What happens when a patient with a head injury can't be taken to the local trauma center because there's no surgeon available and the nearest trauma center is in another state? What happens when a woman knows she needs good prenatal care for her baby but can't find a local doctor willing to practice obstetrics?
Sadly, these are not hypothetical scenarios. Depending on where a patient lives, needed care may or may not be available. In some cases, that can mean a patient may not survive. If a patient lives in California or one of the few other states with tort laws that protect access to physicians, lucky for them. But if they live in Florida, Georgia, Mississippi, Nevada, New Jersey, New York, Ohio, Oregon, Pennsylvania, Texas, Washington or West Virginia, it's a far different picture.
That is why national tort reform is needed, and why the American Medical Association strongly supports the Help Efficient Accessible, Low-cost, Timely Health Care Act of 2002 as the best option to effectively reform the nation's broken liability system and ensure that patients have access to physicians when needed. The HEALTH Act, already introduced in the House, is a common sense approach to stabilize the professional liability insurance market and bring about fair and reasonable reforms to the out-of-control legal system that is forcing physicians to stop offering high-risk procedures.
Rather than face an uncertain future because of unsustainable increases in liability insurance rates, many physicians aren't just limiting their practices-they are retiring early or moving to states that have enacted tort reforms (See related story, p. 30). The AMA says enough is enough-pass the HEALTH Act now.
Why a federal solution? Because tort reform has worked in some states-California, Indiana and Louisiana, to name a few. But a dozen other states are in crisis and three dozen more are seeing warning signs now: rapidly escalating premiums, decreased willingness to continue high-risk procedures and early retirements. In states such as Ohio, where the Legislature passed major reforms and the governor signed them, the state's Supreme Court overturned the law. A federal law would provide consistency and stability.
According to 2001 data from Jury Verdict Research, the median jury award in medical malpractice cases jumped 43% to $1 million from 1999 to 2000. Further, median jury awards grew at seven times the rate of inflation, while settlement payouts grew at nearly three times the rate of inflation. Even more telling, however, is that the proportion of jury awards topping $1 million increased to 52% in 2000 from 34% in 1996. It is clear that the increasing proportion of multimillion-dollar jury awards is driving the boom in claims costs.
These numbers speak for themselves-there is no doubt that our current system for resolving medical liability claims is critically flawed.
Already this year, trauma centers in areas of Mississippi, Nevada, Pennsylvania and West Virginia have either closed or operate under the threat of closure because physicians cannot afford insurance premiums that have doubled or tripled in a single year. Maternity wards and clinics in Arizona, Oregon, Pennsylvania and Washington have closed for the same reason.
The HEALTH Act would stem the exodus of doctors and ensure that patients have access to healthcare when they need it, where they need it.
The legislation has won bipartisan sponsorship because it will help stabilize medical liability premiums at a level that allows physicians to continue providing care to people who need it. A similar bill soon will be introduced in the Senate.
The HEALTH Act would benefit patients by:
* Awarding injured patients unlimited economic damages such as past and future medical expenses, loss of past and future earnings and cost of home help.
* Awarding injured patients noneconomic damages of up to $250,000 for pain and suffering, mental anguish and physical impairment.
* Awarding injured patients punitive damages of up to two times economic damages or $250,000, whichever is greater.
* Establishing a sliding scale for lawyers' contingent fees, therefore maximizing the recovery for patients.
* Allowing states the flexibility to establish or maintain their own laws on damage awards, whether higher or lower than those provided for in this bill.
The AMA believes the HEALTH Act would work because it is based on reforms that have worked in California for more than 25 years. This law would ensure that doctors are held accountable for their actions-as they should be. This bill has no cap on real economic damages that a patient suffers. The safety and quality of care of patients in our healthcare system is an issue of great concern to us all. That's why the AMA has led the way in supporting patient-safety initiatives at the state and national levels. Preventable injuries and complications must be identified, diagnosed and eliminated through methods that maximize safety and quality of care while minimizing secrecy, blame and retribution. Where a patient has been injured through the negligence of a physician, the doctor should be held accountable. This is and has been our position for decades.
We strongly support the HEALTH Act and believe every member of Congress should do the same in the name of preserving patients' access to physicians. Where will patients get care if physicians can't get insurance?