Serious students of health care reform recognize you’re hard pressed to achieve meaningful savings without reforming the malpractice system that forces doctors to practice defensive medicine.

And serious students of politics realize that asking the party of the trial bar to embrace meaningful legal reforms is as likely as the Washington Nationals mounting a late run for the pennant.

Philip K. Howard lays it all out in a piece titled “Why Medical Malpractice Is Off Limits” from the Wall Street Journal.

The upshot is simple:  A few thousand trial lawyers are blocking reforms that would benefit 300 million Americans.

The American public also favors legal overhaul.  A recent Common Good/Committee for Economic Development poll found that 83% of Americans believe that “as part of any health care reform plan, Congress needs to  change the medical malpractice system.”

But of course the trial bar has a stranglehold on scores of Capitol Hill Democrats who are protecting their deep-pocketed benefactors at nearly every turn.

Congress now realizes it can’t completely stonewall legal reform.  But what has unfolded so far is a series of vague pronouncements and token proposals - all of which assiduously avoid any specific ideas that might offend the trial bar.

The real tragedy is that trial lawyer greed both hurts legitimate victims and is trumping a solution that so many different experts agree is worth a try.

But under the current system, 54 cents of the malpractice dollar goes to lawyers and administrative costs, according to a 2006 study in the New England Journal of Medicine. And because the legal process is so expensive, most injured patients without large claims can’t even get a lawyer. “It would be hard to design a more inefficient compensation system,” says Michelle Mello, a professor of law and public health at Harvard, “or one which skewed incentives more away from candor and good practices.”

As for the trial bar’s cry that they’re the only guardian of victims of medical mistakes - well Howard puts that claim to the test.

Trial lawyers also suggest they alone are the bulwark against ineffective care, citing a 1999 study by the Institute of Medicine that “over 98,000 people are killed every year by preventable medical errors.” But the same study found that distrust of the justice system contributes to these errors by chilling interaction between doctors and patients. Trial lawyers haven’t reduced the errors. They’ve caused the fear.

Former Sen. John Edwards, for example, made a fortune bringing 16 cases against hospitals for babies born with cerebral palsy. Each of those tragic cases was worth millions in settlement. But according to a 2006 study at the National Institutes of Health, in nine out of 10 cases of cerebral palsy nothing done by a doctor could have caused the condition.

So as they used to say “follow the bouncing ball.”  It’s in the Democrats court now - unless of course the trial bar has already snatched it and hid it in their pocket.