Balance of Power

The doctor was Republican Sen. Tom Coburn of Oklahoma, an obstetrician. When Democrats said they were skeptical that limits on awards actually reduce malpractice premiums, Coburn insisted that they’ve gone down every year in Texas since it imposed its own malpractice award caps.

And from his own experience, Coburn said, it’s “ridiculous” to suggest that the threat of lawsuits doesn’t make doctors order unnecessary tests. “It turns the patient from a patient into an adversary,” Coburn said. “It totally changes the way you practice medicine.”

Cue Democratic Sen. Sheldon Whitehouse of Rhode Island, a former U.S. attorney and Rhode Island attorney general. His speciality was the philosophical argument. The whole idea of limiting punitive damages is “competely wrong,” Whitehouse said, because “it puts 100 percent of the costs of this problem on the woman who is coming home from the hospital with a disabled baby who she’s going to have to take care of for the rest of her life — on the woman who’s coming home with a disfiguring injury which she’ll have to deal with for the rest of her life.”

“Even if it did save $300 million or whatever it was in Texas, guess who paid?” Whitehouse demanded, with the flourish of a closing argument.

Even the acting chairman, Sen. Christopher J. Dodd of Connecticut, who noted he has supported other tort overhaul measures in the past, said the evidence from national studies shows malpractice limits don’t really save much money. “I’m not a stranger to tort reform by any means,” said Dodd, but “from the work I’ve done on this subject, I don’t see the correlation.”

And with that, the committee voted down Gregg’s amendment, 11-14. Ironically, Coburn voted against it — not because he agreed with the Democrats, but because he wanted to leave the issue to the states.

Gregg said he wasn’t surprised at the failure. “The trial lawyers have, and always have had, a stranglehold on the Democratic caucus,” Gregg said. As for Obama’s trial balloon to the AMA, Gregg said, “it was a sop to the AMA. They knew he wasn’t going to do anything with it.”

Will Obama try to force congressional Democrats to do something with it? If he does, expect it to happen late in the process — when he’s not trying so hard to stay above the fray. But from the early signs, don’t count on it.