With tort reform at the top of the Republican majority’s agenda in the General Assembly, new Gov. Matt Blunt hopes lawmakers will pass medical malpractice reform that is more substantive than the bill vetoed last year by then-Gov. Bob Holden.
The new laws would impose a limit on payouts of noneconomic or pain-and-suffering damages to $250,000 in medical malpractice lawsuits and restrict where personal-injury lawsuits can be filed. Missouri doctors, who have seen their malpractice insurance rates more than double over the last four years, support the changes.
The rate increases have driven some Columbia doctors out of practice or to other states where malpractice insurance is less expensive.
Curt Vogel began to think about retirement after 30 years as a general and vascular surgeon. In 2003, he considered scaling back to working a few days a week. But after seeing his malpractice insurance costs jump almost $60,000 in one year, Vogel decided it made no economic sense to keep practicing.
“There were no malpractice claims against me, and I’d never lost a malpractice claim,” Vogel said. “It was just a sudden increase without any other options.”
According to a report by the State Department of Insurance, doctor’s malpractice insurance premiums rose 121 percent between 2000 and 2003 in Missouri. Data aren’t yet available for 2004.
A recent survey showed that among 79 Missouri neurosurgeons, 21 are considering leaving the state and 31 are thinking about early retirement.
Michael L. Burks, president of the Boone County Medical Society, said that if the proposed legislation does not pass, quality of care in the area will suffer, as fewer doctors will be able to care for patients.
“It really affects things right from square one, whether people go to medical school, what specialty they pick, and after that, if we are going to be able to keep physicians in Missouri,” Burks said.
Burks and other doctors say frivolous lawsuits are primarily to blame for the soaring malpractice insurance rates. However, lawyers say the problem has been exaggerated.
Randy McConnell, director of public affairs for the Missouri Association of Trial Attorneys, said the rate increases were caused by poor decisions made by the insurance industry in the late 1990s.
“There is no excuse in the insurance industry for them to have raised their rates by 82 percent in 2003,” said McConnell, who also worked as communications director for the Missouri Department of Insurance for 11 years.
Some lawmakers and attorneys say Blunt’s proposed legislation doesn’t go far enough to ensure that insurers won’t raise their rates again. A bill introduced last week by Sen. Joan Bray, D-St. Louis, would force insurance companies to regulate themselves and offer tax credits to health care providers to offset the cost of insurance. The bill would also require insurers that want to raise rates by more than 15 percent to prove the rate increase is justified.
Thad Mulholland, a personal-injury lawyer in Columbia, said there is no guarantee that caps on lawsuit payouts alone would prevent companies from continuing to raise their rates. Further, insurers often raise rates because of different factors altogether, he said.
“It is well known that their investments haven’t done well and they pass that cost onto the consumer — in this case, the doctor,” Mulholland said.
The trial attorneys association opposes efforts to cap malpractice payouts in Missouri and elsewhere. Instead, the group wants to see more oversight on the insurance industry, McConnell said.
“People targeted by malpractice reform are the ones who have been most severely injured by healthcare providers,” said McConnell.
Yet, stiffer regulations on insurance companies could reduce the willingness of insurers to write policies in the state, Burks said. Two years ago, there were 30 companies in Missouri writing new policies, while now there are only three.
“There is a risk in this bill that you might potentially scare off good insurers.” Burks said.