If told that Congress could pass a bill that would reduce health care costs by 9 percent, more than $100 billion a year, without canceling a single doctor's appointment, shutting one facility or cutting anyone actually working in the medical profession, most Americans would react with three rapid-fire questions: "What is it?" "What are they waiting for?" and "What gives?"

The bill is medical malpractice reform. The House has twice passed reform, only to have it killed in the Senate by the powerful friends of the generous trial-lawyer lobby. And yet, under such reform the only thing Americans would give up would be the ability to win lottery-size awards in a courtroom if something goes awry in the operating room.

Medical malpractice lawsuits have been driving up the costs of health care for years. From 1975 to 2002, the price doctors must pay for malpractice insurance increased at an average compounded rate of just less than 12 percent, four times the rate of inflation. In 2002, malpractice costs were $25 billion or $250 per American household. That's more than half of what the average household spent on prescription drugs.

And it's getting worse. 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. The combined costs were $3 billion. And, to make matters worse, up to 40 percent of the money awarded winds up in the pockets of lawyers.

Insurance companies shell out an average of $1.40 in claims for every $1 in premiums, an obviously unsustainable situation. Insurance companies increase rates in areas most hospitable to lawyers and, as a result, doctors leave. The American Medical Association officially designates 19 states as being in crisis.

The University of Nevada Medical Center was forced to close its trauma center for 10 days in 2002 after malpractice insurance for its surgeons jumped from $40,000 to $200,000 a year.

This is one crisis for which policymakers have long known an easy solution. California instituted a reform in 1975 that included a $250,000 cap on the amount of non-economic damages -- damages a person could collect in addition to lost wages and other direct costs related to a malpractice incident. The state also mandated that juries be told if plaintiffs had recourse to other sources of compensation, and it allowed large judgments to be paid out as a stream of payments, similar to most lotteries.

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. Over all, the reform has saved Californians more than $1 billion.

Other states have followed, and study after study shows that the caps successfully cut costs. President Bush's home state of Texas put the brakes on trial attorneys in 2003. Lawsuits are down 75 percent since the reform capped non-economic awards at $250,000.

The next step is a national solution. The House of Representatives has twice passed reform legislation only to see it die in the Senate. With the likes of Sens. Fritz Hollings and John Edwards nowhere to be found, the prospects for reform have increased greatly. With more than $100 billion at stake, malpractice reform is one deal that simply must get done.