(1) Rangel, as usual, is razor-sharp in his analysis of the malpractice problem, and his call for an independent body of experts to adjudicate malpractice suits, in place of an irrational jury system that has only abetted the problem, is long overdue. The creation of that independent system alone would solve a lot of the injustices that now clog the courts, all tilted against physicians.

(2) Bob Herbert, as usual, is playing his role as a hack advocate for the trial lawyers. If he believes his own statistics, which were furnished to him by the Center for Justice and Democracy (which is linked to the trial lawyers), it is obvious he knows very little of what is happening. A decade ago, there were more than 60 malpractice carriers in Florida. As the professional liability problem got worse, only six remained last year, and with only four of these six issuing new policies. ( A website, Pointoflaw.com, provides more telling arguments against Herbert’s
prejudiced thinking.)

(3) The idea of liability subcharges has been bruited about in the face of escalating premiums, and apparently has been welcomed by patients in cases where this has been done. I see nothing wrong with this for the high-risk specialists. There is no other way for patients to maintain access to the services of these specialists if they are left with no choice except to retire, leave for more friendly areas, or cut off certain high-risk services.

Malpractice battles are raging in at least 20 states, most of them linked to exorbitant insurance premiums, usually passed on jto physicians due to the huge number of lawsuits and irrational multi-million dollar judgments benefitting mainly trial lawyers — and that should tell us a crisis is brewing that may destroy our health system beyond repair.

When patients pay the vast sums of money they do for healthcare, they are bombarded that healthcare is a business. When the business messes up – they feel they need to return the product (? the misdiagnosis).

Canadians and UK docs, very rarely get sued. Why? There is less of a “business” feel to healthcare. You know your doctor isn’t perfect, mistakes will be made. And there is a community feel to the care, not a business feel. You are a patient, not a commodity.

Wisen Up USA, healthcare for everyone = less lawsuits. Put the Lawyers outta business.

So much of the content on your blog is well reasoned that I am mystified and troubled by your thoughts on medical-legal issues. I am an attorney interested in reform that will improve the legal system and the medical system, and I think that the ideas you embrace do not seem to be the best route to achieve those goals.

The article “Making a Case for Overhauling the Malpractice System” (published on the American College of Physicians website at http://www.acponline.org/journals/news/jun04/malpractice.htm) reports Dr. Robert Berenson’s conclusion that the current “tort reform” agenda “will keep physicians paying high premiums, stop injured patients from being adequately compensated and hinder efforts to improve patient safety.” I agree.

You have advocated in favor of a $250,000 cap on non-economic damages. Yet the vast majority of doctors carry less than $250,000 in coverage. How will a $250,000 cap on non-economic damages affect premiums on policies that provide less than $250,000 in coverage? Either such a cap would not affect premiums at all or it would affect premiums only in a very indirect and inefficient manner. Moreover, a cap that would apply across the board would have the greatest effect on those patients who suffer the most grievous harms and the least effect (likely no effect) on the patients who suffer minor or disputable harms. If there is a brisk trade in frivolous lawsuits, which some doctors believe, then such meritless claims are not being resolved for amounts approaching amounts anywhere near $250,000 and any law practice based on such claims will be completely unaffected by a $250,000 cap on damages.

You have advocated for reforms in connection with the collateral source rule as a means of preventing double recovery. Surely, in your experience with insurance companies, you must have noticed that the insurance industry will not allow an insured (whether a patient, an auto policy holder, or a doctor with malpractice coverage) to retain funds where two policies have paid twice for the same loss. Invariable, if the patient’s medical insurance has initially paid some of the same costs which overlap with elements for a subsequent award based on malpractice, then the patient’s medical insurer will have a right to subrogation (or reimbursement) out of any recovery for those funds it initially paid out. The recovery of such as costs as medical expenses is generally a fight between the patient’s medical insurance and the doctor’s malpractice insurance; there is no double recovery or windfall.

You have also advocated for changes in the contingency fee system. Yet this very system is the surest form of free market protection against so-called “frivolous” lawsuits. You have commented in the past about the high fees paid to testifying medical experts and other costs of litigation. If a lawyer paid on contingency is incurring these costs, then isn’t he or she financially interested in pursuing only those cases which are the most meritorious and least “frivolous”? If the lawyer is paid by the patient on an hourly basis, then the lawyer has no financial interest in limiting his or her practice to only the most meritorious cases (and, of course, access to justice would be denied those who couldn’t afford to pay a lawyer hourly).

Medical malpractice insurance premiums have increased at a pace comparable to the increase in legal malpractice insurance premiums. There is no “legal malpractice lawsuit crisis” to explain these legal malpractice premium increases. Likewise, there is only conflicting (and arguably biased) evidence with respect to the publicized effort connect increases in medical malpractice insurance premiums with a supposed increase in either the number of suits filed or the amount of payments on claims. I regret that so many doctors have come to see lawyers as the cause of this problem. Of course I am disappointed that these doctors have such an unfavorable impression of the legal system, but I am most distressed that many of those doctors see cutting off their patients’ rights as a way to regulate the lawyers they blame for their insurance premiums.

“There is less malpractice litigation in the UK because the government limits access to jury trial, contingency fees are prohibited, and the loser pays court costs and legal fees for the prevailing side. ”

Well then I guess Canadians and the Brits just have/elect better governments and lawmakers !

Sepsis kills 200,000 Americans a year. Those deaths are not acts of God, they are basically legal homicides. Maybe we should try reducing the amount of medical malpractice in this country.

I would rather sue doctors who make 100x the money than I make. if you wouldn’t charge so much maybe people would not wan’t to sue you.
my cable tv costs 60 dollars in a month. my phone costs 60, my electric bill costs 150. my medical insurance bills are 600 per month. that’s why I wan’t to sue you becuase you charge so much.

sure I might be “ignorant” but I know now how I can get some payback for my thousands of dollars that my family must pay to have medical care.

don’t take it personally but I need the money more thsn you. it’s not pretty… but it’s reality. not bad for being an ignorant customer. Amen to JOHN EDWARDS and KERRY

yawn.

Same old, machi.

A couple of people write letters to the Wash Post, therefore it’s true.

People in California sue more…..for smaller amounts. That puts the lie to the claim that tort reform limits the “right to sue”. Their (California) overall malpractice premium run higher than my state.

If there were no tort reform in their state, the premiums would be orders of magnitude higher……if you could get insurance at all.