Bush Seeks to Limit Malpractice Suits

President Bush plans to call today for stringent new curbs on malpractice lawsuits against health-care providers and insurance companies, contending that limiting such litigation will lower the cost of care and increase the number of medical specialists, administration officials said Wednesday.

But while any move to impose such restrictions will please providers and insurers, it is likely to enrage many consumer groups and energize the nation’s already active trial lawyers to resist such efforts.

In a speech today in Greensboro, N.C., the president will urge Congress to enact sweeping reforms of medical malpractice litigation, officials said.

The legislation that Bush will endorse is modeled largely on California’s law, which critics say has inflicted further pain on patients who have already been hurt by the cost-cutting health maintenance organization system.

In advance of Bush’s speech, Health and Human Services Secretary Tommy G. Thompson released a policy paper Wednesday, saying that malpractice litigation reform would improve public access to health care, encourage efforts to improve quality of care and reduce excesses and abuses in the current system.

“California led the way for the nation by establishing statewide limits on malpractice claims 25 years ago, with bipartisan support,” he said.

“We should learn from the successes of California and other states that have successfully reformed their malpractice systems.”

The report squarely blames the rapidly increasing cost of malpractice insurance for an array of problems in the nation’s health-care system, from the sharp inflation in overall costs to the reduction in the number of specialists.

But consumer advocacy groups denounced the drive to impose federal limits on malpractice litigation, a move that faces uncertain prospects in Congress. Opponents quickly reacted late Wednesday as word of the administration’s intentions spread.

“Limiting liability for providers, who are already pressured by HMOs to cut corners and be less cautious, will turn aspects of the health-care system into an even bigger death trap,” said Jamie Court, executive director of the California-based Foundation for Taxpayer and Consumer Rights.

“Californians have paid for the limited liability of providers and insurers’ profitability with their health and their lives. These restrictions should be lifted in California, not imposed nationwide,” he said, adding: “California is a failed model for anyone but malpractice insurers.”

The HHS report painted a far different picture.

It noted, for instance, that Las Vegas’ only Level 1 trauma center recently closed temporarily when surgeons quit after their malpractice premiums increased by as much as 500%.

The report also cited estimates that the cost of malpractice insurance for specialists has risen more than 10% in recent years and could increase by an average of 20% or more before the end of this year. In states with no limit on noneconomic damages, such as payments for “pain and suffering” or “loss of companionship,” doctors are seeing 30% to 50% increases in premiums.

Bush also is expected to call for a plan called Early Offers, which would encourage doctors to offer economic compensation to patients soon after an injury and encourage patients to accept the offer.

The report also suggested adoption of strengthened medical review panels that would provide streamlined disposition of malpractice claims, with incentives for doctors and patients to use them and accept their judgments.

Along with health-care costs in general, malpractice insurance premiums have resumed their sharp climb after leveling off in the mid-1990s, after President Clinton’s failed in efforts to revamp the nation’s health-care system.

The ever-increasing premiums are prompting health-care providers, particularly in specialties such as surgery or obstetrics, to drastically curtail their practices--or to quit them altogether.

Without federal legislation, the exodus may worsen, and patients could find it increasingly difficult to obtain needed services, said Rep. James C. Greenwood (R-Pa.), a moderate who has introduced a bill to impose limits on the ability of patients to file malpractice lawsuits--and to collect huge awards.

His bill, which has nearly 100 co-sponsors, would limit the number of years that a plaintiff has to file a lawsuit, allocate damages in proportion to a party’s degree of culpability, impose a $250,000 cap on noneconomic damages, and limit punitive damages at $250,000 or twice the amount of economic damages, whichever is greater.

Attempts to reform the nation’s health-care system have foundered for more than a decade, even as costs have soared and the ranks of the uninsured have swelled. Indeed, few issues have proved so contentious--and intractable--for Congress and the White House to deal with.

Just this week, for example, the Senate failed to agree on competing proposals to provide Medicare recipients with coverage for prescription drugs--an increasing problem for the elderly as the prices of medications skyrocket.