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

Curbing medical lawsuits: What Obama really means

[cnn-photo-caption image= http://i2.cdn.turner.com/cnn/2009/images/09/11/art.obamasept11.gi.jpg caption="Curbing medical lawsuits: What Obama really means."]

WASHINGTON (CNNMoney.com) - 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
reform."

"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. Reformed Republican

    Why are the rethugs posting to this site braying and bleating about
    Obama's "go slow quickly" approach?

    Isn't that what these racist obstructionists want for health care reform in the first place? Or it it as these these bat crap crazies are now screaming – "THEY LIE TOO".

    OK folks, just like Wilson please send me money so that I can fend off attacks by these bigoted, exit portals of the lower intestines. You know, those Neanderthals that call themselves "christians" but would rather throw people out of hostpitals than provide a means for them to get medical treatment.

    So much for the Golden Rule if your a brown shirted rethuglican hey America...

    September 11, 2009 12:21 pm at 12:21 pm |
  2. Robk

    Hey, if we are going to have a panel of government experts telling doctors what they can charge for different procedures, how about a similar panel telling lawyers how much they can charge for their services? And another panel telling plaintiffs how much they can get if they win different types of malpractice suits?

    September 11, 2009 12:23 pm at 12:23 pm |
  3. Vets4Obama

    I'm not for TORT reform, it's a solution that a retard thinks will do anything. But I'll live with it if it helps get the bill passed.

    TORT reform was already 'piloted' in Texas. Health Care Costs continue to spiral out of control there. All it did was allow incompetent doctors to save money. The idea that an incompetent doctor is going to call you up and send you some of your money back is moronic.

    September 11, 2009 12:24 pm at 12:24 pm |
  4. rkidd

    As our government cannot do anything the easy way, they will set up 20 committees to look into tort reform costing the taxpayers millions.

    Simple solution : malpractice should be pain and suffering and actual damages.

    Punitive damages should only be awarded in cases of gross negligence or repeat offenses.

    Punitive damages should not go to the plaintive of their attorneys , punitive damages should go to the government to be used to offset the cost of medical litigation.

    If you are injured by another party of course you should be compensated , but 8 million dollars for spilling a hot cup of coffee in your lap is ridiculous.

    September 11, 2009 12:24 pm at 12:24 pm |
  5. AntiRush

    Did Ms. Liberto attach electrodes to the president's head that gave a read-out on her computer of his actual thoughts? This is one of the problems in this country. Everyone tries to interpret what others say, usually shaping the interpretation to the interpretors way of seeing things. Thus, Rep. Wilson can shout out "he lies" because he can either telepathically know what the President is thinking, or he just really hopes that the President is lying. As far as tort reform goes, the Dems better get on board. There are way too many BS lawsuits. Judges should have the guts to throw out frivolous lawsuits. Insurance companies shouldn't settle them just to avoid the cost of a trial. Anyone who doesn't think that doctors paying hundreds of thousands of dollars in malpractice insurance don't have to charge more to cover the costs doesn't understand basic accounting or finance.

    September 11, 2009 12:24 pm at 12:24 pm |
  6. floridian4USA

    Obama is throwing stuff against the wall to try and appear as though he is open to discussions with his opponents on this issue. Why hasn't he taken any of their proposals seriously before. Why does he continue to say that he will entertain other solutions when he has dismissed all proposals that weren't from the libetards? Why does he keep spouting lies about covering illegals and abortions? He lies. Rep Wilson may have chosen a poor time and venue but he spoke the truth. Obama is a liar!

    September 11, 2009 12:25 pm at 12:25 pm |
  7. Sam Sixpack

    Why do you keep clinging to false hope? The game is already over. Meaningful healthcare reform is now dead for years to come. All we can hope for now is that we will be able to afford to pay our soon-to-be required premiums for the care we will be denied.

    September 11, 2009 12:26 pm at 12:26 pm |
  8. texan

    Amen to you Kentucky---- I`m 66, white working male, ex OLD LINE Republican and more a "blue dog' Democrat. I can no longer associate with the Neo-Cons that seem to have taken over the Republican Party.

    September 11, 2009 12:27 pm at 12:27 pm |
  9. Rob

    As long as the Dem lawyers are one of the ones pulling Barry's puppet strings, there will be no such thing as tort reform. Obama's just one big puppet for the libs. And unfortunately, a puppet that may very well take this country down.

    September 11, 2009 12:28 pm at 12:28 pm |
  10. Darth Vadik, CA

    How about curbing the insurance premiums first.

    If a doctor mistakingly does something to my body DUE TO CARELESSNESS, I will sue the hospital so fast their head will spin.

    But a lot of the doctors mistakes can be traced directly to the insurance companies. They are the whip masters that tell doctors what they can or cant do.

    Let focus on the real thieves, not people who have been unnecessarily scared for life and want some compensation, but the dogs sitting in meeting rooms dictating medical policies according to what will give them the best profits.

    September 11, 2009 12:31 pm at 12:31 pm |
  11. Robert Blake

    The republican approach to "tort reform" is to make it as difficult as possible for patients to sue physicians and other health professionals. There are certainly frivolous suits, which should be discouraged. But there are patients who have been seriously injured because of medical negligence who deserve compensation. The usual approach to "tort reform" of capping noneconomic damages and limiting lawyer fees does not distinguich between the claims that are frivolous and those that have merit. Pilot projects might be useful in identifying alternative methods of compensating harmed patients and detering bad medical practices. The President should be commended for avoiding the knee jerk homilies about "tort reform" and exploring other options. After all, the republican "tort reform" of recent years has done nothing to reduce defensive medicine or contain costs.

    September 11, 2009 12:31 pm at 12:31 pm |
  12. No free lunch

    Gee, insurance industry huge ad buy coincides with CNN developing massive and obvious, pro-insurance-industry, anti-Obama, anti-American-people bias.
    Must be a coincidence.

    September 11, 2009 12:33 pm at 12:33 pm |
  13. Lynne

    Has anyone thought about looking into the INSURANCE companies that insure doctors for malpractice to see what kind of profits they are making??? Ask the Republican Congressman who responded to president Obama's speech as he should know a great deal as he has been sued three times for malpractice.

    Why isn't this Congressman still a doctor?? Surely this goes to his credibility??

    September 11, 2009 12:33 pm at 12:33 pm |
  14. Lolly, CO

    What I like about the O-man is he tries to understand and fix the REAL PROBLEM, not just marching in line w/ ideology that conservatives drive into Republican party to protect and reduce oversight on their God – Big Business

    September 11, 2009 12:33 pm at 12:33 pm |
  15. gt

    he is up to his neck with trial lawyers ,,,,,never gone to happen...

    September 11, 2009 12:35 pm at 12:35 pm |
  16. Darth Vadik, CA

    By the way, although illegal aliens are a problem for the US, they are a MINOR problem. It is unfair and unjust to treat them as scapegoats for our problems.

    Though we're not the first ones, Hitler scapegoated Jews, Lenin scapegoated the few filthy rich, Romans scapegoated Christians, we're scapegoating illegals, etc etc etc etc.

    A familiar tune to a different song......

    September 11, 2009 12:36 pm at 12:36 pm |
  17. donttreadonme

    And who will run these pilot projects? Obama's Secretary of Health and Human Services – Kathleen Sebelius.

    Sebelius served as executive director and chief lobbyist for the Kansas Trial Lawyers Association. Reform of frivolous lawsuits very unlikely. Is anyone in the dem party not a lawyer these days?

    September 11, 2009 12:36 pm at 12:36 pm |
  18. matt

    whatever obama you had a guy in your administration who blame the govt and said it was a inside job and now the truth is coming out about Acorn its time to impeach this guy

    September 11, 2009 12:37 pm at 12:37 pm |
  19. Don

    Obama says one thing, means a second thing, will aim at a third, confuses you with a forth, and expects you to believe a fifth thing. Granted he does it with a smile and with very nice words and people still buy it– but "where is the beef"??!!!

    September 11, 2009 12:38 pm at 12:38 pm |
  20. Biff

    why does including a republican idea have insiders "scratching their heads"? Thats what governing from the middle is.

    September 11, 2009 12:38 pm at 12:38 pm |
  21. Competition / Reform

    Let insurance companies offer competition by not restricting them to one specific state and let them sell across the United States. More competition equals lower costs because consumers will have more plans to select from for coverage. Obama is not for this option.

    Doctors perform unnecessary procedures for fear patients may sue them if they failed to detect a health problem. Doctors fear lawyers and have high premiums for malpractice. Obama will not push back and require tort reform since 95% of lawyers send money to Democrats and the Democrats do not want to anger this major campaign base. Placing campaign donations before patients health care is wrong. Obama is wrong to pay lip service to tort reform and not implement change.

    September 11, 2009 12:38 pm at 12:38 pm |
  22. Mississippi Mike

    That's the biggest way to cut medical care costs right away. If insurance premiums go down, the doctors won't have to pass the costs along to patients and suddenly you have a massive cost savings.

    September 11, 2009 12:39 pm at 12:39 pm |
  23. motruth

    Real tort reform will never happen with dims in control. Trial Attorneys OWN the Dimocrat party.

    September 11, 2009 12:44 pm at 12:44 pm |
  24. Sam Sixpack

    The biggest tort is the outrageous prices pharmaceutical companies charge – for drugs developed by your tax dollars in the first place. Once the insurance companies are out of the way, the will charge whatever they want. You believe the insurance companies are the villains because somebody told you what to think.

    September 11, 2009 12:44 pm at 12:44 pm |
  25. Dont blame me

    We have TORT reform here in Texas and it has help tremendously and we have a lot doctors moving to Texas from other states that have no TORT reform

    Not only has it helped keep costs down, but it PUNISHES REPEAT OFFENDERS, as it should.

    September 11, 2009 12:45 pm at 12:45 pm |
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