Second Opinions on Malpractice Reform

Re “California’s Medical Liability Cure,” Commentary, Feb. 4: Former state Supreme Court Justice Cruz Reynoso concedes that over the years, dollars paid out by insurers before and after the initiation of the Medical Injury Compensation Reform Act did not change, when adjusted for inflation. Then how can the massive increases in medical malpractice insurance premiums in the mid-’70s, used to justify “tort reform,” be reasonably attributed to “runaway verdicts”? The reason for this jump in premiums was not runaway verdicts but insurance company investment losses in the recession of the mid-’70s being passed on to doctors as increased premiums. Similarly, now, looking at the claims-paid figures, there is no justification for the recent massive increases in medical malpractice premiums. But there has been a stock market collapse over the last two years. The insurers again have a “shortfall of reserves,” which they are passing on to the doctors as increases in premiums.

Doctors, finding it easier to blame lawyers and wanting to avoid accountability, just don’t get it. If medical malpractice premiums go up when the insurance payout of claim dollars stays steady, but insurance companies lose reserves in the market, why do otherwise intelligent people continue to blame lawyers and injured patients for the increase in rates, rather than the insurance companies? I am a physician and an attorney. My legal malpractice premiums have increased in the last year or two by as much as the medical malpractice premiums have gone up in this state, with no claim ever being made against my group. There has been no increase in the claims paid out against lawyers, just as there has been no increase in the claims paid out against doctors. Does it take a former Supreme Court justice to understand who is playing the public and doctors for suckers?

Arlan A. Cohen MD, JD

Pasadena

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Reynoso’s interesting commentary is not entirely up to date. Today’s California doctor is beginning to face the same high percentage rise in malpractice rates being found around the country, and California will soon be in the same position as other states. Even here in California, dedicated doctors are in a continual adversarial relationship with their patients and are often second-guessing their decisions. What was once a noble profession, at least for primary-care providers, has deteriorated into one of drudgery and frustration. Every patient is a potential litigant. I doubt that any of you would remain in a business where your income was limited as your costs soared and you had the threat of a lawsuit hanging over your head every minute of every day. Doctors cannot survive in this environment much longer. MICRA is a Band-Aid.

Jill Hoffman

Los Angeles