SCRANTON, Pa. - Plunging into a fractious debate over health care, President Bush called forcefully yesterday for a new law to limit the amount of money that juries can award people who sue doctors or hospitals for medical malpractice.

Speaking after a visit to a hospital here, Bush complained that "frivolous and junk lawsuits" were driving up the cost of liability insurance for doctors. As a result, he said, many Americans have suffered as their doctors have had to move or close their practices. He said the problem also burdens the federal government with $28 billion in annual health-care costs.

"The problem of those unnecessary costs," the president said, "isn't in the waiting room or the operating room. They're in the courtroom. Everybody's suing, it seems like."

Bush urged Congress to pass legislation that would limit punitive damages, as well as damages for "pain and suffering," at $250,000 for each type. His plan would not affect the damage awards that compensate victims for their actual expenses, such as legal fees, health costs and loss of salary.

The president delivered his 35-minute speech in a state that scarcely averted a crisis a few weeks ago, when the government intervened to prevent doctors from striking to protest soaring insurance rates. And he was making his 18th visit as president to this politically crucial state, which he narrowly lost in the 2000 presidential election.

The issue of whether to cap medical malpractice awards sets off intense debates pitting the insurance industry, which typically backs Republicans, against trial lawyers, who mostly favor Democrats. Last year, Bush called for a similar law, which passed the Republican-led House but stalled in the Senate, which was then controlled by Democrats but is now led by Republicans.

Democrats quickly criticized Bush yesterday, saying he was offering a gift to insurers that have complained about the awards they must pay when cases are settled or juries side with plaintiffs. These critics said Bush's plan would do nothing to regulate insurance companies.

Sen. Edward M. Kennedy, a Massachusetts Democrat, argued that Bush's proposal "would deprive seriously injured patients of fair compensation and do nothing to guarantee that doctors could obtain malpractice insurance at a fair price."

Sen. John Edwards, a North Carolina Democrat who made a fortune as a trial lawyer in malpractice cases against doctors, said that instead of capping jury awards, the federal government should be "cracking down on the small percentage of doctors responsible for the majority of malpractice cases."

Edwards, who is seeking the Democratic presidential nomination to challenge Bush next year, asserted that the president's plan would not reduce insurance costs for doctors.

"The truth," the senator said, "is the insurance industry has done poorly in the [investment] market and is simply passing those costs on to doctors and patients."

Dr. Anthony Minissale of Pennsylvania, who is president of the American Osteopathic Association, warned that the situation in his state has grown dire and said he hoped politics would not stand in the way of a solution.

Doctors, especially obstetricians, gynecologists, neurological surgeons and other surgeons, Minissale said, have been closing practices and seeking work in neighboring states such as Maryland and Delaware where insurance rates are lower. Pennsylvania is one of 13 states that has no limits on malpractice awards.

Minissale complained that neither party in his state had shown much willingness to find a middle-ground solution.

"We've got a state Senate that is loaded with trial lawyers, and we've had a Republican governor who didn't do a darn thing about this," said Minissale, who favors a compromise that would limit jury awards and regulate the insurance industry.

Supporters of Bush's plan say there is clear evidence in Pennsylvania that ballooning awards in medical malpractice suits are driving up the insurance premiums paid by doctors, eventually forcing some of them to flee the state.

More malpractice damages were awarded in Philadelphia in the past three years, the president asserted yesterday, than in all of California, which imposes limits on jury awards in malpractice suits.

The Pennsylvania Medical Society, which backs Bush's plan, estimates that an average obstetrician in Pennsylvania pays more than $80,000 annually in liability insurance but could cut that sum to $50,000 if he or she moved to neighboring Delaware.

Trial attorneys in the state contend that most of the blame lies with the insurance companies, which, the lawyers say, are often poorly managed and are struggling in a sluggish economy, then passing higher costs on to patients.

Public Citizen, a consumer-advocacy group in Washington, issued a report this month suggesting that even as liability-insurance rates have escalated in the past few years, the awards in medical-malpractice cases in the state have declined.

Earlier this month, Pennsylvania's incoming Democratic governor, Ed Rendell, former mayor of Philadelphia, narrowly stopped a walkout by doctors by proposing a one-time insurance-rate break. Under his plan, the state's physicians would have to pay only 50 percent of their usual premiums this year for a state-run fund that pays for catastrophic damages in malpractice suits.

Chiding Rendell's solution, Bush said yesterday that "this problem won't be solved by just throwing money at the problem."

Rendell was not invited to Bush's speech, which was given to a friendly, mostly Republican audience at the University of Scranton. One White House aide noted that "Rendell has made it clear he does not support our position."

Scranton and nearby Wilkes-Barre, aging factory and mining towns in the state's northeastern mountains, have been at the core of the state's crisis. Several large practices, full of surgeons and other specialists, have been threatening to leave the area, a move that would force many patients to travel elsewhere for surgeries and other procedures.

Also this week, a Wilkes-Barre hospital paid $7 million to settle a malpractice suit filed by the widow of a 73-year-old man who died of brain damage after physicians inserted a ventilator into his esophagus instead of into his trachea.

Dr. Edward Dench, president of the Pennsylvania Medical Society, said about 900 doctors have left the state in the past two years to avoid the liability premiums, which can reach $200,000 a year.

But the problem, the president and others argue, is nationwide. On his visit to a Scranton hospital, Bush met with Dr. Denise Baker, an obstetrician-gynecologist from Florida who had to close her practice and send 97 pregnant women to new doctors after her malpractice-insurance company went out of business and she could not afford new insurance.

"I became a doctor to deliver babies, to help a mother through these incredible 40 weeks and to be able to place a newborn baby in a mother's arms," she told the president. "It broke my heart. These are not just patients. They are people with a story and a life."

In his remarks shortly after talking with her, Bush declared that trial lawyers are often the biggest winners in malpractice suits. He said he was shown an advertisement in a local newspaper that assailed his plan.

"A guy held up a full-page ad," Bush said, smirking, "paid for by an excessive jury reward."

Clifford Haines, former chancellor of the Philadelphia Bar Association and a trial attorney who is a close friend of Rendell's, said jury awards are often large in part because jurors are angry over what they believe are a mismanaged health-care system and poorly managed insurance companies.

"They get in that jury room and say, 'This is my chance for payback,'" Haines said.

The solution, he said, may be to better regulate the health-care and insurance industries, while still allowing patients who suffer from malpractice to be duly compensated.

"Large awards are only in cases where people are catastrophically injured or where there are egregious mistakes," Haines said.

"Sure, if you eliminate this system, we wouldn't have some problems. But we established a society that says, when there is wrong done to you, you have a right to be compensated."