The debate over tort reform in North Carolina will reignite next week as the N.C. Senate prepares for its week-long special session to consider malpractice legislation.
Health care workers are pushing for limits on pain-and-suffering damage awards, while trial lawyers insist that such reforms would do little to curb the skyrocketing insurance rates the state's physicians are experiencing and would needlessly burden victims of malpractice.
The original bill, Senate Bill No. 9, was introduced last session and although many new drafts have emerged, its central features will frame the debate for the special session next week.
Crucial components of the bill include caps on non-economic damages awarded and plans for periodic payment of damages. Economic damages--such as loss of income and compensation for living costs associated with disabilities--would not be capped under any of the proposals for tort reform currently on the table.
"[Senate Bill No. 9] is an overly-simplistic silver bullet approach to a very complicated problem," said Bill Wilson, political and legislative director for the North Carolina Academy of Trial Lawyers.
Wilson said the currently proposed measures were unlikely to reduce future increases in insurance premiums by more than 5 percent. Senator Robert Pittenger, who introduced the bill, disagreed. "I [introduced the bill] because of the alarming increases that health care physicians and hospitals were incurring throughout the state," Pittenger said, adding that he has received complaints from his constituents, particularly physicians.
"The coalition is committed toward a bill with caps with collateral source reform," Pittenger said. "[Experts] concur that caps are an important component toward addressing the skyrocketing rates."
Aside from its impact on medical liability, patients' rights advocates are concerned about ensuring a fair legal environment for plaintiffs.
Opponents to reform claim that changes made would discourage patients from taking legal recourse. "The goal of [these reforms] is to essentially make these cases too difficult to pursue from a cost standpoint," Wilson said. He added that in a complicated malpractice case, a plaintiff's attorney may spend anywhere from $100,000 to $200,000 hiring experts.
Those who support tort reform argue that strained health care providers cannot provide quality care, ultimately harming patients in the long run.
"It is a great concern to constituents; not just to health care providers but to consumers, because the cost of medical insurance is directly affected by these increases."
Pittenger said his bill began to receive significant attention from legislators after 3,000 physicians and health care providers staged a rally in Raleigh April 8. He said partisan politics caused the gridlock over the legislation last spring.
"The Democrats don't want to offend a major constituent of theirs and that is trial lawyers," Pittenger said. "They're going to see a major reaction from the health care community if they don't properly address and respond to this crisis."
The liability crisis is not unique to North Carolina--rising malpractice insurance costs have been increasing dramatically across the country.
"Probably every state in the country is trying to pursue the same elements of malpractice insurance that we are--most definitely," said Robert Seligson, chief executive officer of the North Carolina Medical Society.
Although most states are looking at caps on non-economic damages, there are other complementary initiatives that have been introduced as well.
"I think the over-riding thing here is that we need to have insurance reform," Wilson said, pointing to California as an example. California put contingency fees on plaintiff attorneys and caps on non-economic damages but also imposed a more stringent review process for insurance companies before large increases in insurance premiums could be enacted.
Although momentum for tort reform has been building in the past few months, if a bill is agreed upon, final approval will have to wait until the House convenes. Though the nature of the bill is far from settled, proponents of reform are optimistic. "I live in hope every day," Pittenger said.
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