The Palm Beach Post
The story has a familiar plot:
Malpractice insurance rates soar. Doctors respond by threatening to move out of state or stop doing high-risk procedures. Some refuse to work in emergency rooms, not wanting to take on the added exposure.
Doctors blame patients that sue too often and win large settlements. They say the malpractice system is broken and that public health is threatend.
It happened in 1988 and in 1991. Both times, doctors demanded the legislature cap so-called pain-and-suffering awards in malpractice cases. Both times, they lost the fight either in the legislature or the courts.
Now, with premiums soaring 50 percent over the past three years, doctors are crying crisis again. And again, they’re pushing the state for relief. How it ends this time might depend on their ability to find common ground with the state’s powerful trial lawyers, who consistently have opposed any move that would cap damages or limit a patient’s right to sue.
“I think the pressure is building on all interested parties – the doctors, the insurance companies, the attorneys and the patients – to solve this problem,” says Senate Democratic Leader Ron Klein, a Delray Beach attorney. “We can’t have doctors leaving the state, but people should have the right to pursue claims where there really is an injury.”
Officials from the Florida Medical Association and the Academy of Florida Trial Lawyers met over the summer but have been unable to reach any deal on a legislative package, sources say.
What doctors really want is a $250,000 cap on pain and suffering damages, which go beyond compensating plaintiffs for lost wages and the cost of medical treatment.
In California, where the cap has been in place since 1975, malpractice costs are significantly cheaper, according to a report issued in July by President Bush. California internists pay $4,000 to $15,000 a year for insurance, compared with $27,000 to $51,000 in Florida.
This month, Nevada became the 20th state to cap damages in medical malpractice suits. After surgeons refused to work in Las Vegas’ only trauma center because of soaring insurance costs, the state legislature set a $350,000 cap on pain and suffering in most cases and a $50,000 cap in lawsuits against trauma care physicians.
But trial lawyers and consumer groups oppose such limits, saying it cheats patients who suffer at the hands of incompetent doctors. They say bad investments and artificially low premiums in the 1990s have led to rising premiums.
“The limits have been nothing but cruel and unusual punishment for patients,” said Jamie Court, executive director of the California-based Foundation for Taxpayer and Consumer Rights.
Jacqueline Imbertson of Jupiter argues that limiting reimbursement for medical costs and lost wages isn’t enough. Imbertson’s husband, Ed, sued Palm Beach Gardens Medical Center in 1999 after a nurse allegedly gave him the wrong medication following heart surgery, causing him to go into cardiac arrest. Now, he’s in constant pain, has difficulty walking and lost part of his right leg. The case is still pending.
“You can’t put a cap on how lives are changed by a medical mistake,” she said
Lawmakers already have a full plate of insurance issues. Workers
compensation, automobile and homeowners insurance are also ailing. Neither Gov. Jeb Bush nor Insurance Commissioner Tom Gallagher have made proposals on the malpractice issue.
Compounding the problem for the doctors is the political power that trial lawyers wield in Tallahassee. They tend to present a unified front and show up in big numbers before the legislature. It doesn’t hurt that many state lawmakers are lawyers themselves.
There is precedence for the two sides to come together. In 1987, a group of attorneys and doctors from Palm Beach County met for several months, and their recommendations later became part of a state law that required more stringent procedures for filing malpractice claims and toughened sanctions against negligent doctors.
Dr. Lee Fischer, a West Palm Beach doctor who served on that task force, said state lawmakers need to be presented a solution that helps both sides. “At the moment, I don’t think the issue is impacting patients’ care,” he said. “But if nothing is done in the next six months you will more have doctors deciding to leave Florida or go without (insurance).”
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Size of awards increase
Nationally, both median jury awards and settlements in medical malpractice cases have been escalating since 1995.
Jury awards
2000 $1 million
1999 $700,000
1998 $733,900
1997 $503,000
1996 $474,536
1995 $500,000
Settlement amounts
2000 $500,000
1999 $592,074
1998 $500,000
1997 $400,000
1996 $365,000
1995 $350,000
Median is the point where half the settlements are higher and half are lower.
Sources: Medical Liability Monitor; Jury Verdict Research
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