President Bush has called in a specialist to help him operate on the nation's health-care ills - Sen. Orrin Hatch, R-Utah.

Bush plans to announce a major initiative this week to lower skyrocketing health-care costs by reforming medical malpractice laws. Current laws now force doctors to pay high rates for malpractice insurance and to perform many likely unnecessary procedures only to help guard against lawsuits.Bush has persuaded Hatch to be his point man for the legislation in the Senate. Hatch has pushed similar legislation for years as the ranking Republican of the Senate Labor and Human Resources Committee, which oversees health issues.

"The president asked me to help him, and I'm more than willing to do it," Hatch told the Deseret News. "He has adopted a number of the suggestions I've made as I've pushed for medical malpractice reform over the past 10 years."

Hatch said they include:

- Setting limits on the amounts that patients may collect for "pain and suffering" in malpractice suits but leaving unrestricted the amounts they may receive in compensatory damages from lost earnings and medical bills.

- Requiring states to develop alternative "dispute resolution mechanisms," such as arbitration or mediation, that victims could appeal to without lawyers before going to court.

- Allowing payments to victims to be made over many years instead of in a lump sum. Health-care providers would be allowed to earn interest on money they would have to pay.

- Establish guidelines for treatment of some illnesses, which if followed would be a defense against malpractice.

- Use peer review groups and strengthen state medical licensing boards to remove incompetent doctors.

"I haven't seen the president's actual bill yet, but we've been in close contact about what will be in it," Hatch said.

Hatch and Rep. Nancy L. Johnson, R-Conn., already introduced a similar malpractice reform bill this year, as they have in the past.

Hatch said "almost everything" in it will be included in the president's bill. But they differ on some methods.

"The president's bill will punish states that don't come up with alternative dispute resolution methods by withholding federal funds. Our bill wouldn't do that. It offers $200 million in grants to help states set those programs up," Hatch said. But unpopular tax increases would likely be needed for that.

Hatch - who said he handled medical malpractice suits as an attorney before he was elected - said he has tried to change the malpractice system since he was first elected 15 years ago.

"Doctors' fears of being sued makes them practice `defensive medicine,' or performing unnecessary tests, procedures and high-tech examinations to create a history to show they've done everything possible in case they are sued," Hatch said.

For example, he said a doctor could not safely dare today to say someone has a common cold without taking blood, respiratory and heart checks to ensure no other more serious conditions might exist. "So it might cost something like $500 for what used to be a $5 visit," he said.

"As much as 35 cents of every health care dollar spent is estimated to go for such defensive medicine," Hatch said. "That 35 percent adds up to a total somewhere between $50 billion and $200 billion a year."

On top of that, large settlements have forced malpractice suits to skyrocket.

"I sat on a plane last week next to the wife of a doctor in Evanston (Wyo.). I asked her how much her husband pays in malpractice insurance. She said $45,000 a year," he said.

Such high rates have forced many doctors to leave high-risk areas of medicine, such as delivering babies.

Hatch said such problems have resulted in health-care costs rising 21 percent a year, and 12.5 percent of the gross national product being spent on health care.

Still, Hatch foresees stiff opposition from the American Trial Lawyers Association, which has said such reform would restrict their clients' right to seek redress in court.

"The trial lawyers' don't like anything that stops them from milking the system," Hatch said, noting that as a trial lawyer he saw the system close-up.

He added, "Democrats have long been captives of the American Trial Lawyers' Association, but even a lot of them are seeing the need to do something to reform the system."

Hatch noted that both Democrats and Republicans have been working on proposals for a comprehensive healthcare system reform bill, and he is optimistic that malpractice reform will be enacted as part of it.