MEDICAL MALPRACTICE:  Insurance Puppets and Tort Reform

by

Jacob Clark

     Medical malpractice is again on the political platform as it was on at least three other presidential platforms since the 1970’s (including Bush senior).  This paper will discuss the current so-called “medical malpractice crisis,” using incites from the past crisis’.  Further discussion will include the parties and their involvement, such as the patients, physicians, insurance companies, and politicians.  Finally, previous and current tort reform will be analyzed as means of curbing astronomical medical malpractice premium increases.

Medical Malpractice Crisis

     One of the few correct allegations the republican party, the medical community, and the insurance community have made is that: since 1975 the filing of claims has increased and so has the amount of awards.  But before saying “I told you so” let’s look at a couple of key factors as to why.  In 1975 there were 366,425 active doctors in the U.S.  In 2001 that number increased to 750,000; the physician profession more than doubled over that period of time.[1]  Also, in 1975 the children of the baby-boomers would be having children, thus, the population will have significantly grown as well.  It is only logical that with the increase of doctors and the population claims would increase.  And with inflation and high medical costs the awards would naturally increase as well.

     Insurance rates have exploded twice before, once during the mid 70’s and a second time during the mid 80’s.  Each crisis occurring during a weakening economy and dropping interest rates.  Tort reform was aggressively enacted during both these periods.  We are now in a third so-called crisis. 

     Nevada was the first state to react to this crisis enacting non-economic caps of $350,000.  “Within weeks of the law’s enactment, two major insurance companies announced that despite the new law, they would not reduce insurance rates for the foreseeable future.”[2] 

     In 1975 California passed a the Medical Injury Compensation Reform Act (MICRA) hoping to stop the astronomical rise of medical malpractice premiums.  MICRA consisted of a $250,000 cap on non-economic damages, it eliminated the collateral source rule, created a periodic payment system, shorten the statute of limitations, and established a sliding scale for attorneys’ fees (thereby discouraging lawyers from accepting serious or complicated malpractice cases).[3]  Doctors and insurers assured lawmakers MICRA would put and end to the crisis for good.  Premiums continued to rise, and in 1988 California was in another full-fledged crisis.  Over that 12 year period premiums increased 450%.  Insurance companies, trying to justify a decade of continual increases, claimed that court challenges were defeating MICRA.  However, in 1985 the California Supreme Court upheld the damage cap.[4]

     In 1988 proposition 103 was passed by the California voters.  Prop. 103 rolled back the insurance rates in effect at the time of its enactment 20%, statutorily froze rates for one year, created “prior approval” regulation on newly submitted increases, allowed consumers to challenge insurer’s rate increase proposals, ended the insurance industry’s exemption from state and federal anti-trust laws, and made the Insurance Commissioner an elected position.  Within 3 years the total medical malpractice premiums had dropped by 20.2% from the 1988 high.[5]  Surprisingly, medical malpractice insurers were the first to comply with prop. 103.  Three of the states largest medical insurers refunded $69.1 million to doctors by 1992.  All told $135 million was refunded to doctors by major medical malpractice insurers.[6]  Prop. 103 was unanimously upheld in 1989 by the California Supreme Court.

     Insurance premiums in California prior to prop. 103 increased at a consistent rate and well above the national average.  However, after prop. 103 was enacted, insurance premiums declined (20% rollback) then leveled out.  Whereas, insurance premiums on the national level have been increasing dramatically.  Interesting enough, the national average currently mirrors the California trend prior to prop. 103.[7]

     Insurance companies were the ones who benefited from the passing of MICRA.  The next three years malpractice insurers paid less than twenty cents toward victims’ compensation for every dollar worth of premiums paid by the doctors.[8]  From 1996 to 2001, California malpractice providers spent an average of 35% of premiums on defense costs and payouts compared to the national average of 21%.[9]

     The thesis that suits are brought randomly is not supported by a study of 8000 physicians in the Los Angeles area.  In four year period, 46 physicians (0.06% of the 8000) accounted for 10% of all claims and 30% of all payouts.  Analysis indicates that doctors against whom multiple suits are brought represent a higher-risk population than their colleagues.[10]  This analysis supports a categorized group plan by insurers, similar to what they do with auto insurance.  This would also alleviate some of the complaints from doctors who have practiced for many years and never had a suit filed against them, nor a discount by the insurance providers.

     Another complaint by the medical and insurance communities is that out-of-control malpractice suits have spawned “defensive medicine.”  The AMA sponsored a study that listed defensive medicine accounted for roughly $15 billion during the 80’s.  Defensive medicine is the prescription of unnecessary or inappropriate tests and other precautions solely, or principally, to protect the provider against malpractice rather than to protect the patient’s health.[11]  An extensive study sponsored by the Congressional Office of Technology Assessment, however, concluded that the cost of defensive medicine was negligible and found no evidence of adverse effects on the access to medical care.[12]  The very admission by the AMA of the existence of defensive medicine demonstrates the lack of professional regulation.  The practice of defensive medicine not only violates the physicians’ Hippocratic Oath but is also their ethics.

     A major problem is that frequently reported increases in awards have not been adjusted for inflation.  Stephen Daniels has pointed out, an award of $360,000 in 1970 would be equivalent to $1 million in 1985.  In fact, the inflation problem is even more serious since medical costs, which constitute a large portion of most malpractice claims, have increased more rapidly than the general rate of inflation.  Another problem with statistical averages is that they may be inflated by small number of large awards.  For example, if 9 out of 10 juries awarded $10,000 and the 10th jury awarded $1 million the average would be $109,000.[13]  Thus, every time the medical and insurance communities come together to complain about the average awards drastically increasing remember that one large (and likely warranted award) will create a misperception that runaway juries are the problem.

          The medical malpractice crisis does not exist nationally.  In specific jurisdictions aberrations will present themselves.  Although this paper criticizes how premium explosions have created a massive misperception and perpetually reinforces it with false information, it is important to note that the tort reform passed during the 70’s and 80’s added additional hardship on the wrongfully injured.  Federal and state court rules consisted of two high hurdles for a plaintiff to get over in order to reach a jury.  Sanctions for bringing a frivolous suit and summary judgment.[14]  Although, sanctions are used only when a frivolous or meritless suits are brought (rarely done because defense costs are outrageous), summary judgment rears its ugly head in every case (because the defense is trying to say that even if everything the plaintiff says is true there is no liability).

Party Involvement

     Medical malpractice insurance has two main purposes: to compensate the injured patient for sub-standard care of negligent healthcare professionals and protection of the negligent healthcare professional’s practice in order for them to continue to serve the medical needy. 

     Malpractice insurance is required by a majority of the nations hospitals of their agents, employees and independent contractors, irregardless of state requirements.  Solo-practitioners, often carry malpractice insurance to protect their business and personal assets.  However, some states do not require malpractice insurance, thus it is at the discretion of the physician to obtain insurance coverage.

     Potential patients enter into an implied contractual relationship with a physician when the physician fails to turn away the potential patient and thereby begins the process of assessing and treating the patient’s medical infirmity.  A physician has the right to refuse treatment except in an emergency.  If the physician accepts and treats the patient the physician is obligated to provide care until the patient is in stable condition.  The physician can redirect the patient to another care provider at that time if desired.  Furthermore, it has been held in at least one court that a patient-physician relationship does not exists where a potential patient enters an emergency room for treatment, refuses treatment, and upon leaving the emergency room is injured.[15]  The patient-physician relationship is a consensual one.

     Under the care of a physician the patient is entitled to informed consent of the diagnosis (and its meaning), prognosis, and risks involved in treatment and non-treatment.  These are also the main areas of civil medical liability.  But to succeed in a suit under these and other areas of civil medical liability the patient will need to establish a patient-physician relation-ship, that the physician had duty, the physician breached that duty, patient suffered an injury as the proximate cause of the breach, and the plaintiff suffered damages.  The patient will need a medical expert to testify as to the standard of care, any deviation of the standard, and that the deviation was the proximate cause of the patient’s injury.[16]

     An injured patient is required to show a deviation of the standard of care, this burden of proof is extremely hard to meet.  Unfortunately, one court has held that a physician “is not required to exercise the highest degree of care possible.  The law does not require absolute precision, but rather the duty to exercise the degree of skill ordinarily employed by professional peers under similar, then-existing circumstances.”[17]  This standard is physician friendly.  This standard is also consistent with the national standard of care.  There are jurisdictions that use variations on the standard of care.  For example, Nebraska courts require the expert witness to testify to the standard of care of a physician under the same or similar circumstances in “relevant” and “similar localities.”[18]  This standard is even more difficult to prove because physicians within one’s own community are much less likely to testify against fellow physicians.

     The aforementioned is one of the many steps an injured patient has to make in order to be compensated for a wrong committed by a healthcare professional.  There are many other steps many of which will be discussed later under the Tort Reform section. 

Other barriers have crept up under the auspices of misguided and desperate physicians in their attempt to limit liability.  For example, physicians have went on strike,[19] required patients to sign binding arbitration agreements,[20] created a blacklist website of patients who have sued for malpractice,[21] threatened to retire or relocate, fire employees because their spouses are personal injury attorneys,[22] refuse to treat malpractice lawyers and their family members,[23] refuse to treat legislators in opposition of malpractice caps,[24] revising employee code of conduct prohibiting staff from testifying on behalf of plaintiffs,[25] urging state medical boards to investigate plaintiff medical expert testifying against the medical profession,[26] and charging your patients a $10 fee to cover malpractice premiums.[27]  These are just a few of the ways physicians are (mistakenly) fighting to reduce their burdensome malpractice premiums.

The aforementioned limit access to healthcare, begin to violate a person’s constitutional rights to a jury trial, equal protection, and due process, as well as violate the physician’s Hippocratic Oath and ethical obligation to the patient.

     Dr. Robert Zaleski and seventeen other doctors at Wheeling Hospital in W. Va. went on strike in January of 2003.  They threatened to strike for thirty days unless the legislature passed a bill that would cap non-economic damages in medical malpractice suits at $250,000.[28]  He was singled out by President Bush, and used as an example of how “frivolous” lawsuits can lead to premium explosions.  “Upon closer inspection” we find out that Dr. Zaleski has been sued fourteen times from 1987 to 2002.[29]  Eight of which resulted in payouts.  He had also admitted in a deposition to being addicted to prescription painkillers for a substantial time while operating on patients during the 1980’s.  Furthermore, he would write false prescriptions for local addicts and receive a kickback. According to a Public Citizen study only 1% of the state’s doctors made five or more malpractice payouts in the last decade.[30]  “The one surefire way to bring down the number of big-payout lawsuits is to reduce the number of those doctors who inspire most of them.  But state medical boards (which are run by doctors) have been notoriously reluctant to aggressively police their own.”[31]   

     In Las Vegas an increasing number of doctors have been requiring past and future patients to sign binding arbitration agreements in order to limit their professional liability.  Patients are having to relinquish their constitutional right to a jury trial in order to be treated or continue to be treated.[32]  Tort law applies in arbitration, thus, all monetary and time limitations apply.  There have been media reports that doctors in other parts of the country are starting to require these agreements as well.  Arbitration agreements between doctors and patients create a coercive environment.  On a limited basis, arbitration agreements might stand up to civil challenges, however, on a national scale the agreements should be struck down.  The agreements force patients to waive their constitutional rights for treatment that doctors not only swear to provide (Hippocratic Oath) but also get paid very well for.

     In Texas a group of radiologists constructed a website, DoctorsKnow.Us, setting up a national database of patients and attorneys that have sued for malpractice.[33]  Fortunately, this site was shutdown, but only after the media coverage detailed the difficulties of listed persons had in finding medical care.

     General Accounting Office (GAO) studied five states that reported physicians were leaving to practice in other states, closing practices, or retiring because of the medical malpractice crisis.  In Nevada, random calls were made to 30 OB/GYN practices in Clark County 28 responded that they were accepting new patients.[34]  One question that no one seems to ask when claim such as these are made is, where are you going to go and how are you going to continue to pay for your practice?  If there is truly a national medical malpractice crisis where are the doctors going to relocated to.  If this crisis really exists one state can’t be much better than the next.  If the doctors are going to close their practice to new patients, other practices will be more than willing to take on more patients and make more money to help pay their increased medical premiums.  Think of what a doctor will have to do if they were to relocate: moving costs, new practice set-up, no established clientele, their children changing schools.  All of these factors would likely discourage a doctor from relocating even if the nation is in a medical malpractice crisis.

     The American Medical Association (AMA) along with state medical associations (Florida, for example) are pushing for investigations and suspension of licenses of medical experts who testify against healthcare defendants.  Their argument is that the medical experts are “terrorizing” the medical profession.[35]  Medical expert testimony is required in medical malpractice suits and if the investigative and suspension approach is approved the medical profession will have significantly limited the injured patient’s constitutionally protected right to a jury trial, equal protection, and due process.  It is already extremely difficult to obtain experts to testify for the plaintiff because of hourly costs ($300-$3000.00 an hour), distaste for suing physicians, and finally, finding an expert willing to be vilified and blacklisted.  Considering a physician has to review the file, be deposed and sometimes appear at trial the expense to an injured plaintiff is extremely high (easily a minimum of $2500.00 will be spent on an expert).  Some physicians have priced themselves out of the market in order to avoid being hired by a injured patient and crucified by the medical profession for testifying.  On the other hand, insurance companies and their defense firms pay physicians flat fees for reviewing and testifying, often in the range of $300-1000.00. 

     On October 5, 2004, the Massachusetts Supreme Court is scheduled to decide how much protection a medical expert has when hired by the State to review another doctor’s work.[36]  At the trial court level the court dismissed the doctor’s complaint because he did not meet hid burden of proof that the expert’s oral and written testimony to the disciplinary board lacked any reasonable and factual support.  In this case the evidence showed that the plaintiff was consistently deviating from the standard of care required for prescribing drugs.  For example, the doctor was prescribing Tranxene[37] to a patient he knew had been addicted to heroin.  This case could have serious repercussions for medical experts that testify on behalf of an injured patient.

The following are excerpts from the modern Hippocratic Oath:

I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of over treatment and therapeutic nihilism.

I must not play God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.[38]

It seems to me that the physicians have forgotten what the oath means.  The situations I have outlined above are clearly in violation of the oath. 

Ethics are being broken, and why?  Because the doctors are ignorantly supporting the insurance industry.  Robert E. White Jr., president of First Professional Insurance Company, the leading medical malpractice provider in Florida, told the Palm Beach Post “no responsible insurer can cut its rates after a [medical malpractice] bill passes.”[39]  Yet, the doctors continue to push for caps on medical malpractice as well as other tort reform.  Even though it will not help decrease their premiums.  Insurance companies love this.  They continue to raise and collect malpractice premiums from the doctors (who they know can afford it) and then use the doctors to decrease financial the provider’s exposure through tort reform that violates injured patient rights.  All the while promising to reduce premiums and failing to follow through.  For example, in Texas the three primary insurance companies expressed that they would stop raising premiums and might reduce them if the $250,000 non-economic cap was passed.  Shortly after the cap was passed these same insurance companies (which control 70% of the medical market for coverage) submitted increases to the Texas Department of Insurance.  Only one of the increases was in single digits, the other two requested double-digit increases.[40] 

The GAO in October 2003 reported that multiple factors have contributed to premium rate increases.  However, the study states that from 1998-2001 medical malpractice investment income suffered a big hit when interest rates on bonds fell.  The investment portfolios of medical malpractice providers is made up of approximately 80% bonds.[41]  Subsequently, when the bond market took a hit so did the providers.

As any smart business person would do when faced with a financial problem they would seek out a source of income and exploit it.  That is what insurance providers have done here.  The healthcare industry is a trillion dollar business.  They make a lot of money, and can afford to compensate the investment losses of the insurance industry.

Politicians jump on the malpractice bandwagon because it gives them a niche in which they can not only garner large amounts of political funds, but is also great for attracting votes.  Bush senior used this ploy and now Bush junior is using it.  “Frivolous lawsuits and runaway juries brought by evil trial lawyers are the cause of the malpractice crisis.”  It is almost hysterically funny how the Bush family has been able to gain a great many votes on this topic in three different presidential election years from those that are getting the short-end of the stick (people who seek medical care – voters).  There is no evidence to back up these claims, but for two decades now this topic carries the same message.  The sad thing is that it works.  For example, Vice President Cheney greatly exaggerated medical malpractice rates in Wyoming.  He stated, “rates for general practitioner have gone from $40,000 a year to $100,000 a year.”  According to Wyoming Insurance Commissioner Ken Vines the two main insurers in the state offer coverage of $13,000 to $40,000 for general practitioners in Wyoming.[42]

The Media helps by incorrectly reporting on cases such as the McDonald incident.  The truth behind that case is an older woman purchased coffee which was kept at twenty degrees above what was need (180-190 degrees Fahrenheit).  The coffee was so hot she suffered third degree burns on her groin, inner thighs and buttocks.  McDonalds has had this problem before, evidence was presented of over 700 complaints of burns ranging mild from third degree.  The jury awarded $200,000 compensatory damages but reduced them 20% because they believe that was the percentage of her fault in the injury.  The jury awarded 2.7 million in punitive damages.[43]  This is the case most used in jury voir dire to sour the jury in awarding money to an injured plaintiff.  The reasoning behind this is that the mass media spread misleading information to the public about this case and has failed to properly correct the problem.  Most jurors believe the old woman with third degree burns hit the “jackpot” because they don’t know the facts.  This might not be a medical malpractice case but it is the epitome of the media’s incorrect reporting.

What the media often forgets to report are problems such as the one in New York.  An audit conducted by state comptroller, Alan G. Hevesi, found thousands of instances in which hospitals failed to turn over prompt information concerning episodes as serious as patient deaths and mistaken surgery.  The State Health Department punished the hospitals for lapses only in a handful of occasions.[44]  New York’s state law (NYPORTS)[45] requiring prompt reporting of medical errors and patient injuries has all but been ignored by hospitals within its borders.

 

Tort Reform

     Tort reform seems to be the deemed “cure-all” for the medical malpractice crisis.  However, during 1975 a majority of  states reacted by instituting tort reforms to curb the crisis.  In 1984 the next malpractice crisis hit and tort reform was requested again.  This time to modify the old reforms (give them a little more bite) and to institute new reforms not thought of the first time.  In 2001 the third crisis took hold.  The allegations were the same as were the responses; “it’s the lawyers and their frivolous lawsuits that are the problem.”  However, there is no viable evidence that the first two tort reform revolutions stopped the premium increases. 

     Currently, through my own research of state law I verified that 35 states have statutes capping non-economic awards.  Ranging from $200,000 to $600,000.  One of the thirty-five states caps all recovery on medical malpractice claims; Virginia  at 1.6 million.[46]  Caps less than $500,000 are overly restrictive and many times do not adequately compensate the victim.  Exceptions should be allowed to exceed this amount.  For example, the state of Michigan has a $280,000 cap but there are exceptions if the injury involves a spinal cord or brain injury.[47]  The State of Nevada has a $350,000 cap on non-economic damages but it also has exceptions to the cap.[48]  The State of Washington has a cap on non-economic damages that is formula based.  The non-economic award cannot exceed .43 x annual wage x life expectancy.[49]  This is Washington’s second attempt at capping non-economic awards.  Although, this formula might sound fair, as applied to the work force, how would it be applied to a housewife, baby, or the retired. 

     All states have statute of limitations.  Statute of limitations range from 1 year[50] to 5 years.[51]  Thirty states have a two year statute of limitations.  Some of the states apply the discovery rule to statute of limitations, which can either limit or lengthen your time to file (in most states it shortens your time).  The discovery rule states that the statute of limitations begins from the time of discovery.  However, this is an alternative that many courts have rejected based on the reasonableness of discovery.  The injured are required to be diligent in their discovery.  Some states also have tolling provisions for reasons such as fraud or concealment.

     The collateral source rule prohibits defendants from introducing evidence that the plaintiff has received, in some form, compensation for their damages.  Insurance providers would like nothing more than to have this abolished and in most states it has been.  The fallacy of the collateral source rule is that plaintiffs do not collect twice (insurer argument) because of subrogation liens, which is common place with public and private insurers.  In states where the collateral source rule has been abolished courts should allow evidence of the defendant being defended by their insurance company.  Furthermore, the plaintiff should be allowed to offer evidence of subrogation liens.  After all, the plaintiff should be allowed to collect from the tortfeasor and reimburse their own insurer in order to keep their premiums manageable or to retain their insurance altogether. 

     Rules limiting who qualifies as an expert witness.  State and federal courts have rules that require witnesses to meet, in order to qualify as an expert.[52]  Alternative solutions would be to require the expert to be a licensed physician, board certified, and practice in a similar specialty (already required if the malpractice case involves a specialist).  Many times these criteria are already met but enforcing these alternatives will also limit the already limited number of experts the plaintiff could hire.  It would also eliminate the academics who are a valuable resource in improving and discovering the many different healthcare fields.

     Caps on attorney fees are very important.  It allows the patient to keep more of their compensation.  However, the caps have to be reasonable thereby not encouraging attorneys to turn away people who have suffered wrongs and seek compensation because their case is complicated or presents a minimal recovery.  With the malpractice caps on non-economic damages many injured patients are without recourse.  California has a sliding scale for attorneys who take on malpractice cases.  This has cause some disgruntle attorneys to turn down cases where liability is arguable.

     Some states have enacted periodic payment statutes that penalize the injured plaintiffs that recover.  Instead of the traditional lump sum approach insurance defense counsel can request periodic payment if the amount awarded is over a certain amount (generally $100,000-$200,000).  As part of this request the amount is also reduce to its current value.  Thus, the insurer gets to hold onto the money, invest and earn on it as well as not have to pay inflation or interest to the injured.  Furthermore, the periodic payment does not pass to an heir upon the plaintiff’s death.  The insurance provider keeps the remainder of the award.  This is clear and blatant abuse of the legislative power.  And in no fashion does it protect the plaintiff (insurance defense argue this approach protects the plaintiff from spending the money carelessly).  Anyone who has dealt with insurance companies and expects a monthly check knows that many times the check is late, short, or altogether forgotten about.  This approach not only greatly benefits the insurer but extremely hinders the plaintiff.

     Screening panels have been set up in only a few states.  The Panel reviews the cases and then they decide whether or not the cases should proceed.  Or the panel hears the case on the merits and offers an opinion.  The suggested set-up of the panels consist of a physician, attorney and a lay person.  The panel’s decisions can be either binding or non-binding. 

     Alternative dispute resolution is another reform some states have enacted.  It can be mandatory or voluntary.  Mediation and arbitration are the two most used forms.

     All of these reforms limit the injured’s “day in court.”  The reason for providing in the constitution for a right to jury trial was to protect the little person (majority of America).  This is a deeply rooted tradition that has been continually treaded on since 1975.  At some point the strict reforms need to be rewritten or exceptions created that allows the wrongfully injured to pursue a remedy, as was the original purpose of the constitutional right laid down by the Framers.

Case Studies

     In Roa v. Codi Med. Group, Inc.,[53] the plaintiff sought to have a $500,000 settlement approved on behalf of their minor son.  Additionally, they sought to have the attorney fee agreement approved at a rate of 25%.  This rate would violate Medical Injury Compensation Reform Act by $30,000.  Court held that California’s sliding scale protected injured plaintiffs from attorneys receiving a windfall.  Chief Justice Bird dissents: “while discouraging frivolous and meritless suits is a legitimate state interest, there is no evidence that a number of frivolous claims in the medical malpractice field is high, or that such claims contribute to the cost of medical malpractice premiums.  On the contrary, the difficulty in proving medical malpractice and the risk of zero recovery make attorneys very selective about cases they are willing to pursue.  Even insurers have acknowledged that attorneys reject a vast majority of malpractice claims they see.”

     A Duke Law School study identified every medical malpractice case in the state and federal courts of North Carolina between 7/1/84 through 6/30/87.  895 cases of which 95% were tracked down.  50% were settled (plaintiff receiving compensation), 40% were dropped (statute of limitations, plaintiff withdrew, or summary judgment for the defendant).  Only 118 reached the trial stage.  3 were tried by a judge, 31 were settled after the trial started, withdrawn by plaintiff, or disposed of by directed verdict.  84 went all the way or 9.4% saw a jury.  The plaintiff prevailed on liability 17 times.[54] 

     A second study was conducted between 1987-1990 of the 14 largest counties in North Carolina (out of 100 counties).  326 cases were found, of which 51% were settled, 40% were dropped or terminated, and 9% (32 cases) went to trial.  Of the 32 cases plaintiff prevailed in 4.[55]

     The entire study from 1984-1990 included evidence that punitive damages were requested in only 13% of cases.  Court records indicate the most were dropped by the plaintiff or disposed of by summary judgment.

Conclusion

     There is no evidence of a medical malpractice crisis, nor has there been one over the last three decades.  The medical community is being used and abused to recoup losses on investment income by insurance providers.  The medical community is blaming the wrong party, yet at the same time failing to self-regulate.  Studies show that insurance reform is the best method to reduce outrageous malpractice premiums.  And finally, tort reform has effectively reduce a wrongfully injured person’s opportunity to be adequately compensated, as well as violate their constitutional right to a jury trial, equal protection, and due process.