How about a cap on malpractice insurance premiums?
Kari Chisholm
For a while now, doctors have been complaining that their malpractice insurance premiums are too high. Now, that may or may not be true, but the proposed solutions are all wrong.
Last year, Oregon voters turned down a ballot measure (#35) that would have capped the amounts that malpractice victims could receive in compensation. Now, it appears that the insurance companies are back with a cap on attorney's fees.
Doctors say multimillion-dollar jury verdicts are causing malpractice coverage premiums to soar. ... An initiative proposal has been filed that would cap attorney fees in medical malpractice — and other personal injury cases — at $100,000.
Hey docs, I got an idea for ya. Instead of capping compensation for victims (or their advocates), if you're so concerned about high insurance premiums... why not just cap insurance premiums?
High jury verdicts may or may not be causing high malpractice insurance premiums (not!), but why try and attack a perceived cause? Why not just directly deal with the problem?
(And just in case, you think this is too obvious to be a worthwhile idea, I'll point out that it's exactly what California did - and insurance premiums stayed low. Unlike every other place that's tried capping compensation to victims and their advocates; those places don't see any effect on insurance rates.)
[Full disclosure: I was a consultant to the No on 35 campaign last year. I am not currently working for any organization working on this issue.]
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Jul 7, '05
Slight problem - Put a cap on premiums and companies won't underwrite the insurance.
When you mention California as a success, you should also mention the paucity of OB/GYNs not associated with large clinics that can help pay the premiums. This mostly affects lower income people in isolated areas.
Jul 7, '05
Slight problem - Put a cap on premiums and companies won't underwrite the insurance.
When you mention California as a success, you should also mention the paucity of OB/GYNs not associated with large clinics that can help pay the premiums. This mostly affects lower income people in isolated areas.
7:57 a.m.
Jul 7, '05
Why the docs typically side with the insurance companies escapes me. Lawyers self-insure through the Professional Liability Fund - a concept that the insurance companies would oppose if proposed for doctors, because it would take away one of their big profit centers. A cap on rates would be a good first step, too.
Jul 7, '05
In a word "NO". How about if we cap Doctor's fees? This problem stems from the number of deaths and medical injuries that occur each year. There are an estimated 44,000 to 100,000 deaths annually from medical errors. That suggest that in Oregon with about one percent of the nation's population we should have about 500 to 1000 deaths annually from medical errors. So how about if the state just published an accurate account of those numbers annually just like they make a big deal out of the deaths from illegal drugs? I could go on and on with this subject, but this should do for a start. M.
Jul 7, '05
Actually, I changed my mind - caps are a good idea. Taxes are too high, can we can public employee salaries? Better yet, my grandmother's prop tax keeps going up and she is on a fixed income, so lets cap property taxes.
Jul 7, '05
Docs won't do a PLF because of two primary reasons.
1) The OMA makes a killing on selling policies for CNA. That biz represents six figures to the association.
2) Docs aren't that upset about insurance. They just don't like getting sued. As is the case with many advanced professions, they believe that regular folks aren't qualified to judge their actions, no matter how heinous.
And California didn't cap med mal rates or any insurance rates. Instead, voters approved a proposition that better regulated insurance rates and subjected insurance companies to state antitrust laws. The proposition also allowed challenges to proposed rate increases and decreases that introduced transparency into the rate setting process. The results have been a steady path for insurance rates across most property and casualty lines -- and not the volatile up and down in premiums that typifies the insurance cycle.
Jul 7, '05
From the NYTimes today: Study Says Malpractice Payouts Aren't Rising
"When Mike Kreidler was an optometrist in Olympia, Wash., he railed against trial lawyers. He believed that aggressive trial lawyers were the reason he faced rising insurance premiums.
"Dr. Kreidler, now in his second term as Washington State's insurance commissioner, has changed his mind. He has decided that the problem is not the lawyers - although they have contributed - but also the insurance companies ...
"A study to be released today by the Center for Justice and Democracy, a consumer advocacy group in New York, may add fuel to that debate. The study, compiled from regulatory filings by insurers to state regulators, finds that net claims for medical malpractice paid by 15 leading insurance companies have remained flat over the last five years, while net premiums have surged 120 percent.
"From 2000 to 2004, the increase in premiums collected by the leading 15 medical malpractice insurance companies was 21 times the increase in the claims they paid, according to the study. (The net totals in the study are calculated after accounting for reinsurance.) ..."
10:44 a.m.
Jul 8, '05
Since the 1970's there has been a perceived and rather loud hollering about a crisis, where doc's claim that insurance premiums are too high and driving them out of business. Since the 1970's there has been no actual crisis. Insurance premiums remain high in states that both have or do not have caps on damage awards, or pre-trial review panels, or any other "tort reform" that only hurts people who have already been harmed by bad doctors and doesn't do a thing to help good doctors. Docs leave rural areas (or don't go to rural areas) not because of malpractice insurance, but because they make more money elsewhere (same reason other professions don't flock to rural areas).
Nobody likes getting sued. But the truth is that some docs do make mistakes. It's a hard job, yes, there's a ton of pressure. But when a doctor (for example) mistakes a heart attack for Chagas disease because the patient happens to be born African but has been in the US for over a decade, that's malpractice. Or when a doctor (for example) leaves the room without checking on the baby's position and fails to read the instruments that are beeping at him and the baby is strangled by the umbilical cord, that's malpractice. And when we take it upon ourselves to tell an American who's heart is half-dead or a parent who's baby is all-dead that they are not entitled to compensation for their pain and suffering because even though the doctor was at fault we've decided that their pain is less important than the doctor's insurance, well then, that is not justice.
The legal system exists so that people who are responsible for harming others must pay for that harm. This system not only compensates the people harmed for their loss, but punishes the perpetrator and deterrs such harmful behavior to begin with. In every profession and and in every industry, this same standard applies, and yet doctors would like to be exempted. Because their insurance costs too much. Bummer for justice.
And the insurance companies sit back and laugh all the way to the bank, their simple and transparant divide and conquer strategy having been aided by traditional professional competition and the fat bank rolls that prevent any real insurance reform from winding through state legislatures. This is what you're paying for, doctors, with your high insurance premiums - the insurance industry's lobbyists and campaign contributions and access to legislators to ensure that your insurance premiums remain high and the insurance industry remains unfettered by any type of caps or regulation or other reform that would actually affect your premiums. Helluva deal for insurance. Huge shaft for justice.
Jul 8, '05
As a relatively solid conservative, I support tort reform. However, I found myself opposing the cap on damages. It's not that I wanted to hurt my cigar-chomping billionaire CEO buddies, but that I think unlimited damages are currently the only check on irresponsible corporate actions or policies. If a damages cap is put in place, HMO's will only build it into their budget and it's business as usual. However, I also see the flip side of skyrocketing malpractice rates. I would support keeping a cap-free system for damages, but moving to a loser-pays system where frivilous suits are discouraged by insisting that a plaintiff cover the costs if the case loses or gets tossed. This will discourage the greedy opportunistic remoras of our legal system from filing suits without merit, while not allowing corporations to simply budget for bad behavior.
Jul 14, '05
Loser pays systems only ensure that justice is for people of means. Doctors pays half attention in emergency, delivery, recovery etc. happens overwhelmingly to lower-income people. with loser pays, there's even more incentive for this to happen.