Clinton Ponders Limits on Doctor Fees, Vulnerability

Article excerpt

WASHINGTON _ As part of their effort to control health costs, Clinton administration officials are considering asking Congress to impose restrictions on medical malpractice lawsuits and limits on doctors' fees.

No decisions have been made. The proposals, under study by health policy experts at the White House, have not been endorsed by Clinton or reviewed for their political acceptability.

But confidential work papers from the President's Task Force on National Health Care Reform show that the administration is seriously considering many proposals to limit lawsuits and payments for injuries caused by doctors' negligence.

Doctors support many of the malpractice proposals, which grow out of the movement to curb liability lawsuits and are favored by such conservative critics of trial lawyers as former Vice President Dan Quayle. But doctors oppose the idea of fee limits being considered as an element of the plan that President Clinton will send Congress by May 1. The president has said he wants Congress to approve his proposals this year, but the legislation is sure to be complex and hotly debated.

A White House group studying medical malpractice said the current method of compensating injured patients and disciplining doctors "has produced only a litigation lottery."

Among the ideas under consideration, some of which have been tried at the state level, are these: Limit damages for a patient's "pain and suffering." Reduce damages to take account of any money the patient gets from insurance or workers compensation. Allow doctors to make payments periodically, over a number of years, rather than in a lump sum. Encourage patients to settle claims through arbitration rather than court trials.

Supporters of such measures say they have produced benefits when tried in some states, particularly California.

In the context of major changes in the health care system, the documents say, consumers "might accept some modification of their legally prescribed rights, some reduction in their potential financial recovery or some change in factfinding procedures" in exchange for an assurance that they would be paid for injuries resulting from a doctor's treatment.

A White House official said Clinton was trying to balance concerns of doctors and trial lawyers.

The task force, headed by Hillary Rodham Clinton, has a staff of 300 to 400 people, divided into more than 30 committees. The panel studying malpractice is headed by Dr. Robert Berenson, a physician, and Kathleen Hastings, a lawyer and nurse. Berenson is a member of the Jackson Hole Group, an influential organization of health care executives and policy analysts who are trying to mix free-market economics with government regulation in a strategy known as managed competition.

Clinton has adopted many tenets of the Jackson Hole Group, named for its meeting place in Wyoming. …