Bush Urges Congress to Put Limits on Medical Liability Awards
By DAVID STOUT
The New York Times
January 5, 2005
WASHINGTON, Jan. 5 - Restating one of his campaign themes, President Bush prodded the new Congress today to put curbs on medical-malpractice lawsuits, which he said were driving up the cost of care and driving good doctors out of medicine.
"The United States Congress needs to pass real medical-liability reform this year," Mr. Bush told an audience of doctors in Collinsville, in southwestern Illinois.
Recalling that the House of Representatives had passed several bills to limit malpractice awards, but that the legislation had always stalled in the Senate, Mr. Bush signaled that he was eager for another try.
"A new Congress is starting over, you know," Mr. Bush said. "We got a new chance to get something done for the, on behalf of the American people."
Mr. Bush chose Collinsville for his address at least in part because the judges in Madison County, where the city of 22,000 is located, are rated by business groups as being overly friendly to plaintiffs in personal-injury lawsuits.
Mr. Bush punctuated his remarks with campaign-style personal touches, offering tributes to Speaker J. Dennis Hastert of Illinois, whom the president will count on to shepherd legislation through the House, and to local and state Republicans. The last time the House voted on the issue was in March 2003. By a vote of 229 to 196, it passed a bill that would have put a $250,000 ceiling on jury awards for pain and suffering caused by medical malpractice, limited punitive damages and restricted the contingency fees plaintiffs' lawyers could charge.
The National Conference of State Legislatures says 34 states have enacted caps, and the experience in those states suggests that limits on awards do result in lower insurance costs. The nonpartisan Congressional Budget Office concluded that a measure like the one the House passed in 2003 would lower insurance premiums nationwide by 25 percent to 30 percent.
But the Budget Office also reported, in January 2003, that malpractice costs were less than 2 percent of overall health care spending and that even a 30 percent reduction in malpractice costs would lower health care spending by less than 0.5 percent.
"Medical-liability reform is a national issue, and it requires a national solution," Mr. Bush said today, tacitly acknowledging that laws governing malpractice have historically been the domain of the states, and that some people believe the states should still have control.
"What's happening all across this country is that lawyers are filing baseless suits against hospitals and doctors," Mr. Bush said. "That's just a plain fact. And they're doing it for a simple reason. They know the medical-liability system is tilted in their favor." The president cited several examples of doctors who he said had been chased out of their practices by skyrocketing malpractice-insurance premiums.
But others who follow medical-malpractice cases say the situation is hardly as clear-cut as Mr. Bush has made it out to be. The Consumer Federation of America, for instance, has argued that the insurance industry's business practices are a big part of the reason for higher premiums.
Politically, Mr. Bush has had little to lose by attacking trial lawyers, as he did often during the campaign. They traditionally have been big supporters of the Democratic Party, and a onetime prominent trial lawyer, Senator John Edwards of North Carolina, opposed the Bush-Cheney ticket in the last election as Senator John Kerry's running mate.
"Junk lawsuits change the way docs do their job," Mr. Bush said. "Instead of trying to heal the patients, doctors try not to get sued."
The president said he favored plaintiffs being able to collect punitive damages over "truly egregious wrongdoing" during medical care. But he reiterated his proposal for a $250,000 limit on non-economic damages in most instances.
"I intend to go back to Washington here shortly," Mr. Bush said, "and when I see members of the Congress, as I work this issue, I'm going to say: 'I spoke to the good folks of Southern Illinois. They understand the problem, and they expect you, members of the United States Senate and the United States House of Representatives, to get the job done.' "In his third debate with Senator Kerry during the presidential campaign last year, Mr. Bush asserted that malpractice lawsuits and "the defensive practice of medicine" by wary doctors and hospitals cost the government $28 billion a year and "our society between $60 billion and $100 billion a year."
Independent analyses suggested that the president's cost estimates were exaggerated, and the actual size of malpractice awards is impossible to calculate, since so many suits are settled before they reach trial. The Congressional Budget Office reports that 15 claims are filed for every 100 doctors each year and that about a third of the claims result in an insurance payment.
Dr. Donald J. Palmisano, whose term as president of the American Medical Association ended in June 2004, said in an interview last year that "as much as 50 or 60 percent" of the cost of malpractice insurance could be attributed to unjustified awards to plaintiffs for "noneconomic damages," which usually means pain and suffering.
Todd A. Smith, president of the Association of Trial Lawyers of America, said around the same time that high insurance costs had "nothing to do with noneconomic damages" and "everything to do" with greedy insurance companies.
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