Voters may see malpractice initiatives on ballot

Basin Legislative reps show support for I-330

COLUMBIA BASIN — It remains to be seen whether or not two malpractice reform initiatives will pass through the Legislature or go to voters on the November ballot.

Initiative 330, proposed by the Washington State Medical Association, would limit lawyer's fees and cap non-economic damages such as pain and suffering in medical malpractice lawsuits. Initiative 336, which is backed by the Washington State Trial Lawyers Association, calls for the revocation of doctor's licenses who have three jury verdicts against them for medical malpractice. I-336 would also require insurance companies to hold public hearings before they could increase their malpractice insurance rates.

"I think we're going to send them to the people and see what happens," said Rep. Bill Hinkle, R-Cle Elum, who believes I-336 could be a step backwards for health care reform.

"What will happen is anyone with a negative malpractice suit, rather than take (it) to court, they will settle out of court so our efforts to improve health care quality through (the) law like this would be counterproductive," he said of I-336.

State Senator Joyce Mulliken R-Ephrata, voiced concern about the high cost of malpractice insurance which has run some doctors out of the state. "We know that we have to get medical malpractice costs lowered to lower the liability insurance that physicians, hospitals and emergency rooms have to pay to have liability coverage," she said.

Local hospitals said the cost to provide malpractice insurance has continued to increase significantly from year to year.

"Malpractice insurance premiums represent the single biggest increase in our expenses in the last three years," said Terry Litke, chief financial officer at Samaritan Hospital.

According to Litke, in 2002, the hospital paid $515,589 for malpractice insurance and in 2004 those costs accrued to more than $1 million.

Al Beach, administrator at Columbia Basin Hospital, said they have seen an increase of 15 percent for the past five or six years. Malpractice insurance costs have continued to increase, he said, "in spite of the fact that we've had no payouts or claims."

Beach said he sees the real issue facing health care today is continuing to improve quality and standards. "I think that the key in health care, in general, is working very hard to address our quality and risk standards and make sure the care we provide is the best," he said. "I think we need to be more transparent about that."

From a physician's perspective, Dr. James Irwin of Irwin Surgical Group in Moses Lake, said the current malpractice system gives too much reimbursement to attorney's fees. "The patients end up getting only 20 percent of the premium dollar," he said. "Plaintiffs' attorneys are receiving up to 50 percent of an award, plus their expenses which seems like quite a bit."

Irwin added that there are already adequate safeguards in place to prevent malpractice, such as those set forth by the State Medical Quality Insurance Commission. "Physicians' insurance has been in existence for about 25 years; there has been no physician in the state among that group that has had three suits in 10 years," he said.

Moses Lake Attorney Patrick Acres says I-336 is a matter of ensuring responsibility on all sides and will give the public a better view of where the money is going. "People should be responsible for their actions; both the patients and the doctors," he said. Part of the problem is making the public aware of "what the insurance companies are charging for malpractice premiums and (to) let the public see what has or hasn't gone on."

The initiatives are currently awaiting further discussion in the House and Senate Judiciary Committees.

Here is the breakdown for each initiative and what it proposes

I-330

— Supported by the Washington State Medical Association

— Places a limit on non-economic damages such as pain and suffering awards to between $350,000 and $1,050,000

— Limits the amount of a damage settlement given to lawyers

— Allows damages exceeding $50,000 to be paid overtime

— Permits juries to have access to sources of payments made to the patient

— Calls for joint and several liability, requiring defendants to take partial responsibility for mistakes made

I-336

— Supported by the Washington State Trial Lawyers Association

— Revokes licenses from doctors with three jury verdicts against them within 10 years for preventable medical injuries

— Bans secret settlements in medical malpractice cases

? Requires public hearings in order for insurance companies to increase malpractice insurance rates by more than 15 percent, and requires those insurance companies to open their records to the public

— Creates an insurance fund for health care agencies including clinics and hospitals

— Increases the number of people representing the public from four to six, on the state's Medical Quality Assurance Commission