Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: THURSDAY, May 6, 1993                   TAG: 9305060029
SECTION: NATIONAL/INTERNATIONAL                    PAGE: A13   EDITION: METRO 
SOURCE: Associated Press
DATELINE: WASHINGTON                                LENGTH: Medium

SHIFT URGED IN MEDICAL LAWSUITS

Clinton's team has discussed "enterprise liability," with doctors', hospital and consumer groups.

Kirk B. Johnson, the American Medical Association's general counsel, said some White House advisers "have made at least a preliminary decision that [enterprise liability] ought to be the centerpiece of liability reform."

The White House task force is eyeing other possible changes in malpractice law, including caps on damages for pain and suffering.

Consumer groups and organized medicine alike have misgivings about the possible changes.

Enterprise liability has been championed by two academics, Paul C. Weiler of Harvard Law School and Kenneth S. Abraham of the University of Virginia School of Law, who argue that malpractice suits should be aimed at organizations, not individuals.

Institutions already bear the malpractice liability in most other fields, said Weiler. "If an airplane crashes due to a mistake made by a mechanic, it's the airline company that's the target of liability."

"Our proposal is to shift the focus of liability from the individual doctor to the hospital or HMO or other enterprise under whose auspices the patient's care has been delivered," he said.

Doctors spend $5.6 billion a year on malpractice premiums.

The administration wants doctors to stop ordering costly tests and procedures simply to protect themselves in case they are sued.

A recent study by the consulting firm of Lewin-VHI Inc. estimated that Americans could save $36 billion over five years by curbing so-called defensive medicine.

Gene Kimmelman, legislative director for the Consumer Federation of America, said it was unclear whether injured patients would get more or less redress under such a system. "Enterprise liability is sort of a black hole," Kimmelman said.

Malpractice revision has been a staple of Republican proposals to rein in health costs. It could help Clinton sell his package to the GOP minority in Congress, but he runs the risk of alienating consumer and labor groups if he tries to impose "Draconian limits on what people can recover," said Kimmelman.

Johnson said the AMA was more interested in getting malpractice reforms like California's, which limits pain and suffering damages to $250,000, allows periodic rather than lump-sum payments of big awards, and encourages juries to deduct what a patient gets from health insurance and workers' compensation.

James F. Doherty, president of the Group Health Association of America, said transferring malpractice liability to HMOs "would force them to practice defensive medicine to an extent detrimental to both physicians and patients."