Kathy Kneer, president and CEO of Planned Parenthood Affiliates of California, said the state's pain-and-suffering cap has helped protect women's access to obstetricians. “To the extent we have a stable obstetrician provider pool, there is evidence it is working,” she said.
Patient access to OB-GYNs and other physicians has been raised as an issue in the brewing political battle over California's $250,000 cap on pain-and-suffering damages in medical malpractice cases that was enacted with the state's Medical Injury Compensation Act of 1975.
Opponents of the cap are gathering signatures to put the Troy and Alana Pack Patient Safety Act before voters on the Nov. 6, 2014 ballot. The measure would, among other things, adjust the state's $250,000 cap on noneconomic damages for inflation, raising it to about $1.1 million.
MICRA supporters say access to physicians has improved in Texas since it passed California-modeled tort reform in 2003, while access has declined in New York, which has resisted caps and other restrictions on medical malpractice lawsuits.
Citing a 2010 workforce study, a pro-MICRA group known as Californians Allied for Patient Protection, or CAPP, notes that there are 19 New York counties without an obstetrician and 22 without an internal medicine specialist. In contrast, they cite Texas studies that show the state has 14,000 more doctors than it did before the cap was imposed. According to these studies, there are fewer rural counties in Texas without obstetricians, emergency medicine physicians and specialist surgeons.
But other studies have not found strong causal connections between putting caps on medical liability lawsuits and physician supply. Some experts say the supply of physicians in Texas has tracked population growth in that state.
California has no caps on damages for economic losses or lost wages in medical liability cases. But MICRA opponents argue that capping noneconomic damages makes it hard to find lawyers who will take the cases of women, senior citizens or children injured by medical negligence who don't have significant economic losses.
Kneer said, however, that even with the pain-and-suffering damages cap, the law still protects mothers who don't have paying jobs. She said “all those things they do” in running a household can be calculated into economic damages if they now need to pay for assistance in taking care of their children or home.
Carmen Balber, executive director of Consumer Watchdog, the organization spearheading the effort to get the measure raising the cap on the ballot in November 2014, said there “is no credible evidence” that caps have a significant impact on access to physicians. She added that women have been disproportionately affected by the MICRA cap and said it's “shocking” that Planned Parenthood is part of the campaign to leave the cap at $250,000.
On Aug. 15, Consumer Watchdog sent a letter to Kneer and the women who lead the state's individual Planned Parenthood Affiliates asking the organization to reverse its position. The letter was signed by 15 women “whose lives have been devastated by medical negligence.”
Follow Andis Robeznieks on Twitter: @MHARobeznieks