As I See It

Restore tort reform in Missouri

Updated: 2013-12-29T23:29:40Z


Special to The Star

On June 8, 2002, the Star’s headlines screamed, “Insurance rates reach crisis level for doctors; Some physicians have been forced to leave practices.” Other Star headlines issued such ominous warnings as, “Malpractice: Soaring rates forcing doctors to leave practices,” and “Surgeon’s departure could shut down trauma center.”

Readers who were here a decade ago can recall how Missouri was mired in a medical lawsuit crisis that threatened access to health care in Kansas City and across the state. At that time, an effective and long-standing limit on non-economic damage awards in medical tort actions had been eviscerated by inflation and judicial tinkering. The results were as devastating as they were predictable. The health care tort system swung so far out of balance that liability insurers could no longer reliably measure or contain their risk. As a result, lawsuit premiums skyrocketed, driving physicians out of their practices, compromising patient access to care, decreasing the quality of health care services and generating higher health care costs for everyone.

Nowhere was the crisis more acute than in Kansas City. In worrisome numbers, physicians fled the toxic condition here and moved their practices across the state line into Kansas, where a reasonable cap on non-economic damages (unquantifiable things such as loss of enjoyment, loss of consortium, and pain and suffering) kept lawsuit insurance rates affordable.

The crisis reached the boiling point in 2005, and the Missouri General Assembly responded by enacting a commonsense, bipartisan tort reform measure that slowed runaway litigation and stabilized the health care environment. A reasonable limit on non-economic damages was the linchpin, and the results were dramatic. The number of lawsuits filed in Missouri dropped substantially, the lawsuit insurance market stabilized, new liability insurers entered the market, and insurance premiums became affordable again.

As a result, physicians returned to Missouri to practice. In the three years leading up to tort reform, Missouri lost 225 physicians to the lawsuit crisis. But since the first full year of reform, more than 1,000 additional physicians are providing care within our borders. And despite gaining all those physicians, Missouri has seen a $75.5 million decrease in the professional liability insurance premiums paid. This is money that did not go toward fighting lawsuits, but stayed in the health care system, creating jobs, providing higher quality services and improving access to care.

Unfortunately, last summer a deeply divided Missouri Supreme Court eviscerated the successful tort reform law. In Watts v. Cox Medical Center, the court ignored more than 25 years of precedent and ruled the new non-economic damages cap unconstitutional, touching off evidence-based forecasts of the same conditions that crippled the health care system here 10 years ago. If no remedy is forthcoming, we will certainly have to relive that perilous time.

Fortunately, the Missouri legislature has made it a priority to fix the problem. When the 2014 General Assembly convenes in January, legislation will be offered in both the House and Senate to restore the vitally important cap on non-economic damages. A large coalition of concerned citizens, health care providers, business leaders, and others has formed in support of this critically important effort. Every Missourian should tell their senators and representatives to support the effort.

Lancer Gates of Kansas City is the president-elect of the Greater Kansas City Metropolitan Medical Society. He is a hospitalist physician in private practice north of the river.

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