Malpractice insurance rates jeopardize health care for all

Guest Editorial by Sen. James E. West
for The Daily Herald

Washington State - 1/23/03 - Bad doctors should be made to pay for their avoidable mistakes -- no one disagrees with that. However, we have a crisis on our hands when good doctors can no longer afford to practice medicine because a few clever trial lawyers attend clinics on how to make more money from the system.

The tort system is designed to provide people with compensation for damages suffered by the negligence of others. It is not supposed to be a lottery creating instant millionaires.

Earlier this month, newspapers across our state ran the story about dozens of surgeons who canceled nearly all scheduled surgeries in four West Virginia hospitals due to the rising cost of medical malpractice insurance. Some patients were being transferred to hospitals as far away as Ohio and Pennsylvania.

Last summer, more than 60 specialists at the University Medical Center in Las Vegas left their jobs, forcing a 24-hour trauma center to close its doors immediately.

Closer to home, Memorial Clinic in Olympia and Everett Family Practice have both closed their doors due to rising costs. In my own hometown of Spokane, many prominent physicians are retiring early or simply closing their practices and moving to friendlier states because of increased malpractice costs. As doctors across Eastern Washington are forced out of business, their patients are left with little or no choice when it comes to medical care. In the case of obstetricians and gynecologists, many women now have no one to care for them during their pregnancies.

In fact, since 1998, Washington state has experienced a 31 percent increase in the number of physicians moving out of state.

One driving factor behind this decision is the rising cost of medical malpractice coverage and the lack of choice in the medical malpractice insurance market. In 1975, a family physician not delivering babies or performing surgery paid $788 per year for insurance. Now it's more than $11,000 -- a 1,348 percent increase. If he or she adds major surgery, the annual premium can be nearly $24,000. Neurological surgeons pay $78,567 and obstetricians pay more than $60,000 -- representing a 1,164 percent increase since 1975.

It's no wonder the American College of Obstetricians and Gynecologists has named Washington one of nine "Red Alert" states experiencing an acute liability crisis.

So what does that mean to the average citizen? It means two things. One, your family's access to good medical care is in jeopardy -- especially if you are a pregnant woman, and two, your cost for health care rises.

You're probably wondering how we got here. Well, the blame lies in three key areas: the courts, the Legislature and overly generous jury settlements.

According to the Washington Medical Association, in 2001, the seven medical malpractice verdicts or settlements in our state alone totaled $44.7 million. This drives up the cost of malpractice insurance for the entire field -- not just the doctors who were involved.

Since the 1970s, the Legislature has addressed similar liability crises -- most recently through the Liability Reform Act of 1986. Unfortunately, by 1989, the Supreme Court had already begun chipping away at those reforms. Over the years, the rest of the act was weakened to where we are today.

What should we do now? Interestingly enough, we could look to California, where malpractice premiums are considerably lower than in our state. California passed comprehensive medical malpractice liability reform in 1976. Since then, medical malpractice premiums have increased at a rate much lower than the national average. In fact, premiums have increased only 167 percent in California versus 505 percent nationwide and 559 percent in Washington.

Furthermore, injured patients are recovering more of the damages awarded without having to pay excess fees to the lawyers. According to the Physician Insurers Association of America, these patients receive 17 percent more of the total award than under the traditional contingency arrangements. The proceeds from a $1 million judgment with California's reforms are anywhere from $111,000 to $278,000 higher than in states like ours without these reforms. Don't feel too bad for the California trial lawyers, though. They still receive roughly $220,000 for a $1 million settlement.

In the months to come, we will hear a litany of excuses why we can't have tort reform. We'll hear horror stories of patients wronged by bad doctors and how they deserve multi-million dollar settlements for their pain. We'll hear about the greed of insurance companies that are artificially raising premiums to pad their pockets. We'll be reminded that Washington's courts have decided that caps on non-economic damages are unconstitutional.

We will need to weigh these arguments against the very real crisis facing expectant mothers and their families who cannot access good doctors across this state. Other states are facing this crisis and updating their laws. We should too -- before it's too late.

Sen. James E. West (R-Spokane) is majority leader of the state Senate.


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