Earlier this year, a national task force of emergency physicians graded states' ability to provide emergency medical care. The District of Columbia earned a B and ranked fourth in the nation. But the components of that grade tell another story: For its “medical liability environment,” D.C. got an F.
Chalk that up to soaring premiums for malpractice insurance that are driving physicians out of the District to places such as Virginia and Maryland, where insurance is more affordable. According to NORCAL Mutual Insurance Company, D.C.’s average payment for patient liability is more than $580,000, the highest in the nation and much higher than the U.S. average, which is about $265,000.
To his credit, Mayor Anthony Williams has offered some solutions. His Health Care Reform Act, introduced last year, would cap pain-and-suffering awards at $250,000 for doctors and $500,000 for hospitals. But the D.C. Council, ever beholden to trial lawyers, pronounced that bill dead on arrival.
Now the council is diddling around with two other bills that place no limits on damages for pain and suffering. These are sops to the plaintiffs' bar. In no meaningful sense can they be called reforms.
To see where the District is headed, take a look at Pennsylvania. Last year, the journal Obstetrics and Gynecology reported that one-third of Pennsylvania resident physicians in high-risk specialties said they will leave the state after their residency is over and set up practice where insurance is more affordable. And the number of neurosurgeons in the state has declined about 25 percent since the late 1990s.
Despite such evidence, the trial bar keeps singing the same tiresome song. Wayne Cohen, president of the Trial Lawyers Association of D.C., is a perfect example. "There is no relationship," he asserted last year, "between caps on jury awards and insurance rates. Insurance rates for doctors have not dropped in states where there are caps. The facts are the facts."
Oh, really? In 2003, Texas enacted tort reforms that included caps on noneconomic damages — the same limits Mayor Williams proposes for D.C. Last month, the California-based Doctors Co. announced that it is lowering insurance premiums for Texas physicians by an average of 18 percent. Rates for some will drop more than 45 percent.
Capping noneconomic damages isn’t a perfect solution, let alone the whole solution, to the problem of exploding health care costs in D.C. But caps are a reasonable and essential part of a solution. That’s why 27 states have enacted them.
Meanwhile, D.C. preserves the lottery for trial lawyers.