ANNAPOLIS - Gov. Robert Ehrlich and the Maryland General Assembly's priorities are wrong in recent efforts to reform medical malpractice, said Populist presidential candidate Ralph Nader, who advocates protecting a patient's right to sue and recover damages.

"The first obligation (for Ehrlich) is to do anything he can to weed out bad doctors and prevent malpractice," Nader said to about a dozen people at a news conference in the Maryland Inn.

Nader put forward a three-part plan to reform malpractice in Maryland:

• The state should fund more investigations into insurance companies and negligent doctors.
• Doctors should "police their own ranks."
• The state should set up a hotline for patients to report negligence.

Nader's main attack was against tort reform. In fact, he's even against the term.

"'Reform' usually means expanding people's rights, not restricting them," he said.

Patient lawsuits are the best way to cut down on malpractice because only under the threat of financial loss will insurance companies and medical licensing boards work to remove negligent doctors. Legislatures vote against patients' interests because they are lobbied by "doctors doing the bidding of insurance giants who often stay behind the scenes," he said.

"Doctors should not be used as tools against their own malpractice patients," he said.

Nader also said he opposes capping malpractice damages because they "pre-judge what judges and juries would decide." However, Nader did advocate a limit on attorneys' fees, saying they shouldn't be more than one-third of the settlement -- enough to preserve access for the poorer and middle-class patients who can ill afford to go to court.

Maryland's medical malpractice situation is getting more serious since the main insurer is scheduled to raise premiums 33 percent in January, and doctors have closed practices and threatened strikes. Ehrlich and legislative leaders are trying to craft a solution in time to call a special session this year on the issue.

Senate President Thomas V. Mike Miller, D-Calvert, agreed more needs to be done to protect patients. He said Maryland is on "the very bottom tier of states" when it comes to protecting patients from bad doctors.

Instead of rewarding bad doctors by reducing possible settlements, the state should be "rewarding good practitioners and doctors who don't have malpractice problems," Miller said. "Yet their insurance fees go up." Increased Medicaid reimbursement could be a possible reward, he said.

Nader said if he were elected president he would urge state medical licensing boards to step up investigations of insurance companies and negligent doctors, but would not interfere with a state court because "the federal government should have no business in pre-empting state law."

Ehrlich said he expects to have a draft of a medical malpractice bill soon. He, Miller and House Speaker Michael Busch, D-Anne Arundel, met behind closed doors last week to discuss the issue.

A spokesman for the governor said he is still working on the bill and there's no deadline for its completion.

Miller is not optimistic about the governor's measure, saying it will probably be full of "right-wing" and "un-passable" ideas.

Nader also spoke briefly on the prospect of slot machines in Maryland, which has been a hot topic as Ehrlich and the Assembly have battled for two years over whether and where to permit the devices. Nader called gambling a "sign of social decay," and said it should not be state-sponsored.

"People who bet on the future instead of build on the future are losing their direction," he said.

Nader added that he was against outlawing gambling completely. He said "like any addiction, it's beyond the range of legal action," and criminalizing gambling would only drive it underground.

In Maryland, Nader is polling 1 percent against rivals Republican incumbent President Bush, who is running at 42 percent, and Democratic Sen. John Kerry, who is at 52 percent, according to a recent Gonzales Research poll.

Nader received 3 percent of the Maryland vote in the 2000 presidential election, when Vice President Al Gore carried the state's 10 electoral votes, defeating then-Gov. Bush 56 to 40 percent.

Capital News Service reporter Ryan Spass contributed to this story.

Copyright © 2004 University of Maryland Philip Merrill College of Journalism