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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