N.Y. Times News Service
President Bush sent a proposal to Congress earlier this month to
limit medical malpractice lawsuits, accepting a
recommendation that the American Medical Association had been
pushing for five years.
The association has said the limits work in California and has
suggested that changes in the malpractice laws could
ultimately reduce health-care spending.
But lawyers who file the malpractice suits insist that the doctors
have not proved their point.
The California law sets a $250,000 ceiling on payments for
"noneconomic losses" like pain and suffering, and it
appears to have slowed the rise in the state's medical insurance
But it has not been shown that the savings were passed along to
patients and employers who pay medical bills.
William K. Scheuber, president of Medical Underwriters of
California, the managing arm of the doctor-owned insurance
company Medical Insurance Exchange of California, cited the
premiums for an obstetrician-gynecologist who bought
$500,000 of coverage.
The doctor paid $33,380 in 1991, compared with $11,380 in 1975,
the year that California enacted the ceiling. The rates
increased, on average, by only about 7 percent a year.
In another example, premiums paid by general surgeons in
California hovered around $20,000 from 1986 to 1988, while
premiums for surgeons in Florida surged from $70,000 to $100,000.
But Michael Maher, a lawyer in Orlando, Fla., who heads the
Association of Trial Lawyers of America, said there was no
national pattern linking limits on malpractice awards with
insurance rates, which have indeed been dropping nationally
He said premiums were reduced by 20 percent in 1989 in Maine, for
example, before that state had passed malpractice
limits, but in Louisiana, the rates continued to rise despite
"significant limitations" on malpractice awards in that
"I think the system is working," Maher said. "Doctors are being
more careful. They are practicing a higher quality of
medicine because of the tort system."
Beth Hamel, a spokeswoman for the St. Paul Cos., the largest
private malpractice insurer, said the company would
"neither support nor oppose changes in the tort system," adding:
"There are so many legal challenges to the laws and
they change so frequently that it is hard to see any kind of
She said the company, based in St. Paul, began cutting rates in
1988, as the amount and frequency of claims turned