Locke offers plan on malpractice costs

Published 9:00 pm Thursday, December 18, 2003

OLYMPIA — Gov. Gary Locke and other Democrats have proposed spending $30 million to ease malpractice insurance costs for some of the state’s doctors, setting up a confrontation with advocates of strict limits on pain and suffering awards in malpractice cases.

The money proposed Thursday is the sweetener in a broader proposal aimed at reducing malpractice insurance costs without capping legal judgments.

Of the $30 million, $20 million would go for bigger Medicaid reimbursements for doctors who deliver babies, one of the specialties that carries the biggest malpractice risk because of the possibility of a child damaged at birth. Because many deliveries are paid for by Medicaid, bigger reimbursements would have the effect of giving doctors more money to pay the insurance bill.

The remaining $10 million would set up a state insurance fund that doctors could buy into to supplement private malpractice insurance and protect themselves against exceptionally large malpractice judgments.

"This will help them pay for their medical malpractice insurance," Locke said. "We need to make sure that our medical community is there to provide care."

Malpractice insurance costs have increased dramatically in recent years, especially in high-risk specialties. Insurers fearful of big jury awards in Washington’s wide-open legal climate have pulled out of the market, and doctors have had difficulty acquiring, retaining and affording coverage.

Locke’s idea runs smack into the Washington State Medical Association, which wants to attack the problem by capping pain and suffering awards in malpractice cases at $250,000.

"It’s a Band-Aid rather than a fix," said Dr. Maureen Callaghan, an Olympia neurologist and past president of the association. "We need help right now."

Much of the rest of Locke’s package — which includes measures aimed at reducing medical errors and bringing down some of the costs of lawsuits — stalled in the Legislature early this year, as did the $250,000 cap.

Callaghan welcomed the extra Medicaid money, but dismissed the rest of the package as "a theory" that hasn’t been proved to fix high malpractice rates, which doctors typically blame on greedy lawyers.

But Locke and leaders of the Democrat-controlled House aren’t interested in imposing the caps. Cap opponents — most prominently the state’s politically influential trial lawyers — typically blame malpractice rates on profiteering insurance companies. They argue that capping damages would shortchange people who have been maimed by doctors’ errors.

House Judiciary Chairman Pat Lantz, who stymied the push for the $250,000 cap earlier this year, has said such limits aren’t even on the table. Lantz, D-Gig Harbor, said the Democrats’ approach would attempt to improve patient safety, speed resolution of malpractice complaints, and perhaps set a schedule of suggested amounts for damages.

"If we can resolve differences quickly, much of the rancor goes away, and much of the cost goes away," said Lantz. "All of that has to happen without attacking our constitutional rights."

But imposing caps — along with a sweeping package of other limits on lawsuits — is the highest priority of the Republican-controlled Senate, where the idea of getting the state into the malpractice insurance business will likely get a chilly reception.

"It basically sounds like the state would be writing a check from our general fund to the personal injury attorneys," said Senate Majority Leader Bill Finkbeiner, R-Kirkland. "Let’s just cut out the middleman and we can all just write a $50 check to the personal injury attorneys."

Backing Finkbeiner and other GOP leaders is the Liability Reform Coalition, a powerful alliance of corporations, professional groups, business associations and local governments.

The radically different approaches by the two sides may well lead to what happened earlier this year. Competing packages of bills passed by the Legislature’s two chambers died in committees in the opposite chamber.

However, the Democrats’ proposal does have one advantage over the caps — it doesn’t require an amendment to the Washington Constitution. Changing the constitution requires two-thirds majorities in the House and the Senate, and then a statewide vote.

"What would be a real tragedy for this legislative session would be if nothing happened," said Senate Minority Leader Lisa Brown, D-Spokane.

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