Republicans have long suggested that the U.S. could save money on health care by reining in the cost of medical malpractice suits. Democrats are generally skeptical of that idea, and there is no consensus on how much lawsuits affect health care bills. Still, an effort to limit malpractice litigation could have a political pay off, as NPR's Scott Horsley reports.

SCOTT HORSLEY: In the Republicans' most recent weekly radio address, Wyoming Senator Mike Enzi offered several of what he called common sense reforms aimed at curbing health care costs: more competitive insurance plans, better information for health care shoppers and that old Republican chestnut, cutting down on frivolous lawsuits.

Senator MIKE ENZI (Republican, Wyoming): We need to reform our flawed medical liability system and eliminate junk lawsuits against doctors and hospitals. Unnecessary lawsuits drive up health care costs.

HORSLEY: Democrats, who get significant backing from trial lawyers, have generally resisted efforts to curb lawsuits. But former Democratic Senator Bill Bradley suggested in a New York Times op-ed this week a grand bipartisan compromise: Give the GOP the relief from lawsuits that Republicans want, Bradley suggested, in exchange for the universal health insurance that Democrats want.

Dr. NANCY NIELSEN (Former President, American Medical Association): I read the op-ed piece, and all I could think was from his lips to God's ears. I mean, it would be a wonderful thing if it were that simple.

HORSLEY: That's Nancy Nielsen, immediate past president of the American Medical Association.

AMA members stood and applauded back in June when President Obama promised to let them be healers rather than bean counters. The doctors' loudest applause came when the president said he would consider steps to shield them from looking over their shoulders for lawsuits.

President BARACK OBAMA: Stop, stop. Just hold on to your horses here, guys.

(Soundbite of laughter)

Pres. OBAMA: I want to be honest with you. I'm not advocating caps on malpractice awards.

(Soundbite of laughter)

HORSLEY: In general, doctors really like caps on malpractice awards, like the one that Texas imposed six years ago. It limits pain and suffering damages to a quarter million dollars. That cap has made it cheaper for doctors in Texas to buy malpractice insurance, and it's encouraged more doctors to set up shop in the state. But a review by The Dallas Morning News found no evidence that malpractice savings had been passed on to consumers. And parts of Texas still have some of the nation's highest medical bills.

Limiting lawsuits by itself won't change a system that gives doctors a financial incentive to do more and more. But doctor and University of Texas law professor Bill Sage says limiting lawsuits could be useful if it helps win doctors' trust.

Dr. BILL SAGE (Law Professor, University of Texas): Health policy experts almost all agree that the most important thing for overall health reform is changing the way medicine is practiced and health care is delivered in this country. And if one of the things that is perpetuating the current system is fear of malpractice liability, I'm certainly willing to consider dramatic changes to the malpractice system.

HORSLEY: So far, there are no dramatic changes in the offing, although one version of the House bill does include incentives for states to explore alternative liability systems. Mr. Obama has said he's willing to consider a range of ideas, short of capping malpractice awards. But White House spokesman Robert Gibbs sounded doubtful this week that medical liability reform could be the basis of any grand bipartisan compromise.

Mr. ROBERT GIBBS (White House Spokesman): The president's willing to consider any number of approaches. But there have to be people on the other side of the table to respond to those gestures. I'm concerned people in those chairs seem to be leaving more rapidly than the American people want them to.

HORSLEY: For his part, Senator Enzi isn't talking about a grand compromise, either. In his radio address, the Republican Senator called for scrapping the current health care bills, despite months of negotiation in which he's been a key player.

Scott Horsley, NPR News, the White House.

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