Presidential Documents

48133 

Federal Register 

Vol. 74, No. 181 

Monday, September 21, 2009 

Title 3— 

The President 

Memorandum of September 17, 2009 

Demonstration Grants for the Development, Implementation, 

and Evaluation of Alternatives to the Current Medical Liability System 

Memorandum for the Secretary of Health And Human Services 

As part of my Administration’s ongoing effort to reform our health care 

system, we have reached out to members of both political parties and listened 

to the concerns many have raised about the need to improve patient safety 

and to reform our medical liability system. Between 44,000 and 98,000 

patients die each year from medical errors. Many physicians continue to 

struggle to pay their medical malpractice premiums, which vary tremendously by specialty and by State. The cost of insurance continues to be 

one of the highest practice expenses for some specialties. And although 

malpractice premiums do not account for a large percentage of total medical 

costs, many physicians report that fear of lawsuits leads them to practice 

defensive medicine, which may contribute to higher costs. 

We should explore medical liability reform as one way to improve the 

quality of care and patient-safety practices and to reduce defensive medicine. 

But whatever steps we pursue, medical liability reform must be just one 

part of broader health insurance reform—reform that offers more security 

and stability to Americans who have insurance, offers insurance to Americans 

who lack coverage, and slows the growth of health care costs for families, 

businesses, and government. 

In recent years, there have been calls from organizations like The Joint 

Commission and the Institute of Medicine to begin funding demonstration 

projects that can test a variety of medical liability models and determine 

which reforms work. These groups and others have identified several important goals and core commitments of malpractice reform that should serve 

as a starting point for such projects. We must put patient safety first and 

work to reduce preventable injuries. We must foster better communication 

between doctors and their patients. We must ensure that patients are compensated in a fair and timely manner for medical injuries, while also reducing 

the incidence of frivolous lawsuits. And we must work to reduce liability 

premiums. 

In 1999, the Congress authorized the Agency for Healthcare Research and 

Quality, which is located within the Department of Health and Human 

Services, to support demonstration projects and to evaluate the effectiveness 

of projects regarding all aspects of health care, including medical liability. 

I hereby request that you announce, within 30 days of this memorandum, 

that the Department will make available demonstration grants to States, 

localities, and health systems for the development, implementation, and 

evaluation of alternatives to our current medical liability system, consistent 

with the goals and core commitments outlined above. 

This memorandum is not intended to, and does not, create any right or 

benefit, substantive or procedural, enforceable at law or in equity by any 

party against the United States, its departments, agencies, or entities, its 

officers, employees, or agents, or any other person. 


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48134 Federal Register / Vol. 74, No. 181 / Monday, September 21, 2009 / Presidential Documents 

You are authorized and directed to publish this memorandum in the Federal 

Register. 

THE WHITE HOUSE, 

WASHINGTON, September 17, 2009. 

[FR Doc. E9–22887 

Filed 9–18–09; 11:15 am] 

Billing code 4110–60–P 


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