President Bush continues to push for limits on jury awards for medical mistakes with a visit Wednesday to an Illinois county where the White House says frivolous lawsuits have run amok.

Bush says large malpractice awards have driven up the cost of business so high that doctors have to close their businesses or scale back services.

Exhibit A in Bush’s case is Madison County, across the Mississippi River from St. Louis, named the country’s top “judicial hellhole” by the American Tort Reform Association last year because of its reputation for big awards.

Lawyers in the area say the legal situation has been exaggerated and Bush is demonizing the county even though large malpractice awards have been scarce. Leading Democrats in Congress say the number of doctors practicing in Illinois has risen in recent years, despite higher malpractice insurance rates that they say are driven by the state’s weak insurance regulation.

Bush was personalizing his point by meeting with a neurosurgeon, an obstetrician gynecologist and a pregnant woman who had to change doctors repeatedly because so many were going out of business, White House spokesman Scott McClellan said.

“We don’t want to have to see pregnant mothers having their OB/GYN doctor go out of business or move to another area because they can’t afford to practice their medicine,” McClellan said. “We want them to be able to get the care they need when they need it.”

Caps on damage awards of varying types have been implemented in 27 states, but a proposed federal cap, though successful in the House, was defeated because of Democratic opposition in the Senate.

Republicans strengthened their majorities in both chambers and intend to work again with Bush to impose a nationwide cap on pain and suffering awards.

McClellan said Bush will urge Congress to pass medical liability reform that will end “these junk lawsuits.”

But the lawyers who win those awards for malpractice victims and other opponents of Bush’s initiative say the real problem is insurers who look to raise premiums and, consequently, their bottom line. They also use personal stories to tell their side, such as a woman who said doctors switched her test results and mistakenly told her she had breast cancer before amputating both her breasts. She is featured in a $250,000 television ad buy in the St. Louis and Washington markets to coincide with Bush’s visit.

McClellan on Tuesday brushed aside questions about whether Bush would examine rising malpractice insurance rates. McClellan blamed “unlimited and unpredictable liability awards” for raising the cost of health insurance premiums and making insurance too expensive for some Americans.

Bush says tort reform is a key part of his plan to lower health care costs and help the more than 40 million uninsured Americans obtain coverage. Democrats in Congress say that won’t amount to much savings, pointing to a year-old Congressional Budget Office report that said malpractice costs amount to only about 2 percent of overall health care spending.

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