Medical malpractice lawsuits have been driving up the costs of health care for decades. In recent years, they have actually started to limit patient access to quality care.

From 1975 to 2002, malpractice insurance premiums increased at four times the rate of inflation. By 2002, the malpractice cost to Americans was $25 billion - or $250 per American household. That's more than half of what the average household spent on prescription drugs.

Lottery-size awards drive the problem. The average award increased from $700,000 in 1999 to more than $1 million in 2001. Seven of the top 20 lawsuit awards in 2001 and 2002 were for malpractice resulting in a combined cost of $3 billion. Up to 40% of the awards wind up in the pockets of lawyers.

"What the system does is make trial lawyers rich," Charles Lockwood, chairman of Yale School of Medicine's Department of Obstetrics, Gynecology and Reproductive Sciences recently told The Sacramento Bee.

The attorneys' payday must come from somewhere. Insurance companies shell out an average of $1.40 in claims for every $1 in premium, an obviously unsustainable situation. When the insurance companies are forced to increase rates, doctors are forced to make a choice: Pass the costs on to patients, work for less or quit engaging in high-risk practices.

That's what fourth-generation Ohio physician Tom Schwieterman and his brother did last October, when they delivered their last babies. Although they'd never been sued, their malpractice insurance costs skyrocketed from $25,000 to $80,000.

"We should be getting up at 2 in the morning and delivering babies," Schwieterman said. "We should be burning the midnight oil because we are at the prime of our careers, and instead it got taken away."

Consider some other recent salient examples:

* In 2002, the University of Nevada Medical Center was forced to close its trauma center for 10 days when malpractice insurance for its surgeons jumped 500%.

* In West Virginia, hospitals willing to deliver babies are as rare as affordably priced insurance for the doctors.

* Doctors have fled Mississippi for Louisiana, where insurance is more affordable. The American Medical Association officially designates 19 states as being in crisis.

This is one crisis for which policy-makers have long known an easily available solution.

California instituted a reform in 1975 that included a $250,000 cap on the amount of non-economic damages a person could collect.

As a result, the average award in California in 2002 was $452,000, compared to $1 million in New York and $800,000 in Florida. Malpractice insurance premiums have increased at one-third of the rate of the national average.

Other states have followed and study after study shows the caps successfully reduce costs. President Bush's home state, Texas, put the brakes on attorneys in 2003, capping non-economic damages at $250,000. Lawsuits are down 75%.

A 2002 study by the Department of Health and Human Services found that such reforms, if taken national, would reduce health care costs by up to 9%, or $108 billion a year.

Most recently, a study by health economist and former Clinton administration official Kenneth Thorpe found that premium in states with limits on non-economic awards are 17% lower than in states where attorneys have free reign.

A national solution is exactly what the doctors are ordering.

The House of Representatives has twice passed legislation only to see it die in the Senate where the trial-lawyer lobby has many friends.

Yet with the likes of Sens. Fritz Hollings (D-S.C.) and John Edwards (D-N.C.) nowhere to be found, the prospects for change have increased greatly. With more than $100 billion at stake, malpractice legislation is one prescription that needs to be filled.