A little county with a reputation for big lawsuits — some call it a "judicial hellhole" — is getting a visit from a man who wants to make it much tougher to sue somebody.

His name is President Bush.

Madison County, just across the Mississippi River from St. Louis, is already a focal point in the national debate over tort reform (search), and Bush's visit Wednesday is certain to raise its profile even higher.

"Madison County really does symbolize all that is wrong from a tort reform perspective and what needs to be changed," said Lisa Rickard, president of the U.S. Chamber Institute for Legal Reform (search).

The American Tort Reform Association (search) dubbed the county the nation's top "judicial hellhole" in 2004, blasting its reputation for handing out big awards and allowing lawsuits that would be thrown out in other districts.

It is the second year in a row that the association handed the crown to Madison County and said the county's problems "have metastasized" into neighboring St. Clair County, which for the first time appears on the group's list.

Last year, one county judge ordered cigarette maker Philip Morris USA (search) to pay $10.1 billion for falsely marketing light cigarettes as less harmful than other brands. More than 1,400 asbestos cases were filed in Madison County (search) over the last two years, and it was home to 179 class action lawsuits (search) during that time.

The chance to elect a judge from the area to the Illinois Supreme Court, which is considering the Philip Morris case and others, turned into an expensive battle between national interest groups last fall.

Organizations representing doctors, lawyers and insurance companies donated more than $8.5 million to the two candidates, making it the most expensive state court race in American history.

The winner was a Republican whose supporters favor more restrictions on lawsuits, such as limiting damages for pain and suffering or tightening the criteria for filing cases. But these efforts have stalled in Congress and the Illinois Legislature, in part to strong opposition from trial lawyers who want to protect victims' rights to sue when they are injured.

During his visit to the town of Collinsville, the president will address more than 1,000 doctors, business leaders and Republican officials on reining in lawsuits that he says have driven up the cost of health care, Bush spokesman Jim Morrell said Monday.

Supporters hope Bush's visit will build momentum for federal and state responses to the calls for change. Doctors in Illinois and throughout the nation say costly lawsuits are pushing up their malpractice insurance rates and forcing them out of business.

Bush made lawsuit reform a key part of his re-election campaign, and supporters expect his visit will force reticent leaders in Springfield and Washington to reconsider their opposition.

"I think the benefit is it will keep this in the public eye," said U.S. Rep. John Shimkus (search), a Collinsville Republican who helped organize the president's visit. "Hopefully, legislators will continue to realize that this issue will not go away. He's using the bully pulpit as he should."

But lawyers argue officials should look more closely at insurance companies who are charging the exorbitant rates. They contend critics of the legal system exaggerate the Madison County situation, where filings of class action lawsuits are on the decline.

"He's trying to demonize one county as kind of an example of what the entire country looks like," said Kevin Conway, president of the Illinois Trial Lawyers Association (search).

They argue Bush and others who advocate change should not ignore the concerns of those who understand the legal system and those who turn to it for help.

"If there is some type of resolution," said Ronald Motil, president of the Madison County Bar Association, "I think it would have been profitable for members of the bar and victims groups to have some say-so."