America's patients are losing access to care because the nation's out-of-control legal system is forcing physicians to give up practicing medicine. Frivolous lawsuits and jackpot-sized jury awards are causing insurance premiums to skyrocket. When doctors can't afford insurance, they can't provide care. There are now 20 states in a full-blown medical liability crisis-up from 12 in 2002. There are 25 additional states showing the problem signs of a potential crisis. In crisis states, some patients have been forced to travel hundreds of miles to receive care. Some have died. The AMC/NOMA is standing side-by-side with physicians across Ohio to protect patients' access to care.
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The Ohio legislature passed tort reform legislation but additional reforms are still needed to keep your doctor practicing. |
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Tort reform measures have been passed in Ohio before, only to be overturned by a decision made by the Ohio Supreme Court. |
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Personal injury lawyers are free to continue to file frivolous lawsuits and pursue huge contingency fees. According to data from the Physician Insurers Association of America, nearly 70 percent of all medical malpractice claims made against doctors do not result in a payment to the plaintiff. |
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Only 1.3 percent of all claims against a doctor result in a jury award. In 2000, the median cost to dispose of a claim that goes to a jury was over $70,000, even when the physician was found not guilty. The cost to defend against lawsuits ranges from $16,000 to more than $90,000. Each dollar spent is a dollar that is cannot be utilized to improve health care. |
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The average award reached $3.9 million in 2001. But plaintiffs lost the majority of their cases that went to a jury. Overall, plaintiffs won just 30.5% of medical liability cases in 2002. Of the 7% of claims that went to a jury verdict, the defendant won 82.4% of the time. Limiting runaway jury awards will help put a stop to jackpot justice, improve quality and reduce costs. |
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The U.S. Department of Health and Human Services estimates $70-$126 billion would be saved in health care costs each year by placing a reasonable limit on non-economic damages. |
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Physicians feel pressured because of the threat of lawsuit abuse to order extra tests. A nationwide study estimated "DEFENSIVE MEDICINE" COSTS YOU AN ADDITIONAL $50 BILLION PER YEAR, driving up YOUR health care costs and ultimately YOUR health care premiums. |
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Due to liability concerns, some doctors are closing their practices and taking years of experience with them; EXPERIENCE THAT WILL NO LONGER BE AVAILABLE TO YOU. This will also impact upon training of future physicians and patient care. |
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A majority (59%) of physicians believe that the fear of liability discourages open discussion and thinking about ways to reduce health care errors. |
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Many medical school graduates are avoiding specialty fields due to the malpractice crisis. Nearly half of 3rd and 4th year medical students surveyed in Northern Ohio said the medical liability situation was a factor in their choice of specialty.A SHORTAGE OF PHYSICIANS IN CRITICAL SPECIALTIES could ultimately affect the quality of YOUR care by LIMITING YOUR ACCESS TO TREATMENT OPTIONS. |
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According to the Medical Liability Monitor (MLM) - premiums are spiking across all specialties in 2002. When viewed alongside previous double-digit increases in 2000 and 2001, the new information further demonstrates that the litigation system is threatening health care quality for all Americans as well as raising the costs of health care for all Americans. HHS also believes that excessive medical liability adds $47 billion annually to what the federal government pays for Medicare, Medicaid, the State Children's Health Insurance Program, Veterans' Administration health care, health care for federal employees, and other government programs. |
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Blue Cross/Blue Shield plans nation-wide report that approximately half of the plans expect ob/gyn and surgical fees to increase as a result of increased professional liability premiums. This was expected in both crisis and non-crisis states. |
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Many critically important specialists have been forced to limit the care and types of treatments they offer because they cannot afford insurance. |
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Data collected by the AMC/NOMA shows if the medical liability crisis continues to escalate and premiums continue to rise, physicians in Northern Ohio will have to cut back on certain procedures and stop accepting certain patients. |
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Additional data collected by the AMC/NOMA shows emergency rooms are losing staff or scaling back certain services due to the medical liability crisis. |
As a health care consumer, you are aware of the rising cost of healthcare. Did you know that litigation accounted for 7% of the increase in your healthcare costs? Litigation includes the effects of defensive medicine, malpractice premiums, risk management and reinsurance, outsized awards and legal cost and class action lawsuits. National surveys have shown that most Americans support reforms to the tort reform system. 62% percent of respondents to a recent poll indicated that medical malpractice cases should be tried in special courts presided over by medical professionals and other experts to review and decide the cases.
We need to reform - not abolish - medical liability laws. Reasonable laws that protect patients should be in place. But abuse of the system with frivolous lawsuits and unreasonable jury verdicts has financially strained our healthcare systems as doctors and hospitals struggle with outlandish insurance premiums. Even if remedies are found to improve the current insurance climate, there must be meaningful reform of the liability laws in Ohio in order to continue to provide patients with access to quality health care.
Damage Caps - Noneconomic damages are limited to the greater of $250,000 or three times economic damages up to a maximum of $350,000 per plaintiff or 500,000 if there are multiple plaintiffs. For catastrophic injuries the maximum may increase to $500,000 per plaintiff or $1 million for multiple plaintiffs.
Collateral Source Reform - Defendants may introduce evidence of collateral sources of payments made to plaintiffs. The plaintiff may submit evidence of any amount the plaintiff has paid or contributed to secure the benefits.
Attorney Fees - No limit on attorney contingency fees, but their fees are subject to approval by the probate court if their fees exceed the non-economic damages awarded.
Periodic Payments Permitted - Court may award periodic payment of damages for awards that exceed $50,000 if the plaintiff or defendant files a motion with the court.
Arbitration - Allows, but does not require, malpractice cases to be referred to non-binding arbitration. Findings are not permitted in court.
Medical Liability
- Ensure that patients receive 100 percent compensation for their economic losses, including medical expenses, rehabilitation costs and lost wages, if harmed by a physician's negligence;
- Establish periodic payments of future damages;
- Maximize the amount of money juries award for patients - not trial lawyers; and
- Place a $250,000 cap on non-economic damages, and also allows states the flexibility to establish different caps.
Patient Safety
- Create a confidential, voluntary reporting system in which physicians, hospitals, and other health care providers could report information on errors to organizations known as Patient Safety Organizations (PSOs).
- Allow PSOs to collect and analyze unique "patient safety data" and then provide feedback on patient safety improvement strategies.
- Provide that "patient safety data" would be confidential and legally protected and not preempt other state and federal peer review laws.
Myth: Caps on Noneconomic Damages Deny Patients Compensation For Medical Negligence
Reality: Plaintiffs' lawyers have alleged that caps on noneconomic damages would deprive plaintiffs of being fully reimbursed for losses suffered due to medical negligence. In reality, economic damages such as medical costs and lost income (present and future) are recoverable with no limit. Noneconomic damages are inherently unquantifiable, because they award for damages such as "pain and suffering." Noneconomic damages are not intended to punish defendants for their actions (those are punitive damages.) Juries and judges vary from court to court, in terms of what level of noneconomic damages they will award for similar injuries. The result is a system that awards randomly and makes insuring against those losses an unpredictable business. Capping noneconomic damages at a reasonable level provides more consistent results and a more stable insurance environment.
Myth: Liability Premiums Account for Less than 1% of All Medical Costs
Reality: Liability insurance claims costs (litigation costs, jury awards, and settlements) are real and must be paid by someone. Insurers raise PLI premiums to cover these increased costs. Physicians who cannot absorb or pass on the cost of these steep premium increases are forced to restrict their services, avoid high risk patients, move their practices to lower risk areas, or retire. Ultimately, patients will bear the costs of PLI claims by paying more for health insurance or by losing access to needed services, such as trauma care and obstetrics, as physicians restrict, relocate, or retire from their practices. The indirect costs to the health care system from this growing culture of litigation are even more alarming. Physicians, hospitals, and other health care providers who fear being sued adopt practice patterns to protect against the threat of litigation (so-called "defensive" medicine). The costs associated with defensive medicine are difficult to calculate, but have been estimated at approximately $50 billion a year.
Myth: Malpractice Cases Are The Only Way to Advance the Cause of Injured Patients
Reality: Typically, personal injury lawyers take 40% or so of any amounts awarded to their clients, plus litigation costs. This provides an incentive for lawyers to represent only those plaintiffs with claims that are likely to produce high awards or settlements. Some trial attorneys actually seek out individuals who have suffered from a medical problem by asserting that negligent treatment was involved, even when there is no basis for that assumption. This has led to a proliferation of meritless claims. A fair schedule for attorneys' fees is important to align lawyers' incentives with their clients.
Myth: The Crisis Is Due to the Natural Cycle of the Insurance Market and Reforms Are Unnecessary.
Reality: Median jury verdicts have skyrocketed in recent years, rising 18.4% for jury awards and 7.4% for settlements per year between 1994 and 2000. By the year 2000, over half of all medical malpractice claims were for more than $1 million dollars, as compared to the period between 1994-1996, when only a third of claims rose to this level. Moreover, the number of suits filed against physicians over their career has also increased with 99 suits filed per 100 physicians in 1999 up from 78 in 1990. To suggest that PLI rates have risen solely because of the insurance "cycle," and not these rapid increases in claims, is illogical. While insurers most certainly use investment income to offset their claims losses, when the severity of claims costs rises exponentially each year, insurers cannot sustain profitability unless they raise their rates. Eliminating "lottery"-type awards through caps on noneconomic damages will stabilize the underlying insurance risk and restore predictability to the market.
Myth: Physicians Are Trying to Cover-up Medical Errors
Reality: Organized Medicine has been on the forefront of the patient safety movement, which focuses on improving the delivery of medical care and reducing the number of medical errors that occur. The American Medical Association formed the Patient Safety Foundation in 1996, which has pioneered this movement and played a pivotal role in advancing this cause. Physicians across the nation are working with hospitals, drug companies, private organizations and other health care professionals to develop and implement "best practices" that avoid systemic errors that might otherwise occur in the course of delivering medical care. The AMA and the AMC/NOMA both support creating a climate where reporting of errors will occur so that the information can be used to improve the system. We support creating a confidential, legally protected, voluntary reporting system in which physicians, hospitals, and other health care providers could report information on errors to organizations known as Patient Safety Organizations (PSOs).
Myth: Doctors Make Plenty of Money, If Their Rates Go Up They Can Pass the Increase Onto their patients.
Reality: In certain areas of the country (including Northeastern Ohio), and for certain types of specialists, double-digit hikes in professional liability insurance rates makes it difficult for these physicians to continue providing services (or certain types of high risk services) to their patients. The increased prevalence of public and private price controls and the lopsided bargaining climate between physicians and managed care plans have essentially eliminated the ability of medical practices to pass on cost increases. A number of businesses, such as airlines and freight delivery companies, were recently able to assess surcharges on their customers in response to increased fuel costs. Given the prevalence of third-party payors, physicians do not have the same ability to pass on sharply increased liability premiums to consumers (i.e. our patients.)
We are a non-profit, 501 (c) 6 professional organization, representing Northeastern Ohio's medical community through legislative action and community outreach programs.
The professional organization was originally formed as the Nineteenth District of Ohio in 1824, becoming known as the Academy of Medicine in 1902. In 1999, the society added the Northern Ohio Medical Association name and became the AMC/NOMA changing our focus to a regional organization. Our bylaws allow the AMC/NOMA to accept physician members, associate members, group members, medical advocacy members, resident members, medical student members and other categories from the contiguous counties in Northeastern Ohio. The AMC/NOMA is an independent regional organization
representing physicians in this region and at the Ohio Statehouse.
The Academy of Medicine of Cleveland/Northern Ohio Medical Association supports physicians in being strong advocates for all patients and promotes the practice of the highest quality of medicine.
Contact Us
Academy of Medicine of Cleveland/Northern Ohio Medical Association
Elayne R. Biddlestone, Executive Vice President/CEO
6000 Rockside Woods Blvd., Suite 150, Cleveland, Ohio 44131
Phone: 216.520.1000 Fax: 216.520.0999
Web site address: www.amcnoma.org
Email: ebiddlestone@amcnoma.org