He added, "Insurance companies have never made more money than they did in 2004," citing a large industry surplus. "The insurers are rolling in dough; they're swimming in dough," Mr. Angoff said.

Mr. Angoff's comments were made as President Bush prepared to launch his call for widespread changes in federal laws governing class action lawsuits in general and med-mal litigation in particular. He will speak in Collinsville, Ill., in Madison County, one of the so-called "judicial hellholes" cited last month in an annual survey by the American Tort Reform Association "as a national haven for asbestos claims" and malpractice suits.

President Bush has said since his re-election he wants to use the "political capital" he gained in the last election to win broad changes in certain areas such as tax cuts, Social Security reform and class-action litigation. He was expected to start this initiative through passage of class-action litigation reform because this has the greatest support in Congress. Such legislation is expected to be enacted quickly, but he is expected to face a much tougher road in winning support for limits in med-mal litigation because members of Congress, including conservative Republicans, view this as a states-rights issue, industry lobbyists and members of Congress have stated.

Speaking for the nation's health insurers, Karen Ignagni, president and CEO of America's Health Insurance Plans, voiced support for the president, hoping he will support the same reforms on class-action and med-mal litigation he has laid out in the past. "I hope the president will continue with his past themes," Ms. Ignagni said. "It is time to end the litigation lottery."

She added, "Our industry hopes the president will lay out a program that will end the irresponsible litigation on the part of the trial lawyers."

Noting that in their conference call trial lawyers and consumer advocates presented information stating that caps on med-mal insurance didn't have the effect of reducing premiums paid by professionals, Ms. Ignagni said there are important numbers that infrequently get looked at. "You have approximately $30 billion going to direct malpractice costs and $70 billion in indirect malpractice costs?the costs of defensive medicine," she pointed out.

Ms. Ignagni said the current system encourages excessive tests, discourages doctors from talking about what goes wrong, and in many cases patients don't get satisfaction because it takes four years on average to litigate a claim. "Wouldn't it be better to step back and establish new administrative remedies?" she asked.

In his comments, Mr. Angoff defended the current med-mal system, saying, "Illinois is notoriously known among regulators for not just having weak regulation but for the commissioner having no authority" to review rates, order rebates or reject rates.

He added that malpractice companies can charge whatever they want "and the commissioner is impotent to do anything about it." He also noted that Illinois keeps rate filings data secret, eliminating public challenges.

In her comments during the conference call, Rep. Janice Schakowsky, D-Ill., talked about testimony at various congressional hearings on the issue, especially about insurance industry officials testifying that the industry can't guarantee rate decreases if caps are set.

She noted that statistics showed that med-mal insurance rates for doctors increased more in states with caps than elsewhere, and added that she did not think it was surprising that rates might be higher in Illinois, because there is "virtually no regulation" in the state. She also said that President Bush's likely proposal had "built-in discrimination" against women and children.

Rep. Schakowsky added, "We need to deal with insurance regulation, and we need to deal head-on with the problem of malpractice and medical mistakes."