‘Cap’ cheats patients and doctors

Published on

The Atlanta Journal-Constitution


After a surgeon removed the wrong kidney of retired California insurance broker Harry Jordan, a jury unanimously determined that medical negligence was to blame because doctors read the X-ray backward.

For this error, Jordan lived the rest of his life in excruciating pain, with only 9 percent kidney function and virtually unable to walk.

A California law that ties an individual’s salary to the value of their life and limb — called tort “reform” — limited the amount Jordan could collect from the wrongdoers to $250,000 for his noneconomic damages — money that courts award malpractice victims to compensate for lost quality of life and pain inflicted by medical errors.

At 61 years old, Jordan was awarded $6,000 for economic damages. That was not even enough to cover his legal bills and nowhere near what he needed to pay his own health insurance costs, which rose to $1,700 per month.

Some Georgia politicians advocate the same rules for Georgia. They say the $250,000 “cap” on noneconomic damages is needed to protect doctors from inflated insurance premiums.

For the insurance companies hoping to profit from the cap, this would be a dream come true. But make no mistake: the $250,000 cap will fail to lower doctors’ insurance costs in Georgia, as they have elsewhere across the country.

The nation’s largest medical liability insurance company admitted as much.

GE Medical Protective recently filed a plan with the Texas Department of Insurance for a 19 percent premium increase on doctors just six months after Texas legislators passed a $250,000 cap on noneconomic damages. The company stated, “Noneconomic damages are a small percentage of total losses paid.”

In California, doctors’ premiums increased by 450 percent in the first 13 years after the 1975 passage of a $250,000 cap on noneconomic damages, and only began to decrease after voters enacted insurance reforms to scrutinize rate increases and require a rate rollback.

In Washington — a state without damage caps, but blessed with a tough insurance regulator — the largest insurer recently cut its rates because doctors were paying too much while the company amassed record profits.

Evidence suggests that the real crisis is not rooted in injured patients filing malpractice lawsuits — but in medical malpractice itself.

As many as 195,000 people are killed by negligence and abuse in U.S. hospitals each year, according to a recent study by hospital consultants Health Grades Inc.

Yet in Georgia, the Board of Medical Examiners, which is responsible for monitoring doctors who practice here, fails to weed out the few doctors who repeatedly injure their patients. Since 1990, just 3.5 percent of Georgia’s doctors have been responsible for 40 percent of the state’s medical malpractice payouts.

Good doctors pay higher insurance premiums than they should, and subsidize a dangerous health care system.

In preparing for the 2005 General Assembly, newly elected Speaker Glenn Richardson (R-Hiram) promised Georgia residents that the state House would only consider new laws that promote personal accountability.

More accountability is just the solution that patients and doctors need to weather this health care crisis.

Better discipline for the few negligent doctors who malpractice over and over again will protect Georgia families from unnecessary injury and suffering. More affordable insurance helps Georgia doctors and hospitals stay in business, and more oversight of insurance companies will guarantee stable, affordable insurance rates for years to come.
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Douglas Heller is executive director of the Foundation for Taxpayer and Consumer Rights. Allison Wall is executive director of Georgia Watch, a nonprofit, nonpartisan consumer advocacy group.

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