WASHINGTON -- In his first response to calls for changes in the nation's health care system, President Bush is sending to Congress this week a plan to pressure states to limit court awards for medical malpractice.
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 can collect for pain and suffering, to set up mediation systems for resolving disputes and to strengthen medical licensing boards, among other things.
States that fail to go along would lose some of the federal payments they receive under the government's Medicare and Medicaid programs, which pay for health care for the elderly and the poor.
Though it is limited to malpractice reforms, the proposal is the administration's first significant one in the area of health care.
White House officials say the plan will lower the cost of medical care, chiefly by cutting what doctors will have to pay for insurance, thus allowing them to charge less for services. The officials said the plan would also increase access to care, noting that some doctors, for example, have stopped delivering babies because of the cost of insurance.
The officials said future health care proposals will not attempt to create a national health insurance or other such sweeping 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.
There is widespread support for lessening the flow of money associated with malpractice suits. But the idea of penalizing states -- and hospitals through the federal money the states pass on to them -- for not making changes drew objections from their representatives.
An expert on malpractice expressed concern that the Bush proposal addressed doctors' worries about large awards but not patients' worries about malpractice itself.
Democrats said in interviews in the past several days that the chances of passing the president's proposal as it stands are small.