Continuing a fight with Democrats on how to cut health-care costs and improve medical access, Sen. Orrin Hatch, R-Utah, introduced a bill last week to reform malpractice laws.

The bill, which was introduced in the House at the same time by Rep. Nancy Johnson, R-Conn., seeks to lower medical costs by helping states develop arbitration systems to resolve malpractice claims without expensive court action.It also makes several changes in malpractice law such as putting ceilings on some types of claims, limiting awards to attorneys and shortening the time in which claims must be filed.

Meanwhile, Democrats led by Sens. Edward Kennedy, D-Mass., and Chris Dodd, D-Conn., have been trying to improve medical access by forcing employers to offer insurance to their employees - which Hatch says could force smaller companies out of business.

Hatch said his legislation is superior because it could lower health care costs, which would make insurance more affordable and therefore more available. It would also allow doctors to avoid extra tests and surgery performed mainly to ensure against malpractice suits.

"This legislation is an access-to-health-care bill. Over 30 million Americans have limited or no access to our health care system. Their access may be limited by geography, by lack of insurance, by the withdrawal of medical specialists from high-risk services or by high costs," Hatch told reporters.

An example of why malpractice laws need reform, he said, is that "in Utah, more than half of the general and family practitioners have stopped providing pregnancy-related care" because of the high risk of malpractice suits and the high cost of malpractice liability insurance.

Also, the Department of Health and Human Services estimates that unnecessary health care performed only to help avoid malpractice suits adds 25 percent to the cost of health care. Hatch said that is at least $121 billion a year.

The Hatch-Johnson bill would give states $200 million to develop arbitration systems to settle malpractice claims out of court. Johnson said that will lower legal costs and provide legal access to people with small claims who cannot now attract lawyers because their potential settlements are too small.

The bill would also give $10 million to states to research better prevention and compensation from health care negligence, and another $20 million to help states better monitor and discipline those who practice substandard medicine.

The bill would also make several changes in malpractice law, including placing a $250,000 ceiling on non-economic damage awards, a schedule of limitations for attorney contingency fees and a two-year statute of limitation for adults to file claims.

It would also make some changes designed to better protect patients. For example, all fees from doctors' licenses would have to go to the state agency responsible for monitoring and disciplining doctors. It would also set up funding pools to help cover costs of community and migrant health centers.

Hatch and Johnson faced Kennedy and Dodd last year in a battle over how to fund and reform child care laws. Though all had portions of their proposals enacted, Hatch and Johnson were able to enact more of their legislation.

Kennedy and Dodd have continually said Hatch's measures to expand medical access do not go far enough, and say forcing employers to offer health insurance is needed.

For example, a study by the General Accounting Office - a research arm of Congress - earlier this month said 15 percent of the U.S. population under age 65 was uninsured in 1988, including 13 percent of Utah's population or 196,000 people.