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. Sam Sixpack

    Why stop with insurance companies? Why not focus on the real culprit – free enterprise.

    September 11, 2009 12:48 pm at 12:48 pm |
  2. RI Moderate

    Obama will never go against the trial lawyers. They are huge contributors to the dem party. Trial lawyers get big money and contribute to dems. Kind of the same dynamic as repubs legislate for drug companies and drug companies contribute to repubs. ITS THE SAME CORRUPTION WITH DIFFERENT FACES.

    There is no honor among thieves or politicians.

    September 11, 2009 12:49 pm at 12:49 pm |
  3. Dan, WA

    He is a liar period

    September 11, 2009 12:49 pm at 12:49 pm |
  4. Marcj97

    Wow! The President is willing to compromise and some of you idiots are still complaining. You say he is not willing to listen to ideas from republicans and you still complain. What else can he do. Hyperpartisan people fuel hyperpartisan politicians and politics. You idiots are ruining this country with your refusal to consider anybody's point of view except the one that your respective party tells you to! You line up like mindless robots behing your party and spit out anything you see on FoxNews or MSNBC. Both of your party's agree that Healthcare Reform is a must! Yet you both insist on listening to either pie-in-the-sky pipedreams or blatant lies and most of you have'nt done any research to back your arguments. instead of spewing hate, try and com off of your far left and far right soap boxes and come to a compromise in the middle!

    September 11, 2009 12:51 pm at 12:51 pm |
  5. Melissa

    As long as the Republicans are behaving like spoiled whiny brats that aren't getting their way, nothing will get fixed in this country.

    September 11, 2009 12:51 pm at 12:51 pm |
  6. kris

    "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. "

    Shouldn't health care reform be a bipartisan effort? Many Americans were angered by the "it's my way or the highway" approach that Obama, Pelosi and Reid had.

    September 11, 2009 12:52 pm at 12:52 pm |
  7. Melissa

    The Republicans aren't interested in a bipartisan effort. They want everything their way or no way.

    September 11, 2009 12:55 pm at 12:55 pm |
  8. Di

    Obama needs to curb new entities and spending. STOP THE PORK! Obama won the election in Nov. We the people voted for CHANGE. We did not understand he meant ALL OF OUR CHANGE!

    September 11, 2009 12:56 pm at 12:56 pm |
  9. kris

    Make it loser pays.............The losing side in the lawsuit pays the other side...........Also, cut back the fees that blood sucking lawyers receive in an award. Let's see the government regulate that!!!!!!!

    September 11, 2009 12:58 pm at 12:58 pm |
  10. Chuck, Tennessee

    There is a middle ground. First, take actions to try to prevent negligent care, but also place some reasonable limits on med mal case awards. I don't mean a flat cap that applies to all cases, but a mechanism to set a reasonable limit for different types of injury.

    September 11, 2009 12:59 pm at 12:59 pm |
  11. NH Independent

    CNN afraid to post opposing views along with the truth???????

    Obama speaks untruths so his misrepresentation during his speech on illegal’s and TORT Reform really isn't shocking, he a smooth talker but no substance but does however make the Liberals drool....(glad I wasn't cleaning up after joint session)..........Again; Liberals learn to read and get a library card it is amazing what you can find out. if you open a book or newspaper archives...........I only judge Obama by who he surrounds himself with.......Socialist, Marxist, Self proclaimed Communists, Fascists, and ..... ACORN SCUMBAGS......The only news station that reported on ACORN like it is ix FOX....yeah CNN too but they appear to be afraid to tell it like it is what was their headline......."ACORN workers caught on tape allegedly advising on prostitution" Come on CNN allegedly shouldn't be in the headline unless you didn't see what I saw......ACORN are scumbags who get taxpayer money and these workers were advising how to screw the government they very hand that feeds them while advising someone how set up a brothel and exploit children for sex all while screwing the government ......Obama thinks ACORN is a great........... and the mainstream news media should not sleep well at night as they are as bad for not reporting

    September 11, 2009 01:02 pm at 1:02 pm |
  12. Ignorance is bliss

    What does the term money talks actually mean? DUH

    September 11, 2009 01:03 pm at 1:03 pm |
  13. dg houston

    liberals are all for the sue game, there will not be any limits on sueing, so watch everyones premiums go up

    September 11, 2009 01:06 pm at 1:06 pm |
  14. Scooter

    How much did Michelle make when he helped change the healthcare in Chicago. its all about his cash and not for america

    September 11, 2009 01:06 pm at 1:06 pm |
  15. Fed-up

    My new slogan is "PROVE IT!" If Obama syas he will pay for the insurance of 30+ million uninsured US citezens (a number that he dropped from 47 million when he was counting in the illegals he still intends to insure) largely by cutting waste and inefficiencies in Medicare and Medicaid, are we supposed to take him at his word? Riiiight. I will gladly support a public option if he proves he can do this. but PROVE IT first. No bill needed.
    Also, no bill needed to to allow increase "choice and compitition" with allowing insurance companies to compete nationally vs being in state regulated environments. Speaking of government programs, how finacially sound is medicare and Medicaid? last I checked....not so good. Finally, any public option is a stepping stone to single payer. 5% may enroll but a majority of the country will soon be in it as the tax or penalty to companies that drop health benefits (8% of payroll) is far less than the current health benefit expense. Welcome to your new plan. Also, If the evil insurance companies dont do the right thing, they get sued and sued big. Good luck trying to sue public option if denied benefits. Ever try suing the IRS?

    September 11, 2009 01:09 pm at 1:09 pm |
  16. Nunya

    There won't be reform in the malpractice area, too many trial lawyers that are libs and back obama. And the whining that would take place if there was would be boisterous. Course most libs are whiners when the don't get their way.

    September 11, 2009 01:10 pm at 1:10 pm |
  17. Atlanta,GA

    This Liberal Democrats Supports Tort Reform, its common sense. Its just a fact that there are 10's of thousands of ppl out there simply to profit from a system designed to help those that have been hurt. We can reform the system to help those hurt and weed out these ppl scamming and holding the doctor's hostage. Go Obama!

    September 11, 2009 01:13 pm at 1:13 pm |
  18. Willy Brown

    Means Obummer will remain in bed with trial lawyers.

    September 11, 2009 01:13 pm at 1:13 pm |
  19. Rich

    "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."

    This is a great way to curb the extraordinary amount of payments that are being made in the industry right now. Many of the lawsuits that are filed right now have no merit, but the physician and his or her institution of medicine have to take valuable time away from his or her practice to go through the legal process.

    September 11, 2009 01:22 pm at 1:22 pm |
  20. Mason

    Lawyers own the Democratic party. Tort reform should be a litmus test for how serious Obama is about Healthcare. Tort Reform is a no brainer and was quoted in the WSJ it would save $65-$200Billion a year. As with all things Obama watch what he does not what he says. That mention of Tort reform was an imaginary carrot and if his usual verbal deceitfulness applies he can forget any Republican support.

    September 11, 2009 01:30 pm at 1:30 pm |
  21. Ron

    Several years ago, Texas instituted malpractice reform and placed caps on awards. The interesting result is that health care costs have not gone down, in fact Texas has some of the highest costs in the country. In addition, doctors have not reduced the number of unnecessary tests they order. Lastly, the CBO has reported that reducing malpractice costs will have no significant effect on health costs. Tort reform is a red herring!

    September 11, 2009 01:30 pm at 1:30 pm |
  22. eolufemi

    Amazing. He tries to compromise and the republicans still complain. You guys are unreasonable.

    September 11, 2009 01:31 pm at 1:31 pm |
  23. BLemberg

    As a practicing physician, I can honestly call this a crumb thrown my way. By the time these so called experiments get off the ground and are analized, we all will be in the next millenium.This is a sad joke.The medical profession needs help now as does society to avoid the costs of malpractice defensive medicine. I am sure the trial attorneys supporting the democrat party are quaking in their boots. By the way,where are the doctors going to come from to care for all the new patients and increasing needs of the aged? How many will be willing to work even longer hours for less compensation (how else can costs come down?)

    September 11, 2009 01:32 pm at 1:32 pm |
  24. lyn

    Sixpack, WATCH, the game just started and we will have Health care by the end of this Year. ----- President Obama, GREAT JOB you are truly trying to help the people who in this hard time loosing their homes, their Health care we stand with you and may the Lord pretect and guide you from those who are spreading lies and rumors.-– Wilson I don't believe you with your apoligizes you can't fool us, your hatred for our President shows.

    September 11, 2009 01:36 pm at 1:36 pm |
  25. Grrr-awful-o

    Ever seen those mesothelioma commercials on TV? Or any of the other similar medical lawsuit commercials. Those are trial lawyers, taking advantage of favorable laws that allow them to trawl the country for clients willing to help the lawyers make a buck and share in the riches. Ambulance chasers. But who ultimately pays for the cost of all these trivial and trumped up lawsuits? You do! Not the rich. Not the government (you fund the government – there's no magical source of money here). And as long as parasites can suck the system dry you will continue to replenish the system with your money. Taxes going up (and you can bet they will through all of this... sooner or later)? Think about who the money is really going to when that happens. So, why does the government protect these trial lawyers (ambulance chasers) right to plunder the system so fervently? Look who makes up a substantial part of congress. And look at how powerful the trial lawyers' lobby is. It's not complicated to understand. So pay up! I'm ok because I think I'm coming down with a touch of mesothelioma.

    September 11, 2009 01:40 pm at 1:40 pm |
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