Speaking before physicians in Chicago today, President Bush called on Congress to pass Medicare reforms by its July 4 recess, but he received the most applause for his call for federal malpractice reform.
"I am absolutely confident that there will be historic Medicare improvements before the Fourth of July recess," Bush told a hotel ballroom packed with members of the Illinois State Medical Society, his host.
Seemingly with an eye toward his re-election campaign next year, Bush said: "I want to sign Medicare reform and liability reform into law so that we can look the American people in the eye and say we have done our job."
He said passing a Medicare drug benefit would modernize Medicare, allowing it to catch up with changes in medicine that have made drugs often the least costly and most effective therapy.
"Drug therapies are becoming a more important way for docs to treat their patients," he said, adding: "As many as one-third of seniors on Medicare have absolutely no drug coverage."
Reflecting a new change in the administration's thinking, Bush said seniors who stay in traditional Medicare should have full drug coverage.
In an about-face on Monday, Bush officials told Congress that prescription drug benefits for seniors in the traditional Medicare program should be equal to what they would get in private health plans.
Bush made a pitch for his three-tier proposal, offering seniors HMO and a PPO-like coverage as well as traditional fee-for-service Medicare.
"Our seniors should have choices under Medicare," he said, pointing to health insurance programs for federal employees as a model.
Speaking out against unnecessary litigation
Turning his attention to the malpractice insurance crisis, Bush railed against "frivolous lawsuits" against doctors that he said drive up everyone's healthcare costs as well as physicians' premiums.
Trying to get a boost from the state's most famous politician, Bush maintained: "Lincoln was a lawyer who believed in discouraging unnecessary litigation."
Illinois is also a poster child for Bush's push to get a federal cap on noneconomic damages. The state passed malpractice reforms seven years ago, only to have them struck down by the Illinois Supreme Court.
"Medical liability is a national issue that requires a national solution," he declared, to loud applause.
In March, the U.S. House passed a malpractice reform bill with a $250,000 cap on noneconomic damages, but Bush noted that the Senate has not passed the bill. He placed no time limit on reform.
Seeking to put a face on the problem, Bush said skyrocketing med mal rates are about to drive Andrew Roth, M.D., an OB/GYN in Lombard, Ill., out of the state.
He said Roth's premiums rose 50% this year to $170,000 and are expected to rise 40% more next year, even though Roth "has not spent a day in court as a defendant in a liability case and never settled a case," Bush said. "Now he is considering leaving this vital state."
"President Bush was right on," said William Kobler, M.D., president of the state medical society and a family physician from Rockford, after the speech.
Kobler said he and a few physicians and patients met privately with Bush beforehand.
"We talked about seniors being able to choose the healthcare program they want," he said. "Not all feet fit into the same shoe."
Kobler said they also discussed the need for the U.S. Senate to pass malpractice reforms but conceded, "It's going to be difficult."