Obama Clarifies Position on Tort Reform on "60 Minutes"

(CBS)

In his speech before Congress last week, President Obama attempted to win Republican support for his health care overhaul by agreeing to consider including medical malpractice reform in his plan. In an interview that aired on CBS' "60 Minutes" on Sunday the president shed some more light on what he meant -- and in which form he will not accept tort reform. (Read the transcript of the president's interview here.)

Mr. Obama on Sunday clarified that he is so far not willing to consider capping malpractice judgments, a reform proposal consistently put forward by Republicans.

"Many in this chamber -- particularly on the Republican side of the aisle -- have long insisted that reforming our medical malpractice laws can help bring down the cost of health care," the president said last Wednesday to a joint session of Congress. "Now, I don't believe malpractice reform is a silver bullet, but I've talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs."

The president then announced that he was directing Secretary of Health and Human Services Kathleen Sebelius to move forward on an initiative considered under the Bush administration to evaluate different kinds of malpractice reform through state-based demonstration projects.

However, it is unclear at this point whether the demonstration projects will produce valuable results before a health care bill lands on the president's desk. The president has said he would like to finish health care reform this year, and Sen. Tom Harkin (D-Iowa) said Sunday that Congress will pass a bill by Christmas.

The HHS Department will be releasing details about the initiative within the next month, an HHS official told the Hotsheet, such as how much money will be authorized for the projects and the timeline for the initiative. States will be able to apply for grants for various projects.

On Sunday, Mr. Obama discussed some of the types of malpractice reform that might be the subject of the state-based demonstration projects. However, he discounted the idea of capping medical malpractice damages.

"What I would be willing to do is to consider any ideas out there that would actually work in terms of reducing costs, improving the quality of patient care," Mr. Obama said on "60 Minutes." "So far the evidence I've seen is that caps will not do that."

There are a range of alternatives to consider, the president said, such as having medical experts review malpractice suits before they go to court to ensure they meet some threshold of credibility. Another idea would be to encourage, when appropriate, some form of mediated arbitration in place of lawsuits, he said.

Those two ideas reflect an amendment, written by Rep. Bart Gordon (D-Tenn.), that was adopted in the House Energy and Commerce's health care bill -- the only medical malpractice provision that has been adopted in any of the health care reform proposals before Congress. Gordon's provision would provide incentives to states that implement a "Certificate of Merit" or "Early Offer" program.

Yet while those two ideas represent malpractice reform advocated by a moderate Democrat, Republicans are still pushing for capping damages. Rep. Phil Gingrey (R-Ga.) introduced legislation this year that would strictly limit punitive damages in medical practice cases. Punitive damages would only be awarded if it could be proven a person acted with malicious intent or deliberately failed to avoid unecessary injury. The punitive damages would be capped at $250,000. The bill would also set a statute of limitations of three years after the date of manifestation of injury or one year after the claimant discovers the injury, with certain exceptions.

Gingrey has repeatedly introduced this bill, and in 2005 it passed in the House with strong Republican support and the approval of 14 Democrats.

On Monday, Gingrey sent a letter to the president requesting a meeting on the issue.

"The simple reality is that fear of ambitious lawyers and protracted legal proceedings are directly leading to the ordering of unnecessary tests which help safeguard against frivolous lawsuits, but also raise the cost of health care," he wrote.

Mr. Obama conceded on "60 Minutes" that Democrats and Republicans may not be able to reach an agreement on the specific idea of capping damages.

"I think there's also been philosophical issues and differences about whether or not patients who really have been subject to negligence, whether it's fair to just say to them, 'You know what? You can only get a certain amount no matter how egregious it is,'" he said. "So there's been a philosophical difference within the parties."

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Also from 60 Minutes, a discussion about the late Sen. Ted Kennedy with his son and the editor of his memoir.

Kennedy's Son Reflects On Dad's Legacy

[mld678]

Frivolous lawsuits are ruining our economy and America?s legal crisis is putting employees out of work, raising consumer prices and driving down shareholder value. We need to address the country?s litigation explosion and make the legal system simpler, and fairer. Read about the priorities of Friends of the U.S. Chamber at http://www.friendsoftheuschamber.com/issues/index.cfm?ID=306 .

[Stevenapoli7]

Hospital regulatory bodies need to be brought under control. The Joint Commission is out of control,and intrusive, grossly lowering health care effeciency.

[6591Hou]

Insurance is transferring risk. The transfer of risk from the consumer to another party for a fee. It is almost automatically an adversarial relationship between the consumer and the insurer.

Insurance complaints are primarily based upon insurance company's attempts to further reduce their contracted risk by questioning, debating, or denying procedures or billing rates.

Exacerbating this issue is insurance fraud which demands manhours, money, and resources to investigate and prosecute.

It could be argued that the lack of uniform procedures and processes across the insurance spectrum creates dissimilar results, and those dissimilar results are what creates consumers who are satisfied with their insurance and those who are absolutely dissatisfied.

Private insurance companies are not non-profit organizations, they must make a profit in order to satisfy their reason for being in business. In order to make a profit they must control costs, but should not be at the expense of not satisfying contracted terms of coverage.

[hamiltoningrate]

Stupid system.///////////////////unless you aint got no money.

usually legal disputes between poorer folks are settled pretty quick, because the lawyers get on the phone and talk it out, quickly. There is no money to pump. Not so if you have assets. This is not the way . We spend too much time, too much money and too much energy with attorneys.

[hamiltoningrate]

PAID by the HOUR ??? We are all being taken for a RIDE.

We truly need to limit what lawyers charge across the board. There should be a set fixed national price , say for a divorce, or a will, or other categories, not this stupid system of getting paid by the hour ! The longer it drags out, the more money they get. The incentive is therefore to mild your wallet and the system until some one cries uncle ! So many cases never get to court because the people go broke first. This is taking away our rights.

[alphaa10000]

WE ARE NIXONIANS, NOW

hamiltoningrate said, "... We truly need to limit what lawyers charge across the board. There should be a set fixed national price..."
---

No "free market" apostle with hamiltoningrate-- he knows what he likes and what he doesn't, principles completely aside.

With hamiltoningrate, price controls are now kosher. (Where was he during debate about Wall Street salaries and bonuses? Where is he when gas prices rise? Where is he when most of us cannot easily afford health insurance?)

Perhaps it would be just as fair to impose an hourly fee structure on the medical community?

As most of us already realize, so-called "tort reform" made egregious plaintiff awards vanishingly rare, which leaves only the group practices and hospitals still rolling in money.

Why does every major hospital have something under construction? Times must be truly hard for the health care business.

Talk about being "taken for a ride".

[alphaa10000]

WE'LL HANDLE THIS PRIVATELY ?

A forum poster said, "Tort reform is desparately needed in this country. It is too easy for someone to sue when they don't understand the underlying basis of medicine and hospital care..."
---

But a courtroom exists to establish that underlying basis. If it can be taught to you, it can be presented to others, as well.

Should people no longer have the right to sue for justice in medical cases, simply because you fear they may not agree with you?

In any event, the "tort reform" you suggest has nothing to do with proper understanding of the merits of a case. Its sole purpose is to isolate and limit the ability of a jury to decide what is just.

"Tort reform" is an effort to limit legal recourse for Americans who happen to be patients.

Put another way, if only technical practitioners have the facts and know the truth, how could they be held accountable under law for their actions?

Professional peers are already allowed in jury cases-- they are called expert witnesses.

Only those who are not satisfied with this approach seem to want a "tribunal", a closed-session adjudication similar, perhaps, to the disciplinary procedures of a medical association.

In other words, "We'll handle this in-house. The public need not inquire further."

This approach would place medical malpractice above the law.

[alphaa10000]

MALPRACTICE AND "TORT REFORM"

A poster said, "any good doctor today who wants to make money should become a lawyer... there's a lot more money in figuring out what doctors do wrong rather than paying them to do right.
---

Do doctors need to be paid more to "do right"? This claim is false, and slanderous to doctors, in general.

As for theatrical moaning about a wave of medical malpractice suits, the poster already knows the AMA lobby went through state legislatures at least a decade ago in its campaign for what it called "tort reform".

The AMA lobby-- a group representing less than one-third of the 800,000 physicians practicing in this country-- buttonholed friendly, bribeable legislators to secure passage of tort limits (caps) on malpractice damages against physicians, group practices and hospitals.

Their action went well beyond reasonable self-defense. To understand exactly what the AMA and its patrons in the legislature actually did, the phrase "nullification by statute" applies. After the death by medical malpractice of a loved one, grieving family members rarely recover more than the cost of going to court.

Even today-- so successfully have the AMA and GOP legislatively stonewalled malpractice claims by patients-- there is not even a national system of posting names of doctors, alongside malpractice suits made against them.

The matter of malpractice is public record and should be posted as such. The mere posting of a claim is not the point, but to aid prospective patients in assessing the questions they must ask of particular physicians, physician groups and hospitals.

This is literally a matter of life and death. Today, unfortunately, it is easier to find consumer reviews of automobiles and paperback books.

Warning-- those who plan to enter surgery or any other serious treatment should keep in mind the smiling face of a specialist is no guarantee of competence or reasonable safety.

Again, only a publicly-posted track record of malpractice suits filed against a physician or hospital can work toward honesty and patient safety.

Thank the AMA and bribeable legislators for the fact we do not have such a system, now.

[mdjdbs]

Thank you for making me laugh. The phrase "honesty and patient safety" seems to be your #1 priority. I've read about 5 posts by you, and all seem strangely propaganda-like against any sort of tort-reform. I'm finding it hard to believe you are not or do not work for a trial lawyer.

You use the AMA and bribeable legislatros interchangeably. In fact it is the trial lawyers who happen to be one of the largest campaign contributors to the Democratic party.

The funny thing is, research has shown that the longer you practice medicine, the higher your chance of being sued. That is clearly because every doctor is terrible and is out to hurt patients for money. Your national database of those being sued would drive patients towards speciialists that have the least amount of experience...those who have just graduated resdiency.

It is a well known understanding that every physician will be sued at some point in their career. I'm beginning to think all you see is dollar signs when you read this statement.

Your post on medical malpractice seminars is laughable ("PATIENTS AND FAMILIES BEWARE!!!"). Once again, if anyone were to follow your advice, they should refute anything a medical professional tells them as bs, mainly because they must have gone to a malpractice seminar. "Your loved one might not survive the night..." elicits "I'm sure they are fine. Don't worry, we're not planning on litigation...yet".

I think there is a reason malpractice lawyers don't take an oath to do no harm. You would be out of business.

[alphaa10000]

PATIENTS AND PATIENT FAMILIES, BEWARE !

The medical community for the last decade has been blitzed by little-publicized, traveling "legal seminars"-- these professing to help medical professionals avoid litigation.

As innocent as that sounds, some of the methods taught by the seminars are anything but defensive. They cause needless pain and suffering, and are based upon manipulation of patient expectations.

Here is how the methods work--

Suppose a patient and his family rush to the hospital for a critical procedure. They are beside themselves with anxiety, and need all the hope and reassurance possible. While providing emotional comfort seems an easy mission for staff, medical professionals are now told, "Not so fast!-- this is "bad medicine."

The attending physician or other managing professional is instructed to inform the patient's family with a limited or poor prognosis-- "I am sorry, but the outlook is not the best. We'll do what we can, of course, but it appears all four wheels have fallen off. It will be difficult."

What a blow to an anxious family! And what a failure of the oath to do no harm! At hearing such a report, family members have been known to become depressed or violently ill, as a result. But as the seminar tells medical professionals, this is ultimately all to the good.

They are given the following explanation--

"If you promise the moon, but deliver coal and ashes, you probably will be sued by angry relatives, regardless of the effort you made and difficulty of the case.

"If you promise little or nothing-- even advise of the worst-- but deliver something, anyway, and maybe even the sun and moon, combined, you will be hailed as a miracle worker. Even your fees will be received with gratitude."

[chitown639]

Tort Reform won't cut the cost of Health-care in this country....the way to cut cost is to eliminate the "middleman" insurance companies who are taking 30% off of the top of our 3 trillion dollar health-care system for profit.

[notsouthern]

by brian1920
In Texas we have tort award caps and the malpractice insurance rates have fallen lowering the cost of health care. This is proven data and anybody can check it out.

Brian, point US to some sort of Internet verification that insurance rates have dropped in Texas due to tort reform. Liberals from Texas on board have posted the opposite. Or maybe Brian, you are really a fascist, therefore a liar, as all Republicons?

[jsd330]

notsouthern point us to some internet verification to prove it didn't. Where is the proof from these liberals you're talking about that posted it. Just admit it, because he's from Texas you hate him. You are the fascist and a racist.

[alphaa10000]

PARTIALLY PREGNANT

jsd330 said, "notsouthern point us to some internet verification to prove it didn't..."
---

jsd330, did you attend GOP Rhetoric 101?

Your challenge to notsouthern is not a logical defense of brian1920's proposition, "tort award caps and the malpractice insurance rates have fallen lowering the cost of health care".

By analogy, an argument ensues. Says one, "You are pregnant!"

Says the other, "I am not!"

Says the one, "Prove I am not!"

You are definitely a graduate of the Dichard Cheney School of Logic, which insists "absence of proof is not proof of absence."

By that same logic, it is not proof of anything, at all.