Vaccine and liability suits. Government urged to fill insurance breach

The challenges that medical liability insurance pose for a large segment of American society have surfaced in yet another area: vaccine for childhood illnesses. Members of Congress and medical groups are showing increasing concern that unless the federal government steps in, the three US companies that make vaccine may cease doing so because of the high cost of liability insurance.

This latest aspect of the national liability problem is the most contentious element in a multifaceted health bill. It sets up a federal program that would provide no-fault compensation to parents of children harmed by vaccine. This approach would remove much of the threat of suits from manufacturers.

Literally the last piece of legislation passed by the recently adjourned Congress, the bill appears threatened by a so-called ``pocket veto.'' President Reagan has nine more days to sign the measure. If he does not, it will die. His administration is believed split on which course of action he should take.

A bipartisan coalition in Congress is pushing for the measure. Sen. Orrin Hatch (R) of Utah notes that ``the potential for lawsuits'' has caused the price of one vaccine nearly to triple in the past year; ``insurers are reluctant to underwrite the liability,'' he says, ``and when they do, the rates are high.''

Several related issues are also at stake. For one: Is it fair for the government to require parents to have their children vaccinated, unless they obtain exemptions on religious grounds, without government also providing financial compensation if physicians conclude the vaccination has brought about serious adverse affects, as is said to occur with a small number of children? Proponents of the measure say this issue of equity is fundamental.

Theoretically, parents can obtain compensation through the courts. But Sen. Edward M. Kennedy (D) of Massachusetts says that ``most children never receive any compensation because no fault on the part of the manufacturer or physician can be proven.'' A government program, he and other backers conclude, is the only answer now being put forth.

But there are some observers within the administration who counsel that the current problem is not sufficiently serious to merit yet another federal program.

In addition, the administration is believed concerned about the establishment of a new tax -- an excise tax on pharmaceuticals -- which would be used to finance the program. President Reagan has been insistent that he would not permit enactment of new taxes.

The health bill contains other major provisions. This raises once again the recurrent problem when Congress is in a rush to adjourn: the lumping together of disparate elements at the last minute can jeopardize several noncontroversial programs when one component of the measure is in dispute.

This health bill would also establish a national databank so that physicians guilty of malpractice would be unable to set up practice incognito elsewhere in the nation; permit the overseas marketing of pharmaceuticals not approved for sale in the US but authorized in the nations to which they are to be sent; and provide incentives to states to establish comprehensive mental health strategies.