Demand guarantees that tort reform will cut cost of liability insurance

I am a practicing physician and a nonpracticing attorney. Readers might presume that I have a legal bias. In fact, I have no professional partisanship of which I am aware. I try to be reasonable when considering the inter-professional and political dilemma raised by tort reform.

I believe we urgently require tort reform, but not the reform now on the nation's table. Inordinately high liability insurance premiums, reduced patient access to certain high-risk doctor services, unreasonably large pain and suffering awards, claims of frivolous lawsuits, medical error prevention, and dramatically increasing physician angst and anxiety in response to what appears to be a hopeless set of legal dragons arrayed against us demand immediate redress.

The issue is what is the most effective political means by which doctors and patients are most expeditiously and completely expunged of the present perplexity. The consensually evident goals are: decreased malpractice insurance premiums -- now; elimination of frivolous lawsuits; create rational pain and suffering awards.

I believe the Better Health Act introduced last year by Sens. Lindsey Graham (R. S.C.) and Dick Durbin (D, Ill.) approached some of these end points. But it did not deal with pain and suffering awards, and gave tax credits rather than rate reductions for insurance premiums. Perhaps an actuarial evaluation of valid and reasonable pain and suffering awards using parameters identified by a panel of doctors, lawyers, economists and insurance experts studying past awards and employing reasonable award models could produce a formula that would, by statute, guide noneconomic damages in a rational direction.

We have spent so much emotional capital lobbying for tort reform in its current incarnation that we have lost our proper focus. We should demand explicit promises from those whose interests we are serving, i.e., the liability insurance companies that are the instant beneficiaries of reform, to grant us immediate premium relief.

The test physicians should apply to tort reform proposals is simply: What precisely is in the tort reform package for us and our patients, and in what form will benefits that we expect from reform be guaranteed? Are these expectations likely to come from the Bush administrations' proposals? My answer is an emphatic "no." We must aggressively look elsewhere and quickly, for a workable solution.

Scott A. Kale, MD, Chicago

Note: This item originally appeared at http://www.ama-assn.org/amednews/2005/02/14/edlt0214.htm.