Missouri House to tackle medical malpractice

JEFFERSON CITY — Legislation to be debated next week in the Missouri House would impose a flat $250,000 cap on what medical malpractice victims could receive for noneconomic damages, such as pain and suffering.

The permanent cap would be a dramatic reduction from Missouri's current $579,000 limit, which rises annually with inflation and can be applied against each act of malpractice committed by the health-care providers who are sued.

Late Wednesday, the House Judiciary Committee endorsed the legislation.

On Thursday, Republican Gov. Matt Blunt praised the legislation and specifically lauded the $250,000 cap. Unless Missouri lowers the cost of litigation, insurance rates will continue to rise, doctors will quit or move and Missourians will find it harder to get health care, Blunt said. (See Missouri Medical Malpractice Resourses)

To the victims of medical errors, “I would say to those people, we understand your concern,” Blunt said. But “there is no amount of money that you could provide that would alleviate fully their pain and suffering … and $250,000 is a reasonable limit on noneconomic damages.”

Opponents say the proposed restrictions could devalue the lives of the injured.

The cap does not affect awards for economic damages, such as the cost of medical care. And it is only one part of a much broader bill, which would restrict the filing and trial of all forms of tort cases, such as wrongful-death, motor-vehicle-accident, slip-and-fall, product-liability and slander cases.

But it is the medical claims — and specifically the financial limits — that have been the focus of debate in Missouri. Similar efforts to limit personal-injury lawsuits, and specifically malpractice claims, also are occurring in other states and in Congress.

An actuarial report released Thursday by the Missouri Department of Insurance examined 18 medical-malpractice insurance providers from 1994 to 2003. The companies had barely one-quarter of the statewide market share in 1994, but wrote more than 70 percent of the policies for doctors by 2003, partly because other insurers quit writing policies.

The average settlement per claim rose steadily over that time, although the number of claims leveled off in recent years, the study showed. When claim payments were combined with litigation costs for defense attorneys, expert witnesses and court fees, the medical-malpractice insurers incurred more expenses than they received in premiums from Missouri doctors. That especially was so in 2000, 2002 and 2003, according to the report.

“The losses drive rates, period,” said Geri Morrison, regional vice president of Medical Assurance Inc., which writes malpractice policies in Missouri.

If Missouri enacts new restrictions on lawsuits and the law withstands a court challenge, then malpractice insurance rates will go down, Morrison said.

Supporters said new lawsuit restrictions would cut down on some expensive tests undertaken mainly as a defense against lawsuits.

The lawsuit bill is HB393.