Why do I keep harping on all the tort "reform" baloney around us? Because it's such an easy target.
Since damage caps became effective in September 2003, the number of medical negligence lawsuits filed in Texas has dropped dramatically. But in that same time, most of the malpractice insurers in the state have raised their rates.
G.E. Medical Protective, a company that insures 20 percent of the state's physicians, recently increased its rates by 10 percent and changed its products to avoid regulation by the Texas Department of Insurance. This was in response to the state's denial of its previous request to raise rates by 19 percent.
The Joint Underwriting Association asked for a 35 percent rate increase. The largest malpractice insurer in the state, TMLT, agreed to lower its rates by 12 percent, but it had raised its rates more than 100 percent in the previous two years.
Why? Because doctors and legislators are either unable or unwilling to stand up to the malpractice carriers and demand change.
With the backing of the Texas Medical Association, legislators could have required mandatory rate reductions in return for stripping away a patient's right to recover full damages. They did not.
They could have included a provision repealing the damage caps if rates did not decline. They did not.
They could have placed the insurance executives under oath and subject to the penalties of perjury before giving testimony about the true basis of the insurance crisis. They did not.
And so the plundering continues.
U.S. insurance companies saw their profits explode to almost $30 billion in 2003 -- a ten-fold increase from the previous year -- yet rates continue to rise. All the while, insurers avoid any real scrutiny or oversight. Instead, they count their money, impose frequent rate increases and chortle as the doctors and lawyers flog one another.
I have made changes in my practice to try to decrease the chance of financial devastation due to some rapacious attorney. I used to take emergency call at five different hospitals. I've dropped off the staff of all but one. I get more sleep and assume less risk.
Do we doctors like doing this? No! At least here in Texas there is now a $250,000 cap on "pain and suffering." Nonetheless, my liability insurance went up another 10 percent this year.
There's one thing that really needs to be harped on any time a doctor blames lawyers for his or her medmal premiums, and that's this: There's almost no mechanism to remove the bad doctors, the ones who actually get sued, from the market. The AMA wants to protect its incompetents on the one hand while preventing proper redress to the unwitting patients they butcher on the other hand. And President Bush is leading the charge for them.
You think I'm exaggerating? Check this out, from Bob Herbert.
In looking at medical malpractice cases, I've been amazed by the cold-blooded attitude so many people have taken toward patients who have been seriously, and sometimes grotesquely, harmed. Referring to a Wisconsin woman who had both of her breasts removed after a laboratory mix-up mistakenly indicated she had cancer, a doctor from South Carolina told a Congressional subcommittee:
"She did not lose her life, and with the plastic surgery she'll have breast reconstruction better than she had before."