RECOMMENDATION
We recommend the enactment of medical liability reforms modeled on California’s highly effective law. Medical liability reform legislation should:
Medical Liability Reform
Summer 2007
- Impose a hard cap on non-economic damages;
- Limit attorneys' contingency fees;
- Inform juries of prior insurance payments to patients and reduce awards by the amount of compensation from collateral sources;
- Replace joint and several liability with proportionate liability, so each party, including the would pay his share of a malpractice award based on the proportion of which he is liable;
- Allow periodic payment of future damages at a defined award limit;
- Provide for Alternative Dispute Resolution Systems, and
- Require an expert witness who possesses knowledge and expertise and practices in the same medical specialty as the defendant.
Background
California enacted the Medical Injury Compensation Reform Act of 1975 (MICRA) over thirty years ago. MICRA has served as a model for federal tort reform and in California has successfully placed a greater share of insurer payouts in the hands of injured patients. In a recent RAND study, MICRA’s reforms reduced attorney fees 60 percent, while net recoveries to patients were reduced by 15 percent overall. From 1976 to 2003, total premiums in the rest of the U.S. rose 920 percent; in the same period, the increase in California premiums was only 282 percent Claims are settled sooner, allowing patients to receive awards more quickly.
The current medical liability system fails both patients and health care providers. Liability reform must more equitably and quickly compensate those truly injured in the course of medical care without needlessly diverting health care dollars. By reducing liability insurance premiums and exorbitant legal fees associated with lengthy litigation and by ending the need to practice defensive medicine, we can decrease the cost of health care.
Health Courts
Health Courts are another component of liability reform which could meet the needs of patients and providers. By providing a genuine alternative dispute resolution system, an effective Health Court with genuine expertise in health care could both control costs and expedite proceedings. Common Good, the national nonpartisan legal reform coalition, has been awarded a two-year grant of nearly $1 million from the Robert Wood Johnson Foundation (RWJF) to promote the creation of special health courts to handle medical injury disputes in six states. The new project builds on a previous RWJF-funded project by Common Good and the Harvard School of Public Health (HSPH) to design a prototype for special health courts.
California enacted the Medical Injury Compensation Reform Act of 1975 (MICRA) over thirty years ago. MICRA has served as a model for federal tort reform and in California has successfully placed a greater share of insurer payouts in the hands of injured patients. In a recent RAND study, MICRA’s reforms reduced attorney fees 60 percent, while net recoveries to patients were reduced by 15 percent overall. From 1976 to 2003, total premiums in the rest of the U.S. rose 920 percent; in the same period, the increase in California premiums was only 282 percent Claims are settled sooner, allowing patients to receive awards more quickly.
The current medical liability system fails both patients and health care providers. Liability reform must more equitably and quickly compensate those truly injured in the course of medical care without needlessly diverting health care dollars. By reducing liability insurance premiums and exorbitant legal fees associated with lengthy litigation and by ending the need to practice defensive medicine, we can decrease the cost of health care.
Health Courts
Health Courts are another component of liability reform which could meet the needs of patients and providers. By providing a genuine alternative dispute resolution system, an effective Health Court with genuine expertise in health care could both control costs and expedite proceedings. Common Good, the national nonpartisan legal reform coalition, has been awarded a two-year grant of nearly $1 million from the Robert Wood Johnson Foundation (RWJF) to promote the creation of special health courts to handle medical injury disputes in six states. The new project builds on a previous RWJF-funded project by Common Good and the Harvard School of Public Health (HSPH) to design a prototype for special health courts.
Background on Federal Issues
Senate Letter in Support of Title VII Funding in FY '08 (*PDF file)
Congressional Letter in Support of Title VII Funding in FY '08 (*PDF file)
Medical Liability Reform
Medicare Physician Reimbursement
NIH Reauthorization FY08 Appropriations
Summary of President's FY 2008 Budget (*PDF file)
(*PDF file. About PDFs)
