Magazine article Clinical Psychiatry News

Skepticism Builds as Tort Reform Languishes

Magazine article Clinical Psychiatry News

Skepticism Builds as Tort Reform Languishes

Article excerpt

As the presidential candidates make their pitches for how best to reform the nation's health care system, physicians aren't holding their breath that medical liability reform will be at the center of the national debate this fall.

All of the GOP presidential hopefuls support medical liability reform in some form, with most endorsing caps on noneconomic damages, and President Obama has paid more attention to the issue than have most Democratic presidents. Still, national physician leaders expressed disappointment in both parties for failing to enact any type of meaningful federal liability reform law, despite years of opportunities.

"Neither side has really been able to deliver on its promises, however big or small," said Dr. Albert Strunk, deputy executive vice president for the American College of Obstetricians and Gynecologists.

President Obama, who does not support the concept of capping damages, pledged to reach across the aisle to work on alternatives to the current medical liability system. In 2010, his administration awarded $25 million in federal grants to researchers looking at disclosure of errors and early offers of compensation to patients. The Affordable Care Act included $50 million worth of additional grants, but those funds have not been awarded because Congress had yet to provide the money.

But those grants were relatively small and so far nothing substantial has come out of the efforts, according to Dr. Strunk, who characterized the president's efforts on medical liability reform as mostly "lip service."

But Republicans do not fare much better in his calculation. Dr. Strunk said Republicans had the opportunity to enact a comprehensive tort reform package when President George W. Bush was in the White House and Republicans controlled both houses of Congress. They failed to do so.

Tort Reform Still a 'Wedge Issue'

One of the major hurdles to passing medical liability reform at the federal level is the need to garner 60 votes in the Senate, where a super majority is needed to prevent a filibuster. Even if a Republican president who supported medical liability damage caps were elected in 2012, it's unlikely that he could get those critical 60 votes in the Senate, said Dr. Stuart Weinstein, a past president of the American Academy of Orthopaedic Surgeons and a spokesman for the Health Coalition on Liability and Access.

"It's an uphill climb," he said.

The Health Coalition on Liability and Access supports a cap on noneconomic damages like the ones enacted in California and Texas, but that policy option is unacceptable to most Democrats in Congress, Dr. Weinstein said.

Over the years, tort reform has become a "wedge issue between Republicans and Democrats.'"

In January 2011, Republicans intro duced the Help Efficient, Accessible, Low-Cost, Timely Healthcare (HEALTH) Act, H.R. 5, which is modeled after California's Medical Injury Compensation Reform Act (MICRA), which has been in place for more than 30 years.

The federal legislation, which is supported by more than 100 state and national medical organizations, would place a $250,000 cap on noneconomic damages and would require that medical liability lawsuits be filed within 3 years of injury in most cases. Physicians were hopeful that the legislation might get off the ground, especially after President Obama expressed interest in working to curb frivolous lawsuits in his 2011 State of the Union address. …

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