Whatever happened to malpractice reform? When President Clinton unveiled his reform proposal last year, federal tort reform was widely acknowledged to be a crucial part of the effort to help rationalize the healthcare system.
Now the issue, a hot button that pits physicians and hospitals against trial lawyers, has disappeared off the scope.
With the clock ticking away the final moments of 1994's reform debate, Congress is likely to pass only limited, incremental reform measures. It's understandable for Congress to have turned away from such costly features as long-term-care benefits. But tort reform shouldn't evaporate in the rush to adjourn for fall election campaigns.
Some argue that the malpractice crisis is not as acute as it once seemed. Sure, malpractice insurance premiums have been reined in. And medical professionals have had some success in controlling the proliferation and duplication of medical procedures-sometimes a defensive response to malpractice concerns. In addition, a number of states, including California, Florida and Indiana, have taken action such as instituting a cap on damages for pain and suffering.
But state efforts aren't enough, as recent data show.
The frequency of medical malpractice claims against physicians continues to rise. Data from St. Paul Fire & Marine Insurance Co., which insures about 50,000 physicians nationwide, indicates that claims rose to 14.6 per 100 physicians in 1993 from 14.1 in 1992. In 1988, there were 13 claims per 100. St. Paul views the overall claim trends as relatively stable, but still, the drift is upward.
The report showed the average size of a paid malpractice claim dropped slightly to $172,300 in 1993 from $175,800 in 1992. But the decline continues a three-year cycle of increasing, leveling off and decreasing that has been evident since 1983.
It's likely there will be a steady increase in the number as well as the size of claims. After all, we live in a society in which a jury awarded a McDonald's customer $2.9 million for scalding herself with hot coffee.
Congress must stand up to the trial lawyers, who have poured a lot of money into Democratic campaign coffers, and include tort reform in any final plan sent to the president. At minimum, the definitive agreement should include a cap on noneconomic damages and encourage arbitration as an alternative to lengthy and costly legal action. Finally, federal legislation should not pre-empt state efforts.