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Read Making a Killing

home / healthcare / in the media

Palm Beach Post
Feb 14, 2003

by Editorial Board

Place No Cap On Reform

Gov. Bush's task force on the medical malpractice crisis plunged into lawsuit caps but only dipped its toe into quality-of-care and insurance reforms.

The panel offered the Legislature, which convenes March 3, 60 recommendations but concluded that "the most important one is a cap on noneconomic damages in the amount of $250,000." Like every other group endorsing the cap, the task force cited "California's successful experience at the $250,000 level."

California's "successful experience," however, also included a voter-approved rollback of malpractice premiums. The Florida task force recommends nothing like that. In fact, recommendations directly affecting insurance companies primarily relate to housekeeping matters, such as better reporting and collection of data on claims.

Nearly half of the task force's recommendations relate to health-care quality and physician discipline. As with insurers, much of the emphasis is on gathering data, this time about injuries and "near misses" inflicted during medical care. Once gathered, however, "information would not be subject to discovery in lawsuits."

In contrast to the immediate call for liability limits, many recommendations concerning care and discipline are less urgent. The state should "timely develop or adopt" a system to improve prescription accuracy and should "conduct a study to determine if it is feasible to provide information to the public to help them make better health-care decisions." The task force also would take power from administrative law judges hearing discipline cases against doctors and give more authority to the medical board -- which includes 12 doctors but only three consumers. One recommendation with bite does make it easier to prove that doctors facing discipline violated standards of care.

An insurance official surprised South Florida doctors last month when he told them that the proposed cap would not drastically lower malpractice rates. Tom Gallagher, the state's chief financial officer and a former insurance commissioner, told The Post's Editorial Board the same thing this week.

It isn't surprising that so many recommendations are tentative. It will take time to know whether suggestions, which also include improved mediation and alternatives to traditional insurance, could slow malpractice insurance rate increases. The assumption that a liability cap will work on its own is the faulty premise. If the Legislature acts on that assumption, injured patients will give up part of their right to compensation, but the state will get no guarantee that insurers will stop driving doctors out of practice or that physicians will be more vigilant in driving bad doctors out of the profession.




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