September 11th, 2009
11:45 AM ET
13 years ago

Curbing medical lawsuits: What Obama really means

[cnn-photo-caption image= caption="Curbing medical lawsuits: What Obama really means."]

WASHINGTON ( - As President Obama turns up the heat on health care reform, one new and surprising detail to emerge is his pledge to tackle medical malpractice.

"I don't believe malpractice reform is a silver bullet, but I have talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs," Obama said Wednesday night.

Obama's decision to wade into the issue has some insiders scratching their heads, because cutting down on medical malpractice lawsuits is a
Republican tenet.

But the president's idea of reducing health care costs by cutting down on lawsuits isn't the same as Republicans, who want to cap lawsuit damage awards. Instead, Obama plans to run with an idea left over from his predecessor's administration and fund pilot projects in states that trumpet patient safety.

In one approach, the Department of Health and Human Services would fund projects aimed at limiting lawsuits by encouraging doctors and clinics to disclose accidents early and apologize to patients when appropriate.

Experts point to the University of Michigan Health Care system as a potential model. Malpractice claims in the system dropped by 55% between 1999 and 2006.

"If we make a mistake, we'll move quickly to apologize and compensate that patient. But if we didn't make a mistake, we talk to the patient and explain," said Richard Boothman, chief risk officer for the University of Michigan system.

As the Obama administration knows well, medical malpractice can be a sticky issue. When the discussion centers on lawsuit damages, it pits two deep-pocketed lobbying groups against each other: trial lawyers and big business.

Advocates like the U.S. Chamber of Commerce and hospital and doctor groups say that lawsuits, especially frivolous ones, drive up the cost of
health care by increasing the cost of doctors' malpractice insurance.

Trial lawyers counter that limiting their ability to hold doctors and hospitals accountable for mistakes won't reduce costs.

More neutral agencies like the Congressional Budget Office say that efforts to curb medical malpractice lawsuits can prompt cheaper malpractice insurance premiums but don't really affect health care spending.

In June, Obama told the American Medical Association that he was not an advocate of lawsuit caps, which he said can "be unfair to people who've been wrongfully harmed."

Despite his legal background, Obama hasn't always sided with lawyers on legislation targeting the court system.

In 2005, he voted with Senate Republicans to pass a law that limited attorneys' fees in class action suits and shifted most of those cases into
federal courts to prevent attorneys from seeking more favorable state-court venues.

On Wednesday, the president made it clear that he brought up medical malpractice as a sign of good will to the "Republican side of the aisle."

That irks some left-leaning Democrats. Rep. Keith Ellison, D-Minn., said he didn't see the need to address the issue, which is often called "tort

"But you know, if the president wants to discuss tort reform - fine. I am not going to die on that hill," Ellison said.

The next wave of controversy depends on the kinds of medical malpractice pilot projects the Obama administration agrees to fund.

If the projects aim to stop and prevent medical errors and accidents before they happen, the trial lawyers' lobbying group, the American Association for Justice, is on board. If the measures limit liability, that's another story.

"If you really want to solve the health care crisis, you need to focus your efforts on saving lives," said Linda Lipsen, the AAJ's top lobbyist.
"That's where the most cost savings are."

The American Medical Association was more guarded in its reaction, but the doctors lobbying group applauded Obama's intent to address malpractice lawsuits as a way of cutting health care costs.

An administration official said the types of things they're looking to fund include two proposals contained in one of the health care reform bills now in Congress.

One resembles what the University of Michigan already does, where hospitals and clinics disclose errors and apologize when at fault. Meanwhile doctors are well-insured against lawsuits.

"I've the luxury of saying to our physicians, no matter how big a case is, how bad a case is, 'You're completely insured and your personal assets are not at stake,' " Boothman said. "You can't ask them them to be totally honest when they have such things at stake."

The other provision would require patients who want to file lawsuits to get a panel of experts or doctors to agree their lawsuit has merit before they go to court.

But if the Obama administration is truly thinking of running with Bush administration ideas, they'll look at a 2002 Institute of Medicine study aimed at cutting malpractice suits.

That study offered recommendations that have yet to surface in current health care policy discussions.

In one, the federal government would offer backup insurance to provider groups who disclose mistakes and compensate patients for avoidable injuries. But the report also recommended that participating states limit pain and suffering awards.

The other option gave health care providers "immunity," or protection against lawsuits if they agreed to participate in a government-run
administrative system that compensated injured patients, mostly based on a formula.

William Sage, a doctor and attorney who advised the Institute of Medicine, said the 2002 recommendations fit well with the president's pledge,
because they attack malpractice lawsuits from the bedside instead of the courtroom.

Sage said he expects that such medical malpractice reforms will go beyond pilot projects and make it into final legislation.

"This year it's different," said Sage, vice provost for health affairs at the University of Texas at Austin. "We have to have major long-term changes, so malpractice proposals have to appeal more broadly. They have to gain the confidence of a large number of medical physicians and make them think about their work differently without always being afraid of being sued."

Filed under: Health care • President Obama
soundoff (109 Responses)
  1. Mobius

    Amazing that Barry is supposed to be this great communicator, and yet it takes CNN to tell us 'What Obama really means". Seriously?

    September 11, 2009 11:51 am at 11:51 am |
  2. Willy Brown

    Obama I can't really believe you about your true concerns for America and its people.

    September 11, 2009 11:53 am at 11:53 am |
  3. Steve

    Wow, this article does a really good job of laying out the issues.

    September 11, 2009 11:53 am at 11:53 am |
  4. Sam Sixpack

    What Obama really means is his backers in the pharmaceutical industry are angry and he must get something passed so they can enjoy their promised windfall (of your money).

    September 11, 2009 11:57 am at 11:57 am |
  5. Fair is Fair

    "But the president's idea of reducing health care costs by cutting down on lawsuits isn't the same as Republicans, who want to cap lawsuit damage awards. Instead, Obama plans to run with an idea left over from his predecessor's administration and fund pilot projects in states that trumpet patient safety. "

    Fair enough.

    I say let's pilot his ill-conceived healthcare plan too. At least that way, the damage can be minimized and repealed before it's too late.

    September 11, 2009 11:57 am at 11:57 am |
  6. Kevin in Ohio

    No one really knows what he means..... true tort reform is more than just skimming the surface of the medical malpractice issue. And to put Sebellius over this is ridiculous..... isn't she beholden to the Trial lawyers???? What we really need in this country are fewer lawyers and more doctors.

    September 11, 2009 11:57 am at 11:57 am |
  7. BB

    Instead of limiting the award amount, why not just cap what the lawyer can be paid. Lawyers won't waste the court's time with frivolous lawsuits if they aren't getting paid for it.

    September 11, 2009 11:59 am at 11:59 am |
  8. Ken

    Again, I am just so pleased that the real political drama queens have stood up to squawk their immature tantrums. I would like to personally thank the wilson's of SC, the kevin's of OH, the doug's of NJ, the mike's of MI, the eighty-sixed of Phoenix, and all the proud members of the party-of-no.... for the double digit jump in Obama's poll ratings and the 7 figure additions to [D] campaign coffers. You neo-morons, with your juvinile witless behavior and lack of intellectual integrity, are simply the BEST! Keep up the good work…..we on the outside love getting a glimpse inside of the goofy fantasy world of the rightwing…..and having gained a glimpse of that deluded world, most people with brains will indeed contribute to politicians that will help us all avoid it.

    September 11, 2009 11:59 am at 11:59 am |
  9. Kentucky

    The President seems to be a reasonable person who is willing to talk with his political opponents. That is good for the Democrats. The Republicans are being led by Representative Wilson, a screamer, and an admirer of the Great Segregationist Strom Thurmond. Many people are turned off by screamers, and that is what the Republican party has become, a Party of Screamers. Republican leaders who admire old segregationist are sending a strong signal to Blacks and Hispanics that will be picked up. If the Republicans continue down this road, there will be very few Blacks or Hispanics voting Republican in the days to come.

    September 11, 2009 12:01 pm at 12:01 pm |
  10. aproudmemberoftheunpatrioticmob

    This was just something he threw out to try to get the bill passed. There have already been a lot of "demonstration projects." This will never happen nationwide or in connection with this bill, just like cutting out "waste and fraud" will not happen. If they were serious about either of these issues, they would have happened already. Cutting out the trial lawyers and waste & fraud, would very seriously dampen liberal support. They DNC lives off trial lawyer money and the "waste and fraud" people are the core of Obama's support.

    September 11, 2009 12:02 pm at 12:02 pm |
  11. Moderate Democrat

    It's pathetic to see Republicans advocating and supporting INCOMPETENCE, but it's not surprising.

    The whole concept behind TORT reform is: "If you kill someone, no big's an 'oopsie', Doctors should not have to do their jobs". It also dictates that human life is worth a set price. That's LUDICROUS!

    September 11, 2009 12:03 pm at 12:03 pm |
  12. Wake Up

    Honest dems will admit, they won't pass tort reform, because they are all dem backers.
    NEITHER PARTY CAN BE TRUSTED! That is why we want less federal government and more local control. Obama is the opposite of what our founding fathers wanted...a big government partisan hack.

    September 11, 2009 12:05 pm at 12:05 pm |
  13. Centrist

    Good for President Obama to opening consideration for malpractice reforms in a respectful effort towards bipartisan support. Keep up the great work.

    September 11, 2009 12:06 pm at 12:06 pm |
  14. Proud Member..Party of No

    " What Obama really means" is "we're not going to do anything to stop all the insane lawsuits against the medical community because we're in bed with the trial lawyers of the country and they contribute alot of money to us."

    September 11, 2009 12:07 pm at 12:07 pm |
  15. Sam Sixpack

    What Obama really means is he is going to do absolutely nothing about fraud and waste unless you vote for this health care scam. Thereafter, of course, he will do absolutely nothing about fraud and waste. Since when does the president need a new law to stop Medicare waste and fraud? Hello? Is anybody there?

    September 11, 2009 12:09 pm at 12:09 pm |
  16. 2010 can't get here fast enough

    That way he can look good for a while, then say that the pilot programs didn't pan out, it is Bush's fault and he can move on with more misrepresentations of what is in the bill and what is not in the bill.

    When it was Bush, they were called lies.

    Why have the Democrats stopped specific bills that had language that states there will be NO illegals and NO abortions that the, OMG Republicans, have put forward?

    Why can't I buy across state lines Barry, would that not open up uh, uh, uh, uh competition and lower prices for all?

    September 11, 2009 12:10 pm at 12:10 pm |
  17. Stacy from Leesburg, VA

    Simple, I am willing to talk tort reform if the GOP is willing to talk public option. Every avenue to reducing costs should be on the table and in the bill as far as I am concerned.

    September 11, 2009 12:10 pm at 12:10 pm |
  18. Farrell in Houston

    Malpractice suits trumped with high insurance cost are a major problem when you look at the decline in doctors. Something must be done to stop the enormous amounts that attorneys seek for clients as well as themselves which bankrupts our medical society.

    September 11, 2009 12:13 pm at 12:13 pm |
  19. Mike

    The "democrats do" want to cover illegals with health care, why else would they not allow a vote on a Republican amendment to specifically state illegals would not be covered.

    September 11, 2009 12:13 pm at 12:13 pm |
  20. Truth-Bomb Thrower

    Frivulous medical malpractice lawsuits is one of the main reason this country has such high healthcare cost, but yet the ambulance-chasing trial lawyers are one of the democrats most reliable contributors. Anyone who believes that Obama or any other democrat is going to pass anything that is going to cost one single trial lawyer one red cent in income is dreaming. The democrats couldn't care less about improving healthcare or making it more affordable..........all they care about is CONTROL!

    September 11, 2009 12:15 pm at 12:15 pm |
  21. j.

    That`s a slippery slope !!! If we cap suits, more doctors may opt out and go it alone and continue to practice defensive medicine. And still bill the Ins. companies. There not that many suits out there now. Fear has worked well for the companies selling their outrageously expensive liability insurance and doctors will continue to pass the costs on.

    September 11, 2009 12:15 pm at 12:15 pm |
  22. seebofubar

    You can't believe anything that this self serving egotistical sorry excuse for a president says. He has broken every campaign promise and has surrounded himself with the most dispicable of human trash. How stupid can the democrats be to ever have believed in this clown

    September 11, 2009 12:16 pm at 12:16 pm |
  23. Turn Texas Blue

    200,000 medical mistakes per year and rising doesnt help.Some of these doctors are buying their degrees or getting them in crackerjack boxes,plus all the insourced doctors with degrees from high schools all over the world.

    September 11, 2009 12:16 pm at 12:16 pm |
  24. Bob in Pa

    Doctors are people and all people make mistakes. The awards get so outrageuos because people know that an insurance company is footing the bill. It is no longer about the Doctor that made a mistake trying to save their life.

    But then again, how much is having the wrong arm or leg amputated worth it it alters your ability to work for the rest of your life?

    September 11, 2009 12:18 pm at 12:18 pm |
  25. Fed Up

    As long as it doesn't apply to the doctor that may cut off a wrong leg, that's fine.

    September 11, 2009 12:19 pm at 12:19 pm |
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