Medical liability reform moved a step closer to reality when the U.S. House Judiciary Committee approved a bill called the Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act.
The bill, H.R. 5, would set a $250,000 limit on so-called non-economic damages in medical malpractice cases against physicians, drug makers and hospitals. It also would establish a statute of limitations for filing malpractice suits and curtail attorney's fees.
Non-economic damages, sometimes referred to as "pain and suffering" awards, are those that include compensation for emotional anguish, physical impairment or disfigurement above and beyond economic damages. The bill would not limit economic damages, which include loss of past or future earnings and future medical expenses.
Some policy experts say such reform is long overdue. Jury awards for non-economic damages can be eye-popping and have risen sharply in recent years, said Pam Villarreal, a senior analyst with the National Center for Policy Analysis, a Texas-based group that favors free-market economic policies.
Since 2000, she said, jury awards for non-economic damages have doubled, reaching $1 million, on average.
Such awards add direct costs for medical malpractice insurance -- costs that physicians may pass on to patients -- and play a major role in forcing physicians to practice "defensive medicine," ordering otherwise unnecessary tests to protect themselves from lawsuits.
"HR 5 is a bill that's similar to what Congress has tried to pass many times before," Villarreal said. "It is some basic medical liability tort reform. This would reduce the cost of health care and increase the supply of physicians in areas where medical liability costs have been high."
California, Texas and a host of other states have already enacted some version of tort reform, and the cost of medical liability insurance dropped in those states, Villarreal said. However, the highest court in several states has deemed damage caps unconstitutional.
According to Congressional Quarterly Weekly, much of the Judiciary Committee's debate was about the $250,000 cap. The 18-15 vote on Feb. 16 to move the legislation forward was along party lines, with all Republicans in favor and all Democrats opposed.
"The House Judiciary Committee's approval of the HEALTH Act marks an important milestone for the progress of medical malpractice liability reform desperately needed in this country," Rep. Phil Gingrey (R-Ga.) said in a prepared statement after the vote. "Without mending this broken system, we are crippling the access to care for patients and wasting billions of valuable health care dollars. We need to refocus our efforts on bringing down the cost of health care, while improving the access to it for millions of Americans."
Gingrey, who co-sponsored the bill, was a practicing obstetrician/gynecologist before being elected to the House.
Dozens of physician groups and other health care professional organizations, including the American College of Physicians and the American Medical Association, applauded the bill.
"This bill provides the right balance of reforms by promoting speedier resolutions to disputes, maintaining access to courts, maximizing patient recovery of damage awards with unlimited compensation for economic damages, while limiting non-economic damages to a quarter-million dollars," according to a letter to Gingrey submitted by those organizations.
ACP also called for reforms to the malpractice system, including caps on damages, during the College's annual "State of the Nation's Health Care" briefing Jan. 27 at the National Press Club in Washington, D.C.
In testimony before the Judiciary Committee, Dr. Ardis Dee Hoven, who chairs the American Medical Association, said that nearly 61 percent of physicians older than 55 had been sued at least once. A majority of claims lacked merit, with 64 percent dropped or dismissed, according to an AMA report.
A study published in September in Health Affairs found that costs related to medical liability total nearly $56 billion a year, or 2.4 percent of annual health care spending. According to the study, about 80 percent of the costs resulted from defensive medicine.
A Congressional Budget Office report in 2009 found that the federal government could save $54 billion over a decade by reforming medical liability laws.
President Obama's 2010 budget included $250 million in grants to help states try alternatives to the medical tort system, such as health courts, in which specially trained judges, rather than juries, would decide cases. ACP also reiterated its support for that concept during the January briefing.
Though H.R. 5 passed its committee-level hurdle, the bill's future remains unclear. Most observers expect easy passage in the Republican-controlled House. But many Democrats, who still control the U.S. Senate, oppose limits on non-economic damages. And Obama, who voiced support for medical malpractice liability reform in his State of the Union address, also opposes caps on non-economic damages.
More information
The joint letter to Gingrey supporting H.R. 5 is available online.
