- The Washington Times - Wednesday, July 31, 2002

In recent weeks, this editorial page has repeatedly highlighted the troubling events taking place in Las Vegas, where one of the busiest Level-I trauma centers in the nation and one of the first lines of defense against terrorist attack was forced to shut its doors July 3 due to skyrocketing medical malpractice insurance rates. The trauma center, which specializes in treating seriously injured victims of car accidents, stabbings and shootings, reopened ten days later, after local officials and some of the surgeons reached a temporary agreement limiting doctors' liability in such lawsuits for a 45-day period. But, unless the state legislature which Gov. Kenny Guinn called into special session on Monday to reform malpractice insurance is able to come up with a permanent resolution of the problem, the center could shut down again shortly before Labor Day.

President Bush weighed in on the issue last week when he cited the Nevada insurance crisis at a speech in North Carolina calling for malpractice insurance reform. While visiting the Tar Heel State, Mr. Bush met with a group of medical patients and health care professionals to discuss soaring malpractice insurance rates and their impact on health costs.

One of those the president spoke with was Jill Barnes, a Nevada resident who is more than two months pregnant. Mrs. Barnes and her husband were recently told by their home doctor that he would not be accepting any new obstetrics patients. Unable to find a Las Vegas-area obstetrician to treat her, Mrs. Barnes has been forced to go out of state to find one. "When she goes into labor, she'll have to drive across the desert for two hours" to Arizona, her husband told the Las Vegas Review-Journal.

In his speech, Mr. Bush cited the Barnes' situation as a reason to enact tort reform. "That's got to be really frightening for a young mom not to be able to find a doctor with whom she can consult," Mr. Bush observed.

Mr. Bush also met with Dr. Shelby Wilbourn, a Las Vegas-area obstetrician-gynecologist who has cut staff, stopped taking new patients and decided to leave the state (he's going to Maine) after his insurance premium jumped from $33,000 to $80,000 this year. "The trial lawyers, suit after suit, have driven this good man out of Nevada," the president said.

In response, Senate Majority Leader Tom Daschle reportedly promised to filibuster any tort reform bill that came up. Meanwhile, North Carolina Sen. John Edwards, an attorney who has made millions suing doctors in malpractice insurance cases and who may well seek the Democratic presidential nomination in 2004, showed he's still carrying water for the trial lawyers. Mr. Bush's proposal, he said, "fits the pattern with an administration when it comes to the interests of regular people competing with the interests of big corporations, insurance companies, HMOs and energy companies."

One of those "regular people," Mrs. Barnes, has a very different perspective from that of Mr. Edwards. After hearing Mr. Bush, she's optimistic. "He wants to make a change," she said, adding that the president's reform efforts may enable her child to be born in Nevada.

On Monday, Mr. Guinn and Democratic leaders in the legislature reached a tentative compromise agreement, which includes provisions that would place a $350,000 cap on damages for pain, suffering and other non-economic matters, But their legislation includes numerous exceptions to the cap, which critics like the American Medical Association believe are likely to make it largely meaningless. Another provision would cap civil liability for doctors at trauma centers at $50,000.

One problem area appears to be the issue of reforming joint and several liability, under which a doctor partially responsible for an injury can be held fully liable; under the compromise, it would only apply to pain and suffering awards. As the Review-Journal editorialized yesterday: "Is it fair that somebody determined to be only 5 percent responsible can be on the hook for 100 percent of the economic damages?" The correct answer is: of course not.

As this was being written, Nevada lawmakers were engaged in marathon negotiations in an effort to come up with a final bill that addresses these problems. Mr. Bush can rightly take credit for serving as a catalyst for Nevada's debate over reform.


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