Probably the hottest national political issue today is "health care reform." There are many facets to the problem, but I think the biggest stumbling block to passage is containing the high cost of medical malpractice insurance. It is the central problem, but it cannot be resolved until we put a cap on the medical malpractice awards. This does not mean we should not deny fair and adequate compensation to someone who has been injured as a result of the negligence of a doctor or a hospital. The injured patient should be paid in full for all economic damages, including further treatment, medical appliances, loss of income, etc., but there should be a cap on awards for pain and suffering, and that cap should be negotiated between $250,000 and $500,000. No award should be granted for punitive damages. In states that have made this kind of reform, such as Texas and others, the following things have happened: * The cost of insurance has dropped up to 20 percent. * Doctors have been able to quit practicing defensive medicine, that is, over-diagnosing and over-testing and performing other procedures to protect themselves just in case they are sued. * There has been a reduction in insurance premiums, particularly for ob-gyns, anesthesiologists and neurosurgeons. * More doctors are attracted to the area, creating more competition and providing medical services in previously non-served rural areas. * More doctors will volunteer their time. * More insurance companies will be attracted to the area, which in turn, means lower costs. Then what is the hold-up? The "Tort Bar" has Congress in its back pocket. There are more than 12,000 registered lobbyists in Washington, D.C. today, who in the past election cycle, collected and spent more than $200 billion on our members of Congress. It is impossible to say how much of that amount was for lobbying the health issue, and I assume these expenses covered all issues pending in Congress. But a big contributor could obviously get a friendly audience with a member and could ingratiate himself on any issue. More than 80 percent of this money went to Democrats this time, but I am certain plenty of Republicans had their hands in the till. As a result, they don't even talk seriously about tort reform. They talk about single-payer, portability, providing for the uninsured, covering previous health problems, etc., all legitimate issues. The attempted reforms today vary from state to state, but I think we need national standards so doctors and patients can move across state line without risk of losing coverage or encorntering unexpected fees. Don't expect a reduction in medical costs until the members of Congress face down the trial bar and show the courage to do what is right for the American people. Richard Richards is the former chairman of the Republican National Committee. He lives in Ogden. The Richard Richards Institute for Politics, Decency and Ethical Conduct at Weber State University is named after him.