Academy, FMA square off over amendments One of the AFTL’s amendments would amend the constitution to bar licensure of any physician found to have committed three or more incidents of malpractice. The ballot title reads “Public Protection from Repeated Medical Malpractice.” The ballot summary states: “Current law allows medical doctors who have committed repeated malpractice to be licensed to practice medicine in Florida. This amendment prohibits medical doctors who have been found to have committed three or more incidents of medical malpractice from being licensed to practice medicine in Florida.”Justice Charles Wells asked if that meant that if a doctor who had three “friendly suits” go to judgment 40 years ago and had no subsequent malpractice incidents would lose his or her license if the amendment passed. And in contrast, if a doctor who settled three malpractice cases in 1990s, without going to judgment, would be allowed to continue to practice.“That is correct, your honor,” said Timothy McLendon of Gainesville, representing Floridians for Patient Protection. He added that the measure is intended to remove discretion from the state agency that deals with licensing doctors and conceded, “it may inflict some hardship on certain people.”Justice Wells noted the ballot summary says doctors “who have been found to have committed three or more incidents” of malpractice would lose their license.“I think I would reasonably believe that, if a doctor settled three cases for $1 million each, that that person would be covered by this amendment,” Wells said. “But he is not.”That’s the point, said Tallahassee’s Stephen Grimes, a former justice representing the FMA, who argued the summary is misleading.“The voters could not conceive of the fact that maybe his family doctor is going to get disenfranchised,” Grimes said.McLendon said in order for past cases to count against doctors today, those old cases must meet the current definition of malpractice and, if passed, the measure would only apply to a “minuscule” number of doctors.Patients’ Right to Know Another AFTL amendment would give patients the right to see adverse incident reports relating to doctors and health care facilities they use, including those that could cause injury or death. The ballot title is “Patients’ Right to Know About Adverse Medical Incidents.” The ballot summary reads: “Current Florida law restricts information available to patients related to investigations of adverse medical incidents, such as medical malpractice. This amendment would give patients the right to review, upon request, records of health care facilities’ or providers’ adverse medical incidents, including those which could cause injury or death. Provides that patients’ identities should not be disclosed.”Justice Wells said he is concerned that voters reading the summary would be led to believe the amendment gives patients the right to review records of health care facilities “and that would leave the connotation that it is the health care facility that I was at, as opposed to it just opening it up to the world.”McLendon responded that, combined with the title, the summary makes it clear that “we are talking about consumer information and that it is meant more broadly than simply the acquisition of your own records.”“Why didn’t they simply say that then?” Wells asked. “Why didn’t they simply say.. . ‘all medical records are public,’ period? And that is what it says, right?’McLendon contended “the average voters of reasonable intelligence” will understand the chief purpose of the amendment is to make medical records available.Justice Peggy Quince asked who determines if the records being sought are adverse records.“This tracks the Patients’ Bill of Rights in the Florida Statutes, and in the Patients’ Bill of Rights it explains the type of incidents that would be adverse medical incidents, and our summary also makes it clear when it speaks about incidents such as would cause injury or death,” McLendon said.Wells, however, said nowhere in the amendment is the Patients’ Bill of Rights mentioned.McLendon noted the amendment also does not call for the creation of new records, just making records that already exist available to patients.Harold R. Mardenborugh of Tallahassee, representing the Florida Dental Association, attacked the proposed amendment, saying it should be stricken because it would substantially impact more than one branch of government.“The most fundamental impact is that it will effectively overrule the work product privilege that this court has put in place,” Mardenborugh said.“But isn’t that what all constitutional amendments do — override some pre-existing law in virtually every case?” Chief Justice Harry Lee Anstead asked.“This requires only the disclosure of that which is already collected as a matter of law,” said Jon Mills, representing Floridians for Patient Protection. “This is a simple amendment directed to overruling an exemption.”Same Fee July 1, 2004 Managing Editor Regular News The third AFTL-proposed amendment would require doctors to charge the same rate for the same services for all patients and is titled “Physician Shall Charge the Same Fee for the Same Health Care Service to Every Patient.” The ballot summary states:“Current law allows a physician to charge different prices for the same health care provided to different patients. This amendment would require a physician to charge the same fee for the same health care service, procedure or treatment. Requires lowest fee which physician has agreed to accept. Doesn’t limit physician’s ability to provide free services. A patient may review the physician’s fee and similar information before, during, or after the health care is provided.”“I guess the question is whether, if a physician charges certain patients $1,000 for a service but ends up accepting from some patients, after the invoice goes out, accepting $800 for that service from one patient, does he then have to accept $800 from other patients, or can he accept more or less, as long as the invoice says $1,000 for everyone?” asked Justice Raoul Cantero.McLendon said the question hits at the prime problem that amendment is intended to address: “The practice of cost shifting, under which physicians discriminate between patients, in terms of allocating the cost, the changing of the fee for their services, and, yes, this amendment is intended to stop that practice.”“So if a physician accepts from Medicare, reimbursement that some may argue is less than the cost of providing that service, this would require a physician to accept the Medicare or Medicaid reimbursement schedule for all services rendered, regardless of the client’s ability to pay?” Justice Kenneth Bell asked.To which McLendon responded: “The doctors would have absolute ability to value their services. Once they have done so, in a context, whether it be Medicare or somewhere else, they could not charge anyone else a lower fee.”Bell, however, noted the individual physician does not set Medicaid or Medicare reimbursement rates, but are instead required to accept the reimbursement rate established by the government.“There is a rate that is set,” McLendon said. “But the participation by doctors is voluntary.”“So they would have to choose not to participate in Medicare or Medicaid if they did not want to be bound by this amendment, correct?” Bell asked.“If that rate was too small, then that would be one of the choices they could make,” McLendon said.Justice Peggy Quince also noted the amendment says nothing about HMOs or other third-party payers.Malpractice Fees