Bill Clinton: “As you might imagine, we debated that thing for a long time before we presented our plan to the Congress, because we…”

“As you might imagine, we debated that thing for a long time before we presented our plan to the Congress, because we didn't want the whole health care plan to come a cropper on a debate over tort reform. We thought there had to be some. We knew that the States were taking up this issue to some extent, but we thought we ought to do something nationally, even though tort law historically has been completely within the purview of State government, not the National Government. So we agreed that there ought to be a limitation on lawyer fees, contingency fees. And we did some other things that were recommended by you and were in the model work that was done in California. Something else we did that I think has been insufficiently noticed is we agreed to include medical practice guidelines developed by professional groups as raising a presumption that there was no negligence on the part of doctors. This offers an enormous opportunity to dramatically reduce the number of medical malpractice suits, the number of recoveries, and therefore the malpractice rates. My own view is that based on the research I've seen in a couple of places where this has been tried on a limited basis, is it may offer the best hope of all of protecting doctors from frivolous lawsuits by simply raising a presumption that the doctor was not negligent if the practice guidelines developed by the professional groups themselves were in fact followed. So I think that that has been not sufficiently noticed. That is a very, very big step, in addition to the other things I mentioned. My own judgment is that we will not include the national cap because there will be so much difference among the various congressional delegations from different States about what the cap should be and whether it should change with inflation over time. And in fact, you might wind up in California with a situation different from the one you have now if it were to be done. For example, if there were a debate on the national cap, then the immediate thing would be, what should the cap be, and if States have a lower one, should it be required to be raised? Because all those things were involved, we decided that we would leave the cap issue itself to State law and deal with these other matters. I urge you to look at what we have done, because I think we've taken a long step toward trying to relieve doctors of the burden of frivolous lawsuits and trying to control the cost of malpractice insurance.”