In an effort to defend their interests in malpractice insurance, doctors say they need political campaign contributions to make themselves heard to lawmakers.

It begins as a familiar story: Florida doctors prescribing a harsh remedy for the soaring cost and unavailability of their malpractice insurance. The danger, as always, is that some of the "reforms" they ask of the Legislature would immunize even incompetent physicians from legal liability for preventable errors that injure and kill their patients. This issue has wracked state politics, like some endemic plague, several times before.

A difference this time is the cold but commendable candor with which several doctors involved in the cause declared a need for political campaign contributions to make themselves heard. Our colleague Alisa Ulferts revealed in Tuesday's editions the existence of a letter in which two Marion County physicians solicited colleagues for money -- the goal: $10,000 -- to get the attention of Senate President-designate Jim King of Jacksonville and Rep. Johnnie Byrd of Plant City, the incoming speaker of the House.

"Talk is cheap . . .," said the letter, "and if we are to get their attention, it is important that we show up with sufficient funds to convince them that we are serious. We are asking that you make a contribution to the Republican Party of Florida (There is no limit) and send this to us as soon as possible."

That would be just the beginning. According to the Florida Medical Association's political action chairperson, Florida doctors need and intend to spend $1-million in campaign contributions this year. As the PAC's treasurer put it, "Money buys you access."

People may be startled by such apparent cynicism on the part of a noble profession, but there is nothing freshly shocking about the underlying sickness to which it relates. From the state houses to the halls of Congress and the White House, American politics has long since been pervasively corrupted by campaign fundraising. None dare call it bribery, but it is a distinction without a difference. The McCain-Feingold legislation, which ends unlimited soft money contributions to the national parties, barely begins to root out the problem.

Florida's doctors are no more or less to blame for this than any of the many other special interests -- including trial lawyers -- and political committees that by necessity or desire practice this insidious form of insider trading. King himself shed light on it four years ago in his capacity as House majority leader when he urged fellow Republicans to vote for an antilawsuit bill in "fulfillment of a promise to the business community for its campaign contributions and sweat equity."

Confronted with the doctors' letter this week, King did not attempt to fault the mission. He'll take whatever the doctors bring for the GOP to their meeting Aug. 31. So, presumably, will Byrd, who didn't return the reporter's telephone calls. King did acknowledge, however, that for the letter to have linked money and legislation "is awkward at best and sleazy at worst." If only he were so embarrassed by the underlying reality.

One benefit of the disclosure is to make it more difficult for the Senate to pass what the doctors want. King said he'll appoint a study commission to examine the problem with an eye toward voting on legislation in 2004. Whether that is a constructive step will depend on the objectivity of its members. Properly charged and funded, it could -- and should -- pursue all the possible reasons behind this newest malpractice crisis. Remedies that targeted only the rights of patients to sue would be both unrealistic and unfair.

According to the Wall Street Journal, which reported extensively on the malpractice issue last month, there are no conclusive statistics on the part played by jury awards. Meanwhile, the insurance industry's accounting and pricing practices have contributed to the problem. Many malpractice carriers cut premiums too low, in a cutthroat competition for business, intending to turn sufficient profits from investing the premiums on Wall Street. Now that the expected investment profits have failed to materialize, the legal system should not be a scapegoat.

But of course the insurance companies are major campaign contributors, too. With them on one side and the doctors on another, who in the Legislature will be pause to reflect on their rightful constituents, the people?

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