Medical liability crisis: Tort reform bill goes to Congress
Physicians back the measure, which includes caps on
noneconomic damage awards.
By
Tanya Albert, AMNews staff. Feb.
24, 2003. Additional information
A bipartisan coalition in the House of Representatives has
introduced legislation that marks the first step in this year's effort to
pass medical tort reform at the national level.
The move in Congress came as doctors in several states launched work
slowdowns or other protests against rapidly rising liability insurance
rates. Several state legislatures are considering tort reform bills as
high premiums force many physicians to stop offering high-risk procedures
or to leave their states.
The congressional measure, offered Feb. 5 by Rep. James Greenwood (R,
Pa.) along with 68 co-sponsors, would allow unlimited awards for economic
damages, such as medical bills and loss of income, but proposes a $250,000
cap on noneconomic damages, commonly called pain and suffering awards.
The legislation -- the Help Efficient, Accessible, Low-cost, Timely
Healthcare Act of 2003, or HEALTH Act -- also would hold physicians
responsible for only their portion of damages, impose a three-year statute
of limitations on when most medical malpractice cases could be filed and
limit punitive damages to whichever is greater, two times the economic
damages or $250,000.
The bill is nearly identical to tort reform legislation that the House
passed 217-203 last year, but that the Senate never considered.
The new bill drew immediate support from the American Medical
Association, the Federation of American Hospitals, the American College of
Physicians--American Society of Internal Medicine and other organizations
that claim that excessive jury awards have led to increased insurance
premiums.
Rep. Greenwood's bill is nearly identical to a measure passed by the
House last year.
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Those groups and the Bush administration favor legislation that
includes a cap on pain and suffering awards because they say similar
legislation passed in California more than two decades ago has helped keep
insurance rates stable there.
"It brought a crisis state of 1975 to a state of stability," said AMA
President-elect Donald J. Palmisano, MD. "The HEALTH Act will go a long
way toward bringing common sense back to our liability system."
The bill, which Republicans generally support and Democrats generally
oppose, is expected to pass the House again. On Feb. 10, a House
subcommittee held a hearing on medical liability insurance in Greenwood's
district in Bucks County, Pa. The legislation has already received support
from key House members, including House Judiciary Committee Chair F. James
Sensenbrenner Jr. (R, Wis.), Majority Leader Tom DeLay (R, Texas) and
House Speaker J. Dennis Hastert (R, Ill.).
"It is my hope that [the HEALTH Act passes the committees quickly] so
we can pass it on the House floor in March and get into negotiations with
the Senate soon," Hastert said.
But not everyone agrees that a cap on pain and suffering awards would
keep doctors' insurance rates in check. And an uphill battle is expected
in the Senate.
A call to regulate insurers
The American Trial Lawyers Assn., consumer groups and a number of
Democrats in the House and the Senate argue that regulating the insurance
industry is the way to keep insurance affordable and available for
physicians.
"There is absolutely no reason for the most seriously injured and most
vulnerable patients to be penalized to subsidize the insurance industry,"
ATLA spokesman Carlton Carl said of the HEALTH Act. "The legislation would
have no impact on malpractice insurance rates paid by doctors."
Some Democrats in Congress favor insurance regulation to keep
premiums low.
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In late January, four senators circulated a letter to their colleagues
asking them to sign on to a bill called the Medical Malpractice Insurance
Antitrust Act of 2003. The legislation is designed to ensure that "medical
malpractice insurers cannot drive up doctors' premiums by engaging in
price fixing, bid-rigging or market allocations," Sens. Patrick Leahy (D,
Vt.), Richard Durbin (D, Ill.), Edward Kennedy (D, Mass.) and John Edwards
(D, N.C.) stated in their letter.
The four senators said that legislative proposals that focus on award
caps don't protect physicians and patients against skyrocketing costs.
"We believe that one essential step to lower medical malpractice
premiums is to directly address the market behavior of the companies
issuing malpractice policies," they wrote.
Edwards said the Senate also must make sure that legislation stops
frivolous lawsuits, not serious cases, by requiring that lawyers fully
investigate their cases before filing them.
Lawmakers also must "address the handful of bad doctors who are
responsible for a majority of malpractice cases," Edwards added.
At press time, the senators had not yet introduced their bill. But a
measure aimed at regulating the insurance industry had been reintroduced
in the House.
Tide turning in Senate?
With Republicans holding a narrow majority in the Senate this year,
medical groups hope that a bill similar to the HEALTH Act could pass in
that chamber.
Sen. John Ensign (R, Nev.) last year introduced a bill that called for
a $250,000 cap. But the bill went nowhere in the then-Democrat-controlled
Senate.
Already this year a number of Senate Republicans, including Judiciary
Committee Chair Orrin G. Hatch (R, Utah), have voiced support for changes
that would reduce frivolous lawsuits.
"According to the Dept. of Health and Human Services, reforms such as
those the president and I support [including a $250,000 cap] will reduce
federal government costs by at least $28 billion and health care costs for
all Americans by $60 billion," Hatch said.
The Senate Judiciary Committee and the Senate Health, Education, Labor
and Pensions Committee held a joint hearing on Feb. 11 to discuss medical
liability insurance reforms.
Tort reform proponents argue that recent polls show that most Americans
support changes in the legal system where medical malpractice lawsuits are
concerned.
"The public support for medical liability insurance reform is
overwhelming," Dr. Palmisano said. "We are confident [the HEALTH Act] will
pass the House, and we are working very hard to make sure the bill has
success in the Senate."
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ADDITIONAL INFORMATION:
Public support
A recent Gallup Organization poll found that the majority of
Americans recognize that there is a medical liability insurance problem
and support tort reform. According to the poll:
- 72% favor a limit on what patients can be awarded for pain and
suffering.
- 57% say patients bring too many lawsuits against doctors.
- 64% say the issue of medical liability insurance is a crisis or
major problem.
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Weblink
Thomas, the federal legislative
information service, for bill summary, status and full text of the Help
Efficient, Accessible, Low-cost, Timely Healthcare Act of 2003 (HR 5)
(http://thomas.loc.gov/)
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Copyright 2003 American Medical Association. All
rights reserved.
