No Relief for Doctors in Legal Reform Prescription

With the House about to complete action on a broad package of legal reforms protecting businesses from frivolous lawsuits and excessive jury awards, one large and influential group is being left out: America’s doctors.

Despite a strenuous, behind-the-scenes lobbying effort that began well before the November elections, the American Medical Assn. has failed to persuade the GOP to include in its landmark legislation a provision that doctors have long coveted--an absolute limit of $250,000 in non-economic damages for any medical malpractice victim.

And if the AMA is unable to have that provision tacked onto the final legislation in the next day or two, the nation’s physicians will have fallen victims to their own high-stakes strategy during the acrimonious 1993-94 health care debate.

Back then, when sweeping health care reform seemed all but inevitable, the AMA fought a spirited and successful battle to link the medical liability issue to health care reform. The AMA virtually conditioned its support for President Clinton’s massive reform agenda upon receiving a $250,000 cap on pain and suffering awards.

But with the contentious health reform debate over, as the AMA has learned, the new GOP majority at this point wants nothing to do--at least for now--with an issue that is so widely viewed as a health care reform matter.

“The Republican leadership didn’t want to do health care reform. And they looked askance at anything that was a part of last year’s health care debate trauma,” an AMA official said Wednesday.

“What they wanted were things they thought were doable, unconnected with last year’s debate,” said Kirk Johnson, AMA general counsel and group vice president.

Some Republicans also are said to be still miffed at the AMA’s support for one of Clinton’s major goals: universal health coverage.

In any case, with new protections against punitive damages for the likes of medical device manufacturers in the offing, doctors fear that they may end up as the sole “deep pockets” for angry litigants and outraged juries.

The AMA sought to have a limit on medical malpractice damages explicitly included in the “contract with America,” but those efforts were rebuffed by House Speaker Newt Gingrich (R-Ga.), then minority whip.

The GOP’s legal reform package, a centerpiece of the contract, seeks to encourage out-of-court settlements in part by making litigants potentially liable for their opponents’ legal costs, requiring a higher standard for filing securities fraud lawsuits and strictly limiting punitive damages for injuries caused by defective products.

Working behind the scenes, the AMA is counting on Rep. Christopher Cox (R-Newport Beach), an author of the legal reform legislative package, and Rep. Pete Geren (D-Tex.) to shepherd through the House an amendment on its pet cause when the body votes before the end of the week on the punitive damages provision.

But Geren said late Wednesday that he cannot predict the outcome.