Question of the day
Do you favor medical malpractice reform? Why or why not? What, if anything, would you change?
posted by Rich Miller @ 5/18/2005 07:13:00 AM
26 comments
Do you favor medical malpractice reform? Why or why not? What, if anything, would you change?
posted by Rich Miller @ 5/18/2005 07:13:00 AM
26 comments
26 Comments...
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Let the defendant be able to choose judge vs jury trial.
There are no punitive damages in med mal in Illinois. Also attorney fees are limited in med mal. These were part of the reforms in 1986.
No one has come up with an adequate explanation as to how malpractice insurance premiums shot up through the roof during a period of time where claim payments actually declined.
Put on caps and limit lawsuits and you will not see a dramatic decline in premiums.
Yes doctors and hospitals are getting screwed. But it doesn't seem to be coming from the current court system. It's from the insurance carriers, especially their own.
Target the insurance industry. Their explanations for how this happened just keeps falling flat.
Louis G. Atsaves
Tell ISMIE to give the $400,000,000 in excess premiuns it collected from doctors over the last three years back to the doctors.
I guess anonymous 10:00 doesn't understand how insurance works. Contrary to what others have tried to claim, you don't subtract 2004 payouts from 2004 premiums and figure out that an insurance company "made" money. Med mal claims generally run 5-7 years at a minimum. So, you're collecting money for future expenditures. And state law requires that you put money in reserves at a certain level. Please, if you don't understand insurance, don't start posting these comments.
The supporters of malpractice reform tell us that we need it to keep good physicians from fleeing Illinois and its high malpractice insurance premiums. Therefore, it seems to me that any malpractice reform should be directed at lowering – or at least limiting the increase in – the premium costs of health care providers.
The simplest way to do this would be to put caps on the amount that insurance companies can charge doctors.
Attempts to lower premium costs through tort "reform" are needlessly inefficient because they increase the degree of separation between the problem, doctor's high premium costs, and the purported solution, limits on jury awards.
Tort reform is a multi-step Rube Goldberg plan based on an unproven series of assumptions:
• that limiting jury awards may lower the amount insurance companies have to pay in malpractice judgments, and
• that insurance companies could then lower the amount of their premiums, and
• that more doctors might then stay in Illinois.
If any of these assumptions are wrong, tort reform won’t keep a single doctor in Illinois.
All parties agree that the threat of doctors leaving the state is due to high insurance premiums, so any answer to that threat should directly address the costs of insurance premiums.
The majority of cases are settled without a trial. I saw part of a dental malpractice trial last year at the Daley Center. The plaintiff was asking for $10,000. The trial was absurd, with the defense lawyer objecting to EVERYTHING! The judge would require the plaintiff's lawyer to rephrase the question. It took two or three times, but then he asked a qestion, the defense objected, the judge finally overruled him and the question was asked. The question was essentially the same as first asked. They finally settled for an unknown amount. A judge, jury, and an unknown amount of other people were tied up with this stupidity.
The lawyers, ISMIE are the real problem.
from what i understand the doc's are betting that caps will open up the competition for insurance companies in IL -- right now they don't have many choices for insurance carries -- so if caps are put in place the competition would increase for IL doc's business. What i don't understand is if the premiums are so high --- wouldn't more insurance companies want to get those $$$? As for all the doc's fleeing southern IL - I wouldn't count on it --- If all our doc's flee to Indiana, Kentucky or Missouri - they will have a surplus of doc's and the doc's patient numbers will decline --- resulting in the doc's losing money anyway -- no patients no income --- There is no easy answer -- and I don't believe this problem was created in the last 2 years --- at least current legislators/adminstration -- admit the problem is there and needs to be addressed by all sides -- some give and give from everyone (perhaps patients included - there are people who drive 45plus miles just to use a doc/hospital covered under their workplace insurance - when there are docs/hospitals just a few miles from their home -- whose fault is this? I don't see anyone worried about the drive for these folks!!)
I had a nephew from Southern Illinois who had to have emergency surgery due to having a tumor removed from his leg. The surgical site went septic and the closest hospital that could treat him was several hours away in St. Louis. Something has to be done. Children are going to die because of this.
1) Insurance companies are insured by other insurance companies. ISMIE has several layers of reinsurers and ISMIE is responsible for a very minimal amount of a large claim payout.
2) ISMIE is a company owned and run by doctors. They do not want any nominal claim settled just to make it go away. They expend a huge amount on defense attorneys to counteract the plaintiff whores who think there is a fast buck because a doctor is insured. The defense attorneys will take a claim all the way to the courthouse steps and call the bluff of the plaintiff attorney just to keep the doctor's record clean. Why don't we talk some about the plaintiff attorneys?
3) There are legitimate claims where a case should be settled and is. When a case goes to court it is usually because the plaintiff has made such a ridiculous demand for money that there is no recourse but to go to trial.
4) With that said, ISMIE (not the only med mal insurer in IL), could certainly cut their overhead by doing away with corporate Mercedes and Jaguars. No one is monitoring that store for their administrative expenses, which are through the roof.
5) Ill. Dept. of Insurance needs to monitor the requests for med mal rate increases a lot better than they are doing. Get out of bed with the insurance companies and perhaps we would see more affordable rates for doctors.
6) If you think there is not a problem with St. Clair/Madison counties and their judges, you need to visit those courtrooms once in a while. They truly are the cesspools of America.
7) Also to Anonymous 8:42 - sorry, there ARE punitive damages in med mal in this state and I am not aware of attorneys fees being limited. Attorneys fees are limited in disability cases to 25 percent of the amount recovered PLUS expenses. What 1986 reforms are you talking about? The 1993 Tort Reform was ruled unconstitutional.
If you need proof that caps work, you can look at any of the 27 states in the country with caps - all who have lower premiums that Illinois doctors. California is the best example. If you say it's the insurance reform coupled with the caps - insurance reform is in the bill.
Also, insurers aren't in Illinois because THEY AREN'T MAKING MONEY. If it was a profitable industry in Illinois, insurers would be here. There used to be literally 6 times as many insurers only 5 or 6 years ago - they all left because of the frequency and severity of the claims in Illinois.
If you cap what insurers can increase their costs, you drive them out of business. If you don't have insurers, doctors can't practice medicine because their hospitals and managed care contracts dictate that they must carry insurance.
By the way, states with caps have 12% more doctors - in case people think that doctors won't stay in Illinois.
And insurance companies can't agree to lower rates for caps until they're upheld by the Supreme Court.
For those who want caps, they're in the bill. For those who want insurance reform, it's in the bill.
Doctors need to be held liable for the mistakes they make. With med mal reform where is the accountability? You cannot take away a fundamental right and limit a jury award based on what insurance companies think that an injured party should receive. What about childen, elderly persons, women/men who do not work outside the home? Med mal reform will only hurt the most vulnerable people in our society. Insurance reform is what is needed. Hold public hearings and have the insurance companies explain rate hikes. It is also unfair to limit attorneys' fees. Take the amount of a verdict/settlement and divide it by the number of hours worked on the case and it comes out much lower than you think.
Anony 11:21....get your facts straight.
Punitive damages in medical malpractice cases are no permitted - by statute.
Furthermore, attorney fees in all medical malpractice are limited - by statute.
You speak with a lot of conviction and not a lot of facts.
People are entitled to their own opinions, but not their own facts. The fact remains that the Illinois Dept. of Regulation is a non-entity that doesn't do anything to ensure that bad doctors aren't practicing. The insurance companies are gouging the docs, the docs are relying on an insurance company to "look out for them" and yes, there are frivilous cases filed by the lawyers.
However, until all of these entities are at the table, which they are not at this time, any reform will lead to nothing more than med mal deform and unnecessarily hurt an innocent party/s.
It is time for the legislature to look at the hard facts - and not the rhetoric. Up until today, they have not done that!
To Anon 11:25: Good to see the Chamber is submitting posts directly. Please refrain from name calling and mindless insults: "plaintiff whores" and courts as "cesspools." I'm a practicing defense attorney in Cook County currently representing a corporate client in its defense of a personal injury case in Madison County. I may disagree with the court's rulings and opposing counsel's arguments, but your angry rhetoric is not the answer and just makes the situation worse.
Anon 12:00 "People are entitled to their own opinions, but not their own facts." Since when are people not entitled to BOTH. Also, if you can quote me the IRS (that stands for Illinois Revised Statute) number regarding punitive damages in medical malpractice cases and attorneys fees in med mal, then I'll back down from my argument. I can certainly be proven wrong.
And yes, I do speak with a lot of conviction AND a lot of facts. I work for a major med mal insurer - do you?
Anon 12:05 - regarding the affectionate name for plaintiff attorneys and the Madison/St. Clair jurisdiction, take your argument to the press. The names are not my original thoughts but theirs.
To Anon 12:05, I don't work for the Chamber - I'm a patient who has seen his family lose physician after physician in Southern Illinois.
To Anon 12:24:
Attorney contingency fees were passed in 1985 and upheld by the Supreme Court on June 20, 1986. 1/3 of the first $150,000, 25% of $150,000 to $1 million, ane 20% over a million.
Punitive damages were abolished in 1985 and upheld by the Supreme Court on June 20, 1986 as well.
And by the way, they were 1995 reforms, not 1993 - they were declared unconstitutional in 1997. The 1995 reforms were broad tort reforms, not only specific to med mal like the current legislation.
My doctors have given me a ton of information on this situation, I recommend the rest of you educate yourselves as well - it's going to be a heck of a fight in Springfield.
Here are your references:
735 ILCS 5/2-1114
§ 2-1114. Contingent fees for attorneys in medical malpractice actions. (a) In all medical malpractice actions the total contingent fee for plaintiff's attorney or attorneys shall not exceed the following amounts:
33 1/3 % of the first $150,000 of the sum recovered;
25% of the next $850,000 of the sum recovered; and
20% of any amount recovered over $1,000,000 of the sum recovered.
(b) For purposes of determining any lump sum contingent fee, any future damages recoverable by the plaintiff in periodic installments shall be reduced to a lump sum value.
(c) The court may review contingent fee agreements for fairness. In special circumstances, where an attorney performs extraordinary services involving more than usual participation in time and effort the attorney may apply to the court for approval of additional compensation.
(d) As used in this Section, "contingent fee basis" includes any fee arrangement under which the compensation is to be determined in whole or in part on the result obtained.
735 ILCS 5/2-1114
§ 2-1115. Punitive damages not recoverable in healing art and legal malpractice cases. In all cases, whether in tort, contract or otherwise, in which the plaintiff seeks damages by reason of legal, medical, hospital, or other healing art malpractice, no punitive, exemplary, vindictive or aggravated damages shall be allowed.
And to follow up, preople are not entitled to their own facts. The facts are the facts!
If Jay Hoffma is for it, I'm against it.
Medical Malpractice Proposal Number 1: When a doctor or health care professional becomes aware of an error, mistake, injury, or the like, caused by another doctor or health care professional, he should be required to immediately report the offender to the patient and the proper authorities. Instead of good doctors "educating" their patients as to plaintiffs' lawyers, they need to educate their patients about the mistakes, lies, and cover-ups, of other doctors.
Without medical reform, tort reform is _____ [you fill in the blank].
Anon 12:24, Saying "I work for a major med mal insurer - do you?" undermines what little crediblity you had.
The issue in tort reform isn't med mal, and it isn't jury verdicts, it's those pesky trial lawyers, who give a ton to candidates, nearly all of it to Democrats. Some Republicans can't stand that rich guys give to the other party. Caps are an effort to hurt the Corboys and Powers of the world, and by extension, the Democrats. Anything that doesn't get at that link won't be enough for the tort reformers.
The issue arises prior to caps, insurance and other. Can a price be put on the "accidental" loss of a limb? The physician is at fault, but so is the attorney who advises a client (with a less than average IQ) that the "going rate" for a limb ranges in the $1.2-5 million range. This same attorney also pushes for jury awards to play the sympathy game; whereas the client/victim would like to be compensated and move away from the ugly experience.
Yes, physicians need to be held accountable through acts toward licensure, but attorneys must also be held accountable. How many frivolous lawsuits that are thrown out of court actually result in payments being made by the attorney or his client for the time and money wasted in federal/state/county courts?
I gree with the first half of leigh's comment but not the second half. Here's what I propose.
FIRST reform the idfpr so they actually discipline the few bad docs that are out there (they do exist)
SECOND reform the medical community so they begin to practice evidence based medicine, esp in obstetrics which is predominately habit based medicine.
THIRD Cap the salaries of ins. company executives.
If a doctor or hospital make a gross error like using Co2 instead of oxygen and killing someone or putting an epidural in the wrong space leading to the death of a birthing mother (two actual cases documented in the news) I am not referring to just a normal human error, which is tragic but almost understandable. But in the former, then yes, there are punitive damanges in order.
Oh, and maybe if the ifdpr actually looked into the mistakes and patterns like doctors showing up drunk to work (a case among much more scary stuff from a past ifdpr audit in which they failed to take action) and THEN took real action, with more docs PROPERLY disciplined, then some potential future tragedies can be averted.
Essentially, the whole system is "broke". And it needs fixing.
You need some medical malpractice insurance
fat greedy cats like Corboy and Clifford can't make all the money
THAT IS STUPID and bad for the economy
Health care costs are out of control and doctors are leaving the state
I have read all the above comments and I feel most of those who have posted have not had to suffer from neglect or malpractice. From the stand point of the "VICTIM". Lets see what your opinion is when you have lost your quality of life, or your spouse and children have lost a husband, wife or parent because a medical professional fails to do the job they were trained to do. Pain and suffering awards might mean something to some of you if you couldnt ski, golf,go fishing, boating,shopping or even out of your house to enjoy a meal at a restraunt. Let a doc Cut off your leg when it doesnt need to be removed and have a nurse tell you nothing is wrong with you. Then tell me how sorry you feel for doc's and hospitals. Please let me know...
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