Malpractice issues driving donations for legislative races
The Associated Press
On one side, doctors, insurance companies and other health-care businesses hope for a Legislature more willing to rein in the big malpractice judgments they say threaten the future of health care in Washington.
On the other, trial-lawyers' groups are fighting to preserve a system that lets them seek millions for people hurt by doctors' mistakes.
A few elections for control of the House and Senate could decide who prevails when lawmakers return next year.
Together, the two sides have given nearly $1 million — roughly 10 percent of the total cash candidates for the Legislature have received.
Doctors say skyrocketing malpractice-insurance rates — along with increasing overhead and shrinking payments from Medicaid and private insurers — have physicians across the state thinking about retirement, moving out of state or avoiding high-risk specialties.
Dr. Bob Pringle, who runs the North Cascade Women's Clinic in Mount Vernon, said he's seen his yearly malpractice-insurance bill grow from $5,000 20 years ago to $58,000 this year, even though he's never had to pay a malpractice judgment. If the price keeps going up, Pringle and his partners plan to stop delivering babies.
Ushering newborns into the world leaves doctors particularly exposed to malpractice complaints. Not only can a doctor wind up on the hook for a lifetime of medical care and lost earnings if things go wrong, but the wracking emotional toll of a damaged or dead baby can move juries to award staggering damages for pain and suffering.
"It's an intolerable situation," Pringle said. "It's not very difficult for attorneys to find some mechanism by which they can make the doctor and the hospital look bad and obtain a multimillion-dollar judgment."
Some insurance companies have pulled out of the Washington malpractice market entirely, and even Physicians Insurance, a company started by Washington doctors to insure themselves, has stopped taking new doctors because it can't cover the added liability.
The Washington State Medical Association and its allies plan to ask lawmakers to make a series of changes to limit malpractice awards. Among the most significant could be a $250,000 cap on noneconomic damages juries can award for pain and suffering.
Such damages come on top of economic damages for more tangible losses such as medical expenses and future earnings. A similar cap imposed by lawmakers in 1986 was struck down by the state Supreme Court.
Seven malpractice juries awarded judgments of more than $1 million in Washington during 2001, said Gary Morse, vice president of Physicians Insurance.
"Do you want a system that makes the injured party whole if there's been negligence or a system that could lead to a windfall for the lucky unlucky one?" asks Tom Curry, the medical association's executive director.
A similar bill passed the U.S. House recently but is expected to die in the Senate, prompting doctors around the country to look to the states.
Well-organized trial lawyers
Here in Washington, the proposal will have to get past the state's powerful and well-organized trial lawyers. The attorneys say they're sympathetic to the doctors' financial plight — to a point.
"The answer is not to balance it on the backs of the innocent injured person," said Larry Shannon, executive director of the Washington State Trial Lawyers Association.
The lawyers — who give money through 10 regional political-action committees — have poured more than $325,000 into legislative campaigns this year, according to filings with the Public Disclosure Commission.
The primary advocate of the reform effort in Washington is the Liability Reform Coalition. Its members include local governments and a virtual who's-who of Washington business: professional groups such as the medical association, insurance companies, corporations such as Boeing and Weyerhaeuser, and business groups.
Dana Childers, the coalition's executive director, calls the lawyers' spending "overwhelming."
Collectively, the Liability Reform Coalition has spent even more on politicians this year: nearly $1 million.
Members with an interest in health care — doctors, hospitals, nursing homes, insurance companies and drug manufacturers — accounted for more than $400,000.
Limiting jury awards in general is politically tricky because it carries the flavor of favoring big business over ordinary people. But revamping medical malpractice evokes the friendly image of the family doctor — and the pocketbook issue of families' medical bills.
"The doctors make much more attractive poster children for a campaign," said Sen. Adam Kline, D-Seattle, chairman of the Senate Judiciary Committee, which would consider any liability changes. "The insurance industry is not so sympathetic. Who hasn't been screwed by the insurance industry?"
Kline, a lawyer, defends the legal system's status quo.
"The jury is, I believe, the spokesperson for the people," Kline said. "To take their power away from them in the service of big business, of corporate interests, I think is just un-American."
Hoping for change in chair
For reform advocates, the benefits of erasing the Democrats' slim majority in the Legislature would start with Kline surrendering his chairmanship.
"There's no question that we've found more folks on the Republican side interested in our issue, but it's never going to go anywhere if it isn't a bipartisan issue," Morse said.
Kline and the trial lawyers try to portray doctors as pawns of insurance companies trying to make up investment income devastated by the stock market.
"The doctors have a gun to their head — their insurance companies are threatening to quit underwriting or leave the state if they don't get their way," Kline said.
Morse, of Physicians Insurance, says that's largely a myth because the doctor-owned company's money is almost entirely in conservative bonds.
And doctors — not just insurance companies — are plenty steamed about malpractice awards in their own right. They say far too much of the money they pay for malpractice insurance winds up in lawyers' pockets.
"It's not driving doctors to good behavior," Pringle said of the current system. "It's driving doctors out of medicine. It's not compensating patients; it's compensating attorneys. They are paying to preserve a system that is fantastically lucrative to them."
Just how the vast amount of political money surrounding the issue might affect the makeup of the Legislature or its inclination to act on malpractice changes isn't clear.
Democrats are typically less friendly to tort reform, and trial lawyers have given nearly four times as much money to Democrats as to GOP candidates.
The other side of the argument is less unified. The medical association's political-action committee has given mostly to incumbents of both parties because they must deal with lawmakers on other issues, said Curry, of the medical association.
Physicians Insurance, meanwhile, has given more than two-thirds of its contributions to Republican candidates. Morse said candidates must show a serious interest in tort reform to get the company's money.
"We probably don't have the votes," Morse conceded. "But that doesn't mean we're not going to try, because votes can be changed."