Mayor Moves to Curb Medical Malpractice Costs
Thursday, May 5, 2005
D.C. Mayor Anthony A. Williams announced a plan yesterday aimed at reducing the high price of medical malpractice insurance by limiting lawsuits, reducing attorneys' fees and capping court-awarded damages.
The proposal, submitted to the D.C. Council for approval, also seeks to improve patient safety by requiring the city Health Department to develop a system for reporting "adverse medical events." And it would expand the authority of the District's insurance commissioner to demand justification for large rate increases requested by insurers.
But the central focus is protecting doctors and hospitals from frivolous lawsuits and excessive jury awards, problems that Williams characterized as lying at the heart of the malpractice crisis.
"We have the dubious distinction of having the highest premiums in the nation and the highest jury awards in the nation," Williams (D) said at his weekly news conference in the John A. Wilson Building. "If we're really serious about expanding the provision of health care in this city, we ought to adopt these reforms."
Williams was flanked by a dozen doctors and other health care professionals, who complained that the rising cost of insurance is driving doctors out of the District and out of business altogether. Gynecologist John H. Niles Jr., chairman of the D.C. Medical Society's liability reform task force, said he decamped to Greenbelt a year ago, cutting his insurance premiums in half. As of last year, 62 other doctors had stopped delivering babies in the District, Niles said, citing a Medical Society study.
"I was born and raised in D.C., and it was my intention to practice in the inner city. I did so for 32 years. So I'm profoundly sad that I can no longer bring my skills and services to the people who depend on them," Niles said. He declined to say what he pays for insurance, telling reporters only that his Maryland premiums remain "in the six figures."
Orthopedic surgeon Peter Lavine said he has shifted much of his practice from the District to Virginia, which slashed his annual premiums from $62,000 to $28,500. "My situation is not unique," Lavine said, "and I am not alone."
Williams's proposal seeks to cut liability premiums by limiting lawsuits. It would require injured patients who wish to sue to obtain a "certificate of merit" from a practicing D.C. doctor who agreed that there was "a reasonable basis" for the suit. Patients who cleared that hurdle could sue, but their attorneys would be barred from collecting fees in excess of 40 percent of the first $50,000 in damages and 15 percent of damages over $600,000.
Jury awards also would be limited. Doctors would be required to pay no more than $250,000 in non-economic damages, commonly known as pain and suffering. Hospitals would pay no more than $500,000 in non-economic damages to individual plaintiffs, with the total due all plaintiffs in a single lawsuit capped at $1 million.
Wayne R. Cohen, president of the Trial Lawyers Association of Metropolitan Washington D.C., called the proposal "an awful bill" for patients that "protects doctors who commit the worst malpractice."
By limiting non-economic damages, Cohen said, the proposal would discriminate against the poor and those with low-paying jobs because they could collect only small awards for lost wages due to medical errors.
Nationally, rising rates for malpractice insurance have prompted similar proposals in numerous states, including Maryland and Virginia. But the idea of limiting access to the courts is unpopular among members of the D.C. Council, who last year refused even to hold a hearing on an earlier version of Williams's bill.
This year, council member David A. Catania (I-At Large), chairman of the council's Health Committee, has promised to hold a hearing on the topic in the fall.
In the meantime, Catania has appointed a task force stocked with doctors and trial lawyers to study the issue and propose a compromise.