Although President Barack Obama says the Democrats should now incorporate Republican health reform ideas, the White House and Congress still don't fully address medical malpractice reform.

The U.S. doesn't have a nationwide, medical court system to address soaring costs for malpractice and defensive medicine, an estimated $207 billion of which is likely passed on to consumers. The U.S. has long had specialized courts across the country, such as tax, bankruptcy and even workmen's compensation courts. 

You've heard how malpractice suits stop ob/gyn doctors from practicing in certain states and rural areas, or how doctors order excessive cat scans so they won't be hit with the number one most successful medical tort case, misdiagnosis of cancer.

Little discussed is how medical conditions are often mistaken for psychiatric disorders, where doctors dispense drugs that do even more harm, and how a medical court system could sort out all of these problems.

Angina pectoris can mimic panic disorder. Hyperthyroidism can be mistaken for mania. Confusional states caused by medical illness or drug toxicity can be misconstrued as severe depression or dementia, said Joseph J. Zealberg, former president, American Association for Emergency Psychiatry.

But doctors instead mistakenly prescribe psycho-pharmacologic drugs to treat perceived psychiatric disorders, drugs that affect not just the brain, the body's most complicated organ, but the circulatory system, the liver, the complex gastrointestinal system, and other vital organs, Dr. Zealberg has said. And alcohol and drug abuse, often withheld by embarrassed patients, complicate treatment.

Again, all of these mistakes can be sorted out by a medical malpractice court system. But the White House and Democrats in Congress still do not wholly support a full-fledged, nationwide medical malpractice court system. The country is in dire need of one.

Even the best of doctors make mistakes, which a medical court system could sort out equitably. It could also potentially stop egregious and frivolous lawsuits, where tort lawyers shop for juries and judges amenable to their cases.

Instead, President Obama says in an open letter to Congressional leaders that he's “open” to giving perhaps $50 million in grant money for state demonstration projects that settle medical disputes, though the president won't guarantee the funding.

The tort bar is still protected under health reform, as it gives tens of millions of dollars in political donations to Congress each year.

Elected officials in Congress who are also lawyers should recuse themselves from voting on health reform if they balk at tort reform. That's how bad the situation is. Annual doctor malpractice insurance premiums are sky high, from $75,000 to $200,000, depending on the specialty and location. Even higher.

Compare the protection to the tort bar in health reform with the fact that Democrats have demanded higher taxes, cost savings and concessions from medical device manufacturers, hospitals, doctors, even taxpayers in the form of insurance mandates and higher taxes on Cadillac insurance plans, which is really a Dodge minivan tax since this tax will likely hit the middle class because it's not indexed to inflation.

Reforming insurance companies is a must. And so is a medical court system. So would caps on malpractice awards, as Texas has, or a loser pays system akin to the one in Great Britain.