http://www.nytimes.com/2002/07/26/politics/26BUSH.html
IGH
POINT, N.C., July 25 — With doctors complaining about rising malpractice
insurance premiums, President Bush called today for a major overhaul of the
nation's medical liability system, including legislation to cap compensation for
pain and suffering at $250,000 in successful malpractice suits.
"Health care costs are up because docs are worried about getting sued," the
president told an audience of 1,700 health care professionals in a sweltering
gymnasium at High Point University here.
Mr. Bush declared the liability system "broken and riddled with bad, bad
law."
One reason Mr. Bush traveled to North Carolina was to attend an evening
fund-raiser in Greensboro for Elizabeth Dole, the Republican candidate for the
Senate. Mrs. Dole is "constantly breaking what they call the glass ceiling," he
said.
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White House aides said the president expected to help raise $750,000 for Mrs.
Dole and the state and national Republican Parties.
The trip put Mr. Bush squarely on the home turf of a potential political rival
in 2004, Senator John Edwards, a Democrat who became wealthy as a medical
malpractice lawyer.
In a telephone conference call with reporters, Mr. Edwards said today: "I
spent most of my life before I came to the Senate fighting for kids and families
against insurance companies, and I think that's the right side to be on. If the
president wants to be on the side of the insurance companies, we'll let him do
that."
Medical malpractice awards have been a perennial issue in the health care
debate, with many Republicans and the health insurance industry arguing that
until doctors receive protection from lawsuits, they will continue ordering
expensive tests and unnecessary procedures that drive up costs. Mr. Bush echoed
that argument today, saying too many doctors are practicing "defensive
medicine."
Democrats and trial lawyers have traditionally resisted changing the law, saying
patients need legal recourse when they are injured. Today, Mary E. Alexander,
president of the Association of Trial Lawyers of America, accused Mr. Bush of
favoring the insurance industry, which has contributed to his political
campaigns.
"Instead of giving speeches to reward insurers," Ms. Alexander said, "he should
change his economic policies, which are devastating the working families of
America."
Typically, states set their own malpractice guidelines, and Mr. Bush is
ordinarily a strong defender of states' rights. But he said in his speech today
that the federal government needed to set standards, and he cited estimates that
malpractice awards drive up the cost of government health programs, including
Medicare and Medicaid, by more than $25 billion a year.
"It's a national problem that requires a national solution," Mr. Bush said,
calling on Congress to enact legislation by late fall.
Anticipating the president's speech, the Department of Health and Human Services
released a report on Wednesday that said the cost of malpractice insurance for
specialists had risen more than 10 percent in recent years.
Besides caps on awards, the White House wants the legislation to include
provisions for payments over time, rather than in lump sums, and for juries to
be informed if patients have other sources of compensation for an injury. The
president also wants to prohibit cases from being brought years after an injury.
The White House malpractice initiative comes at a time when health economists
and ordinary Americans are growing increasingly concerned about the rising cost
of health care. The White House is also backing a Republican plan to offer a
prescription drug benefit to the elderly, and it has called for tax credits of
$1,000 for individuals and as much as $3,000 for families to help the uninsured
buy private medical coverage.
But the prescription drug plan is in trouble in the Senate, and the tax credit
plan has received a lukewarm reception from Democrats in Congress, as well as
from consumer groups.
One group, Families USA, was also critical of the malpractice plan today. Ron
Pollack, its president, called the initiative an "unfortunate diversion from the
most important health issues facing our country — expanded health coverage for
the uninsured and recently unemployed, prescription drug coverage for seniors
and patients' rights legislation."
The president spoke this afternoon after visiting nearby High Point Hospital,
where he met privately with a number of doctors and patients, including some
from other states, notably Nevada, which has been particularly hard hit by
rising malpractice insurance premiums.
Dr. Shelby Wilbourn, an obstetrician-gynecologist in Las Vegas, told the
president that he was leaving his practice because his premiums jumped to
$108,000 this year, from $33,000.
In an interview with reporters after the president's speech, Dr. Wilbourn, 41,
said he was moving to a rural area in Maine, where he might not earn as much but
would pay just $9,800 a year for insurance in his first year in practice.
"I would strongly advise women in Las Vegas now not to get pregnant," he
said, "because trying to find an obstetrician is very difficult."
To underscore the point, the White House also invited Jill Barnes of Henderson,
Nev., who is eight weeks pregnant and has been unable to find an obstetrician in
Nevada. Ms. Barnes says she drives an hour and a half to Arizona for her medical
care.
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