October 11th, 2009
03:07 PM ET
13 years ago

Casey: $250K cap on malpractice damages 'insulting'

[cnn-photo-caption image= http://i2.cdn.turner.com/cnn/2009/images/10/11/art.caseysotu1011.cnn.jpg caption="Sen. Casey said Sunday that an aspect of medical malpractice reform favored by many congressional Republicans was 'insulting' and wouldn't be 'justice as we have come to understand it.'"]
WASHINGTON (CNN) – A moderate Pennsylvania Democrat came out strongly Sunday against the possibility of imposing a cap on medical malpractice damages as part of comprehensive health care reform legislation currently under consideration in Congress.

“I don’t think the way to go is to limit the rights of Americans who are injured by negligent or intentional conduct,” Pennsylvania Sen. Bob Casey who is a member of the Senate Health, Education, Labor and Pensions Committee said Sunday on CNN’s State of the Union.

“A $250,000 cap on damages, in my humble opinion, is insulting to our system of justice,” Casey also told CNN Chief National Correspondent John King, “That is not justice as we have come to understand it.”

In an interview that aired earlier on State of the Union, Arizona Republican Sen. John McCain suggested that medical malpractice reform was one area where the GOP should begin to crystallize its own positive health care reform agenda now that Congress is about to begin to process of melding together several health care bills in both chambers.

But, pointing to the experience of her state, Michigan Democratic Sen. Debbie Stabenow suggested that the Republican approach to malpractice reform was too simplistic.

“There’s a different way to come at it,” Stabenow told King, “The Republicans have a very traditional approach over and over again – whether or not [malpractice reform] has worked.” Stabenow said damages caps imposed in Michigan had not stemmed increases in the malpractice insurance rates paid by doctors.

Last week, the nonpartisan Congressional Budge Office issued a cost estimate of the health care reform bill drafted by the Senate Finance Committee which concluded that inclusion of tort reform in the legislation would save $54 billion.

soundoff (225 Responses)
  1. Susan

    The only thing that will bring down costs is to take insurance out of the for profit territory. If you can't get the money from the DOCTOR's INSURANCE policy, it will come from the person's insurance. Either way, it comes from US in the form of higher rates, doesn't it? You won't see the insurance company taking a hit over any of this, because their only goal is profit and the bottom line. Here is one more case of a Republican plan that will encourage death, because if someone is really a victim of malpractice, $250,000 is nothing, and if there is no public insurance, the person needing care will eventually either bankrupt their family, or die from lack of necessary care.

    October 11, 2009 03:46 pm at 3:46 pm |
  2. Clay

    Isn't this rich: a bunch of millionaire politicians putting a price tag on the people's suffering for a lifetime that barely equals their own salary for a single year. I think it's high time that we tear the entire system down and start over with people of conscience in charge rather those who are barely human.

    October 11, 2009 03:46 pm at 3:46 pm |
  3. Michael

    A cap? Seriously? Some people can have serious injuries which can last their entire life and the GOP wants to cap their compensation!

    October 11, 2009 03:49 pm at 3:49 pm |
  4. Amazed

    That's $54 billion more profit to insurance companies. Not a dime will go to reducing cost of health insurance. Both parties should stop thinking their own pockets. They forget why they were elected and by who.

    October 11, 2009 03:50 pm at 3:50 pm |
  5. Will

    The entire concept of tort reform is based on misconceptions about our legal system.

    Traditionally, for any kind of lawsuit, if the plaintiff wins the lawsuit, the usual reward is damages plus three times damages (this is known as "treble damages"). The damages pay for the actual cost of fixing what was done wrong, and the rest is to pay your attorney and give you some restitution for having to go through the courts (as opposed to your doctor fixing what he did wrong up front, or if your doctor does something intentional or grossly negligent).

    Now, in your really bad cases (like the doctor who carved his initials in somebody during surgery), the jury may decide to go ahead and tack on punitive damages, which is where your multimillion dollar verdicts come in. Note the JURY decides this, not the JUDGE.

    Now, with Republican tort reform, let's say your doctor gives you a shot with a dirty needle and you get Hepatitis C, and you wind up spending a half million dollars on hospitalization and medical treatment. Under the republican plan, you would only get $750,000, which after paying your lawyer would still leave you in the hole. Or the lawyer could not get paid for his work (which in medical malpractice cases can take years).

    Basically tort reform is attempt to screw over both the victims of medical malpractice and the lawyers who represent those victims.

    October 11, 2009 03:52 pm at 3:52 pm |
  6. PaJC

    Pat F is right. There is no limit on ecomomic damages, only non-economic damages. A doctor can be sued for anything in Pennsylvania. Most of the time nobody has done anything wrong and the patient is fine, but the lawyers sue because the patient "could have been better", "has 'chronic anxiety' and can't work" "didn't know that was would be a treatment complication" even though it's specifically described in a discussion and on a treatment consent form. Cases are often settled even though there's no wrongdoing, because if a jury finds for the plaintiff for eight figures it's a "jackpot." Lawyers always take their ~40% contingency fee, so they are by far the main beneficiaries of the current tort system. Patients get only small fraction of the settlement after taxes, and settle or not, the doctor who's typically done nothing wrong gets a black mark in the National Practitioner Data Bank and has to explain the BS lawsuit every time he or she wants to work somewhere new.

    This enormous churn sucks up health care dollars that could be used to reinvest in the system, improving safety and technology, maybe electronic medical records, hiring more nurses, renovating nursing units, etc. Instead of investing in health infrastructure, it's better for lawyers and malpractice insurers to have subsistence health care. Jackpot payouts justify huge premiums, and errors are just a fact of life in an unimproved health system. Those errors are addressed by retribution in the justice system rather than figuring out why they happen and revamping health care infrastructure to see that they don't happen again. But I guess this is the externality of "protecting the little guy" and "maintaining the right to sue"

    October 11, 2009 03:52 pm at 3:52 pm |
  7. Flo

    what do you say to the patient who has his/her kidney removed only to find that the doctor removed the wrong kidney? Sorry, the doctor didn't mean it and we hope to get you back in the operating table to remove the right one. You think 250k will suffice for all the treatments they will have to receive in their lifetime. Before you say NO ; think about it.

    October 11, 2009 03:53 pm at 3:53 pm |
  8. Reinstate Darwinism

    We already have some really sad caps on Workman's Comp suits and payments. The justification is to protect employers. Why would we not apply the same rules to medical malpractice?

    I'd like to see the insane requirements for education for some of these medical personnel greatly reduced. There is reason millions of people fly out of the country for routine surgeries that cost less due to far less education requirements and the importation od "doctors" who recieved their degrees with far less schooling in another country. That's a lot of money leaving the country. Instead of our lawmakers adding additional schooling to certain professions when someone does something that had nothing to do with their amount of education (ie: leave a clamp in a patient during surgery). How about we just remove their license?

    There are a lot of great people out there, who could be great doctors but are limited due to funds and the almost insurmountable amount of education required for almost every top field of medicine.

    October 11, 2009 03:53 pm at 3:53 pm |
  9. Elmer

    The DEMs need to understand that you cannot feed the trial lawyers while trying to roll out universal health care? We will now be insuring everyone including the underbelly of the country. And these are the folks who do no take care of themselves, smoke, drink, do drugs and will more likely to also sue for invalid reasons (and I am sure some readers will take this to be racist – but majority of these folks I refer to are white). This limit must be low to start out with so that the change has a chance to work before the lawyers get fat. We already have the insurance companies getting fat, and I hope the final plan will lean on them significantly. I know that the trial lawyers love the DEMs because they feed them at every turn they can, but in this one case they need to draw the line. It is idiotic to spend a trillion dollars on a new health care system and increase the costs with huge legal settlements.Granted that $250,000 is too low, but it has to be no more than twice that if we are to get everyone insured.

    October 11, 2009 03:55 pm at 3:55 pm |
  10. Juan

    I agree with Censorship 100%. I don't think anyone really cares how much money doctors make. They deserve to make good money for putting peoples lives in their hands everyday. Now, the insurance companies are crooks, and I have felt this way from the time my father was sick with cancer and I got to see how ruthless these companies can be. So, cap the insurance companies and let the doctors do their jobs with the passion they had when they decided to go into medical school. If you are working and you know the bulk of your money is going into a black hole how high do you think your morale would be?
    If people don't see that the republicans are all about making more money for the already rich they are blind.

    October 11, 2009 03:56 pm at 3:56 pm |
  11. Shawn from Oregon

    I am by NO means a republican or conservative, but I would actually be in favor of capping 'pain and suffering' caused by malpractice to about 1 million. Right now malpractice insurance is a major cost contributing to health care and by limiting pain and suffering damages, it keeps the monetary damages in place so docs have to pay for their mistakes in terms of added care, but also helps to keep malpractice claims in check to a degree.

    But if Republicans think a simple cap on medical claims will fix the entire health care industry I think they need to be taken into the mental health care industry because they would be completely out of touch with reality.

    October 11, 2009 03:57 pm at 3:57 pm |
  12. GOOD CHATTER

    How bout 500K then, and have a sliding scale for their mistake. This would take the ambulance chasers out of the picture.
    Interesting comment about the Bond posted in FL.
    Both sides need to THINK instead of name calling.
    This problem ain't going away folks, and only to get worse.

    October 11, 2009 04:01 pm at 4:01 pm |
  13. Florence

    Very interesting! Republican changed the bankruptcy law to protect the deep pockets and now they’re against a cap on malpractice because…. Well, in my opinion, only to be controversial and divisive not because they care.

    October 11, 2009 04:06 pm at 4:06 pm |
  14. Bob in Pa

    Casey isn't a moderate. It's just that he is never around that you actually don't know his real political views. How do I know, Ihe's my Senator..

    October 11, 2009 04:08 pm at 4:08 pm |
  15. Truth-Bomb Thrower

    Frivulous lawsuits are the main reason that healthcare costs so much in this country. However the ambulance-chasing trial lawyers are some of the democrats most generous and faithful contributors. The democrats would rather see american citizens go broke or without healthcare than to alienate this vital segment of their financial base.

    October 11, 2009 04:09 pm at 4:09 pm |
  16. Gary

    Why not review the successful outcomes of our friends overseas?

    As I understand it – in some commonwealth countries, they use a three judge panel to review medical malpractice cases prior to litigation. If the case is deemed frivilous, it is thrown out, and the plaintiff's barrister is put in a bad light as presenting a frivilous case (which can affect his license to practice). If deemed legitimate, the three judge panel allows the case to proceed.

    A "three strikes rule" where you lose your law license for habitually presenting frivilous cases, protects institutions but raises the stakes for defendant, as their are no caps for damages.

    Something like a panel of arbitrators used in the American system might be an answer. The question is... who picks the arbitrators?
    There are workable ideas out there, but don't expect either side to like them.

    October 11, 2009 04:09 pm at 4:09 pm |
  17. Peggy

    There will NEVER be tort reform in this country because neither the trial lawyers NOR the insurance companies really want it. Both groups are the ones making millions from malpractice. If we really want to have tort reform we are going to have to STOP the insurance companies from being allowed to cover it. That will NEVER HAPPEN. They are making way too much money from these premiums.

    October 11, 2009 04:10 pm at 4:10 pm |
  18. p cymbalist

    I hope the republicans who proposed the $250000 cap will be happy to take it if someone takes off the wrong leg .

    October 11, 2009 04:11 pm at 4:11 pm |
  19. Jim

    I agree $250,000 is inadequate but there is need for a cap. My suggestion would be $1,000,000 plus reasonable cost of care if needed as a result of a medical mistake. Very few Americans accumulate more than one million dollars during their life. This should be sufficient for any situation. If death occurs and/or no care is needed $1,000.000 is a reasonable limit.

    October 11, 2009 04:13 pm at 4:13 pm |
  20. John

    Living in a state with a $250k cap and having an uncle lose his ability to function independently, earn his own keep, and be forced to live in a 24/7 nursing care facility for the rest of his natural life (sounds a lot like prison doesn't it?), I can attest to the pure negligence of the cap system. My family almost went bankrupt placing him in a managed care facility that was up to the standards of service that he needs. My mother has three mortgages open to supplement his disability benefit to ensure the appropriate care for his condition that was caused by a clerical error for a blood test for surgery by a Dr. and a hospital that refused to give the test in time for his procedure causing him to lose his leg. The $250k he was awarded(max award) provided exactly two years of nursing care. He has so far spent 13 years in care and is now about to pass away. There must be a way to eliminate unnecessary money grabs while ensuring that those that have legitimate claims for negligent and or malicious decisions errors at a health provider are taken care of. After all, we're frequently talking about mistakes that effect the remaining years of a persons life. Is that worth $250k, $54 billion, is a life's value more than mere money? Ask your self what any of your family members lives are worth in monetary value? Than consider whether a for profit corporation has any interest in your life. It doesn't and we all know it.

    October 11, 2009 04:21 pm at 4:21 pm |
  21. Mike

    In an Ideal world, I would create a non-profit insurance company.
    In fact, I don't know what is preventing one from being created now.
    Maybe it is all the Red Tape that states use to regulate the insurance companies? The barrier to entry is so high in some states, that BCBS is the only one left.
    And, if the Democrats eliminate max lifetime and max out of pocket expenses, it will further increase the barriers to entry, decrease the competition and lead to even higher insurance costs.
    So, encourage higher-out-of pocket expenses – for lower premiums, just like car insurance, I get high deductible and don't claim the little stuff.
    Cap all lifetime payouts at $1 million. That levels the playing field for insurance. After $1 million lifetime, allow the person to buy into medicare.

    October 11, 2009 04:21 pm at 4:21 pm |
  22. Victoria

    Capping malpractice suits is ridiculous. How about the patient who is paralyzed, blinded, crippled, permanently disabled or dies due to negligence of the medical practitioner. What do they do with $250,000?

    Leave this out of health care reform and instead make sure that irresponsible law suits are not filed by penalizing those who file them.

    October 11, 2009 04:22 pm at 4:22 pm |
  23. AZ Jake

    I don't agree with McCain very much anymore ... but, a cap on liability awards could very well have a positive affect on health care prices.

    We all know that the little guy dreams for the big payday win of a malpractice settlement bonanza. "Hit me I need the money". Sound familiar?

    I've heard that our nation's doctors are all for the plan because it would lower their insurance premiums. We could couple the cap with a Medical licensee three strike law. That way if they screw up three times then they lose their license to practice. Whatever that license may be. That would limit the unthinking screw-ups made by hospitals, doctors, nurses, technicians, and all other medical personnel and bring our costs down a bit.

    October 11, 2009 04:23 pm at 4:23 pm |
  24. Mike O

    This is a cap on 'Non-monetary damages'; the gravy train for lawyers. It is the source of the ridiculous overages on awards, simply because that is where the lawyer gets the biggest cut.

    Such a limitation has made a HUGE difference here in Texas, and true malpractice is still actively sued over. But the truly frivolous ones are far less numerous; no legalistic lottery ticket to be won.

    October 11, 2009 04:24 pm at 4:24 pm |
  25. T

    Pat F, while it's true that the caps imposed in all these tort "reform" schemes limit pain and suffering, in many cases the pain and suffering is the largest element because the average income for a worker in this country just isn't that high. One thing you fail to mention as well is that many of these schemes, like the one in Texas, even mandate that future lost earnings be paid out annually over the life of the plaintiff. If you really are a practicing lawyer, you understand the negotiating leverage this gives the insurance company when the inevitable appeal is filed.

    All of this means that medical malpractice claims become economically unfeasible in tort reform states for all but the highest wage earners. These are very expensive claims to bring and risky because jurors tend to not want to punish local physicians unless they have done something truly egregious. Not to mention that tort reform doesn't actually work. Total claim pay-outs are .5% of our medical costs and haven't changed much over the last ten years, while medical costs have skyrocketed. So-called "defensive medicine" is less about fear of lawsuits and more about doctors and hospitals seeking more ways to make money (see McAllen, Texas). Ever wonder why every little po-dunk town has its own cancer center and so many MRI machines?

    October 11, 2009 04:25 pm at 4:25 pm |
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