The health-care plan being pieced together by the Clinton administration won't be complete unless it imposes sensible restraints on malpractice suits and discourages overtesting.
This simple truth may not please lawyers who make a career of suing doctors. Nor will it please the owners of testing labs, some of whom are, in fact, doctors.But it's hard to see how we can expand medical coverage and cut spending at the same time if we continue to regard health costs as a bottomless pit.
Defensive medicine, prompted, in part, by the threat of lawsuits, is adding anywhere from $15 billion to $25 billion a year to the cost of health care. Billions more are spent by doctors and hospitals on malpractice insurance each year.
Some of this may be a normal cost of doing business, but there's a limit to how much overhead we can afford.
Why, for example, would a young doctor choose to specialize in obstetrics if she knows that every child who isn't born perfect is a potential malpractice suit?
And why do we take heroic measures to keep elderly patients alive while failing to provide even minimal preventive care to younger Americans? One reason: The threat of a suit makes it difficult for doctors to let older patients die in peace.
Hillary Clinton made vague references to malpractice reform in a speech to 2,000 members of the American Medical Association. Her speech, defending the independence of doctors, elicited 15 rounds of applause and three standing ovations from an audience not known to be friendly to the Clinton administration.
But if Mrs. Clinton's task force fails to come up with better ways to handle malpractice cases, the cheers won't last long. State laws on malpractice vary widely, and most legislatures are loaded with lawyers not likely to support limits on lawsuits.
The same is true of Congress. That's why efforts to set up national standards for product liability suits have gone nowhere, despite obvious inequities that fail to compensate some injured persons, overcompensate others and drain billions of dollars into legal fees.
The least we can do in both malpractice and product liability cases is to make it easier to resolve disputes out of court and establish national procedures for handling such suits.
To reform malpractice, Clinton's advisers are considering a system in which suits are filed, not against individual doctors, but against insurance companies, health maintenance organizations and other enterprises hiring and supervising doctors.
The idea has a certain primitive appeal - it seems to take doctors off the hook - but critics say it could invite trouble by creating the impression that employers with "deep pockets" are fair game for lawsuits, even if doctors are not.