President Bush opened a new drive for caps on medical malpractice awards Wednesday, contending that the limits would lower health care costs. Opponents said such ceilings would merely shield doctors and others who provided poor health care.
“I believe the voters made their position clear on Election Day on medical liability reform,” Bush said, citing his re-election as evidence of support for a proposal that has passed the House but failed in the Senate.
The renewed battle revived a partisan debate about whether Bush’s victory in November gave him a second-term mandate to push his big-ticket items through Congress.
Sen. Edward Kennedy, D-Mass., criticized Bush’s medical malpractice proposal, as well as the president’s claim of having new political capital.
“Barely two months after promising to unify and heal the country after a bitter election, the president’s again pushing for legislation that will further divide it,” Kennedy said.
“The president’s medical malpractice plan is nothing but a shameful shield for drug companies and HMOs who hurt people through negligence,” Kennedy said.
Ground zero for tort reform
Bush made his case in Madison County, across the Mississippi River from St. Louis. The county has been called the “judicial hellhole” of the nation by the American Tort Reform Association last year because of its reputation for huge awards won by plaintiffs.
Lawyers in the area say that the legal situation has been exaggerated and that large malpractice awards have been scarce.
“The United States Congress needs to pass real medical liability reform this year,” Bush said, slapping his lectern with an open palm to emphasize his point.
Behind him, the White House advance team arrayed audience members in white medical coats. Bush warned of a crisis but said it could be averted if the Republican-controlled Congress adopts his plan.
“This liability system, I’m telling you, is out of control,” Bush said. While his proposal has stalled in Congress, Republicans expanded their majorities in both houses in the November elections.
The president wants to place a limit of $250,000 on non-economic damages, or the pain and suffering parts of malpractice awards. Caps on damage awards of varying types have been put in place in 27 states; Bush and his critics disagree on their impact.
Bush would impose no limits on economic losses suffered at the hands of bad doctors.
He wants to limit punitive damages to “egregious cases where they are justified” and cap damages to “reasonable amounts,” according to White House documents that did not elaborate.
He would allow malpractice awards to be paid out over time, instead of in a lump sum, and limit the time over which such suits could be filed after the claimed malpractice.
“Because the system is so unpredictable, there is a constant risk of being hit by a massive jury award,” Bush said. “It’s a system that’s just not fair. It’s costly for the doctors; it’s costly for small businesses; it’s costly for hospitals. It is really costly for patients.”
Scope of problem disputed
According to a recent study Bush that did not identify, “frivolous litigation” had helped push the “total cost of our tort system to more than $230 billion a year,” he said.
But Democratic lawmakers and consumer watchdog groups cited a Congressional Budget Office analysis that said malpractice costs represented less than 2 percent of overall health care spending in 2002.
“Thus, even a reduction of 25 percent to 30 percent in malpractice costs would lower health care costs by only about 0.4 percent to 0.5 percent, and the likely effect on health insurance premiums would be comparably small,” the CBO said in its report a year ago.
Doug Wojcieszak, a spokesman for Victims and Families United, an Illinois advocacy group, said Bush was “playing with the facts for political purposes” in singling out Madison County.
The group said that out of 720 medical malpractice and wrongful death cases filed in Madison and neighboring St. Clair counties from 1996 to 2003, just 14 cases resulted in jury verdicts, and six of those verdicts favored the plaintiffs.
According to the group, there has been only one medical malpractice lawsuit in Madison County that produced a verdict in the past seven years that would have been affected by Bush’s proposed $250,000 cap on non-economic damages.
Lawyers who represent malpractice victims and other opponents of Bush’s initiative say the real problem is insurers who look to raise premiums and, consequently, the companies’ bottom line.