The proponents of I-330 are insisting that capping non-economic damages will cut the medical malpractice insurance premiums our doctors pay. While increasing premiums are a serious problem, I think that damage awards paid to patients are the least part of the problem.

Let’s leave aside, for a moment, the question of what economic damage a patient could claim if he was rendered unexpectedly sterile or was maimed in a way that didn’t interfere with his ability to work. Or, as fellow Backyard Blogger Garrett Ferencz pointed out the other day, the question of what non-economic damage means when a child who’s never earned any money dies due to possible medical negligence.

The important question is whether or not limiting damage awards would help achieve the goal of lower premiums as the insurance companies claim.

As a study quoted in the Washington Post points out, the state of Texas saw malpractice premiums rise while claims remained flat or declined from 1998-2002. Doctors’ premiums not only rose, they rose by 135 percent over that time period. I don’t see how anyone could claim with a straight face that the two numbers were connected, but the Texas legislature went and limited damage awards anyway in 2003.

Closer to home, the nonprofit consumer interest group Public Citizen recently released a study of Washington State malpractice cases based on information from the federally maintained National Practitioner Databank. [Note: I’ve been looking for a public access point for the NPDB, but it doesn’t seem to have a web-based version I can get to. However, I consider Public Citizen credible] They claim that over the ten year period of 1991-2001, malpractice claims in the state actually dropped when adjusted for inflation. Further, when cost of living is taken into account, most Washington doctors pay about the same or less than doctors living in California, where a cap on damages has been instituted.

If insurance companies are charging doctors more than any increase in claims justifies, perhaps to cover bad investment decisions, the local medical community should take the issue up with them and leave injured patients out of this fight.

But if we must have cost-cutting, and it’s always a good idea where possible, the data gathered by Public Citizen points the way to a large savings.

According to their research, just 488 repeat offender physicians in Washington have been responsible for 42.6 percent of claims made since 1990. They also found that the state medical board was very unlikely to take action against these doctors, putting Washington in the bottom fifth of states when it comes to disciplining reckless doctors who tarnish their profession. By their count, the cost of preventable medical errors in the state is at least three times the total paid in malpractice insurance.

Enter I-336. It will do what our state review board has so far refused to consider, revoking the licenses of doctors who have three jury awards against them in ten years. As noted above, this is a tiny percentage of repeat offenders whose actions create a tremendous cost in both human suffering and financial loss.

If nationwide numbers hold in Washington, a Public Citizen review of claims by repeat offenders shows that the 1.7 percent of doctors who have three or more claims against them were responsible for over 27 percent of all medical malpractice payouts.

How long will it continue to be acceptable for profit-seeking corporations and well-heeled professional organizations to always and only be looking to trim their bottom lines at the cost of the public? There’s ample evidence that greater savings are to be gained from an examination of their own behavior.

A vote of yes on I-336 and no on I-330 would send a message to the insurance companies and the state medical associations that patients in Washington don’t want to have to pay for other their carelessness.

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