WASHINGTON -- In his first response to calls for changes in the nation's health care system, President Bush will send to Congress this week a proposal to help control the fastest-rising part of medical costs -- malpractice litigation and the insurance to cover it. The plan would press the states to enact limits on court awards.
According to a draft of the proposal made available by White House officials, states would be encouraged to adopt limits on the amounts that malpractice victims could collect for pain and suffering, to set up mediation systems for resolving disputes and to strengthen medical licensing boards, among other things.
States that failed to go along would lose some of the federal payments they receive under the Medicare and Medicaid programs, which pay for health care for the elderly and the poor.
The proposal is the administration's first significant effort in the area of health care.
White House officials say that the plan will decrease the medical costs, chiefly by cutting the amount doctors have to pay for insurance and allowing doctors to charge less for services. They said the plan would also increase access to care, noting that some doctors, for example, have stopped delivering babies because malpractice insurance costs.
The officials said future proposals will not attempt to create a national health insurance program or othersweeping changes, but rather will use incentives to get the states to cut costs and to include more people in the current insurance-based method of paying for health care.
Reaction to the proposal has been mixed. Those most staunchly opposed are trial lawyers, who now argue malpractice cases in court.
"This will take away the right to a jury trial," said Martin Maher, president of the Association of Trial Lawyers of America. "To limit an injured victim's or widows' and widowers' rights to recover fair and adequate compensation by an American jury is wrong."
The American Hospital Association also objects to the measure, chiefly because of the way it is financed: The association fears hospitals will lose Medicare and Medicaid payments if the states do not agree to make the changes.