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President Obama mentioned the medical liability problem yesterday, and it says something about health-care orthodoxies that even this political gesture sent his usual allies into a fluster. We suppose this is progress -- though there's a reason cannier Democrats are smiling.
Of course Mr. Obama deserves credit for even referring to what he called the "real issue" of medical malpractice reform. The paragraph he appended to his stock speech on health care for the American Medical Association yesterday didn't offer much detail -- "I do think we need to explore a range of ideas," he boldly declared -- but trial lawyers and their stratospheric jury awards and settlements have led to major increases in the medical malpractice premiums, thus driving up the overall cost of U.S. health care.
The system today is worse than random -- many lawsuits do not involve any negligence -- and some physicians respond by leaving such high-risk fields as obstetrics, anesthesiology, neurosurgery and emergency medicine. Others practice defensive medicine, ordering unnecessary tests to immunize themselves if they do end up in court. Economists disagree on the precise burden of this legal fear, but some argue that it exceeds $100 billion a year.
Mr. Obama's cri de coeur might have had more credibility had he not specifically ruled out the one policy to deter frivolous suits. "Don't get too excited yet," he warned the cheering AMA members. "Just hold onto your horses here, guys. . . . I want to be honest with you. I'm not advocating caps on malpractice awards." In other words, the tort lottery will continue. California, of all places, has had great success in holding down liability costs for doctors and hospitals after a 1975 reform that limited pain and suffering damages -- balanced against the public interest of fairly treating victims of genuine malpractice.
The trial bar and its Democratic allies say that the threat of lawsuits promotes better care and assures accountability. But they've fought even modest changes that would offer liability protection if doctors adhere to evidence-based guidelines. Mr. Obama showed again with his AMA speech that he's willing to nod at the concerns of his political opponents and take media credit for brave truth-telling, only to dump his conciliation if it offends liberal interest groups.
Mr. Obama's aides have openly told the press that he views medical liability as a "credibility builder" -- that is, a token policy to keep the health-care industry at the bargaining table. Given that the only "bargain" that seems likely to emerge is another major step toward total government control of the health markets, the President seems to be counting on credulity.
