Malpractice Reform

I found “California’s Lesson: Malpractice Reform Won’t Cut Health-Care Costs,” adapted from remarks made by Robert C. Baker to a House subcommittee (Opinion, Nov. 20), to be loaded with erroneous information. For example, in performing cataract surgery with lens implantation for 12 years, I have yet to perform the operation in the 15 minutes described by Baker. The figure of six to 20 operations per day is ridiculous; the average ophthalmologist in Santa Monica (my practice area as well as Baker’s) performs less than 20 cases per month. Finally, the typical insurance reimbursement is less than half of the charge quoted by Baker.

It is curious that Baker does not consider the visual benefit patients who are half-blind derive from restored vision. The only true victims resulting from failure to enact appropriate malpractice reforms are self-serving attorneys who mistakenly condemn malpractice reform.

MICHAEL REYNARD MD

Santa Monica

* Baker is understandably concerned when medical malpractice reform erodes the earning potential of personal injury lawyers. This country’s civil justice system (which is neither civil nor just), is designed to benefit attorneys, not litigants or society. Medical malpractice lawsuits don’t even protect us from incompetent doctors. A malpractice suit is nothing more than “business” and “theater”; if the lawyers can’t agree on a dollar “value” of a case, they conclude their negotiations and they stage a play. We call that play a trial. These trials often degenerate into a techno-babble joust between “experts” who are hired guns for defendants and plaintiffs. Truth, justice, right, wrong, good, evil, guilt and innocence are the casualties. After the final act, the lay jury decides which party had the better lawyer. Only the lawyers win.

The rest of the world laughs at our nation’s court system. They call it “the American disease,” realizing that the U.S. is destroying itself from within (with lawsuits), just as Lebanon did (with guns). Tort reform has helped a bit in California. (Obstetrical malpractice premiums are much lower than in the rest of the U.S.) What we need now is court reform. Special courts must be developed to adjudicate technical and scientific issues, such as metallic stress fracture in airplane wings and the causes of neurologic injury in newborn infants. We already do this in the areas of bankruptcy and maritime law. Moreover, we must move from an adversarial system (a battle of the litigants), to the model used by the rest of the world, an “inquisitorial” system in which the court hires neutral experts and acts as the fact finder.

ALAN R. ZWERNER MD, JD

Seal Beach

* Baker’s real complaint with medical malpractice reforms shows through every crack in his rickety analysis. That is, contingency fee lawyers aren’t making the profit they’d like to be.

Baker’s claim that medical-malpractice premiums have not diminished in California is unsubstantiated and false. Average annual premiums in 1976 were $18,000. In 1991 they were $7,000. In 1992 a California doctor practicing internal medicine paid $5,800 a year in premiums--one-third of that paid by colleagues in New York and Florida.

These lower premiums have meant lower doctor’s fees, keeping down health-care costs overall and making possible continued provision of quality, innovative health care. (Remember, the 1975 reforms were not enacted because the governor and Legislature had it in for lawyers. They came because the instability of a runaway liability system made it impossible or incredibly costly to insure health providers, and no doctor in his or her right mind could practice without insurance.)

JOHN H. SULLIVAN

President

Assn. for California Tort Reform

Sacramento