Malpractice Reform

It was disheartening to read the August 1 front-page story “Malpractice Liability Cap Fails in Senate.” The climate for practicing medicine in California has been difficult, but one of our bright spots has been MICRA, the Medical Injury Compensation Reform Act. This law was passed in 1975 and fully implemented in 1986, after all legal appeals against it were exhausted.

In 1975 the malpractice insurance system in California was close to collapse. In response, the California legislature passed MICRA, which had as one of its hallmark provisions a $250,000 limitation on pain and suffering awards in malpractice cases. There is no limitation on actual damages or costs of treatment, only on the noneconomic “pain and suffering” awards that were threatening the system.

As a result, we have enjoyed relatively reasonable malpractice insurance costs in California, and patients who have suffered real damage have not been adversely affected. The same cannot be said for the trial lawyers who pursue malpractice judgments and whose huge contingency fees were limited by the act; more of the actual awards now go to injured patients, less to malpractice attorneys.

The U.S. House of Representatives passed a bill that would limit noneconomic damages on a national level, but the Senate failed to follow suit. The Psychiatric News article did a good job of detailing the process that caused it to be derailed in the Senate, but it did not document how individual senators voted. I suggest that voting records of all legislators on issues of such critical importance to our profession be printed in our official newspaper, so that APA members can communicate knowledgably with our representatives in Washington and so that we can vote knowledgably on election day.