Name of Meeting / Conference

Date of Presentation

Tort Reform- What it is and why we

need it -

Presented byEmergency Medicine Residents’ Association

Overview

• Background• The problem• Possible solutions• Differing outcomes• What you can do

Torts

• A wrongful act that causes injury• Medical malpractice = part of tort law• Goal = protect patients from bad MDs• A medical malpractice suit requires:– Duty of care– Breach of standards– Compensable injury– Proximal causation

The problem

• Malpractice insurance is expensive!!• The current crisis began in the late 1990s• From 1999-2002, malpractice premiums for a

general surgeon– Increased by 75% to $174,300/year in Dade

County, Florida– Increased by 2% to $10,140/year in Minnesota

Source: United States General Accounting Office

Why is this a problem?

• Some physicians are changing their practices– Relocating– Retiring– No longer performing higher-risk procedures

• Some patients are losing access to care– Reduced access to hospital-based services

affecting emergency surgery and newborn deliveries in scattered, often rural, areas

Source: United States General Accounting Office

Why the price increases?

• Losses on medical malpractice claims– The primary driver of rate increases

• Reduced competition as insurance companies leave unprofitable markets

• Reduced investment income• Increased reinsurance costs

Source: United States General Accounting Office

[Possible] solutions

•Tort reform!!

Caps on non-economic damages

• Economic damages = medical costs, future care costs, quantifiable loss of income

• Non-economic damages = not easily quantifiable amounts for pain and suffering

• Punitive = usually for gross negligence

Problems

• Caps don’t always mean lower insurance rates

Why?• Caps have been litigated and found

unconstitutional in several states:– Texas amended its constitution to specifically

authorize caps on non-economic damages (2003)– In 2010, Illinois’ and Georgia’s Supreme Courts ruled

their caps unconstitutional

Arguments Against Caps

• Caps disproportionately injure the most vulnerable

• No proof caps lead to lowered premiums• Maintain the incentive for physicians to follow

the standard of care

Source: American Bar Association

Other Reforms

• Joint & Several Liability• Contributory Negligence• Expert Witness Rules• Case Certification Requirements• Pre-Trial Review Panels

Other Reforms (continued)

• Statute of Limitations• Collateral Source Rules• Periodic Payments• Limitations on Attorneys’ Fees

Burden of Proof

• Preponderance of the evidence• “Clear and convincing” evidence• “Willful and wanton” negligence

Federal Reforms

• Health Care Safety Net Enhancement Act of 2015

Texas v. New York

Outcome

Source: Cunningham Group

2000 2002 2004 2006 2008 2010 2012$0

$20,000

$40,000

$60,000

$80,000

$100,000

$120,000

$140,000

$160,000

Annual Premiums

IM (NY)GS (NY)OG (NY)IM (TX)GS (TX)OG (TX)

Year

Effects

• Lower malpractice premiums lead to more physicians

• Reduced risk for lawsuits does not lead to less “defensive medicine” or fewer costs

What can you do?