A Brief History…

I looked at Washington Monthly today, as I usually do to see what the far left is thinking. They were, as usual, obsessing about the health “reform” legislation and yesterday’s summit. I noticed a link to another article about malpractice reform.

First, from Wash Monthly,

John McCain recommended malpractice reform modeled on California and Texas.

There’s two examples right now of medical malpractice reform that is working. One is called California and the other is called Texas. I won’t talk about California because we Arizonians hate California because they’ve stolen our water.

“But the fact is that Texas has established a $750,000 cap for non-economic damages; caps doctors at $250,000; hospitals at $250,000; and any additional institution, $250,000; and patients harm to a finding of medical malpractice are not subject to any limitations on recoveries for economic losses. And I hope you’ll examine it.”

Wash Monthly comes back with a response that is based on lies.

I hope policymakers will examine it, too, because the results of the experiments in California and Texas offer some important lessons.

McCain preferred to ignore California’s experience, not because of water rights, but because the caps haven’t worked the way conservatives would have liked.

This is a lie. The “source” he links to is Jamie Court who is a really far left anti-insurance zealot and part of the phony Prop 103 auto insurance “rollback” that passed a decade ago and screwed up California’s auto insurance for a while. Here is what Court says:

Data from the National Assn. of Insurance Commissioners show that doctors’ malpractice premiums nearly tripled in the first dozen years after the 1975 California law. Premiums fell sharply and stabilized only after Californians passed insurance reform Proposition 103 in 1988.

Under 103, $135 million was refunded by malpractice insurers. The insurance measure also created an elected insurance commissioner who imposed a rate freeze for his entire first term, implemented stringent regulation and ended price fixing.

This is just a lie. I was practicing surgery in California the entire time he refers to. I began my private practice in 1972. My malpractice premium was $3500 per year. In 1974, following the stock market decline which devastated insurance company investments, my malpractice carrier raised my (and my partner’s) premium to $35,000 per year, but we learned that the company was insolvent. For a while, there was no insurance available except at stratospheric rates we could not afford. Thousands of California doctors practiced without insurance for several years. In 1974, there was a statewide doctor’s strike. Many doctors refused to treat any but emergency cases until the state did something about medical malpractice. Governor Jerry Brown called an emergency special session of the state legislature in January 1975. They passed a very good law called AB1XX, named for the special session. Since that time, it has been called MICRA, The Medical Injury Compensation Reform Act.

It has been attacked many times by the trial lawyers, with whom Court is affiliated. Eventually, the State Supreme Court upheld the reform act, in spite of furious attacks by the medical malpractice bar. It has resisted further attacks every few years for the past 25 years.

Court claims that premiums tripled and that Prop 103 affected the rates. Both are lies. My partner and I practiced without insurance for three years. In 1978, when we added another surgeon to our practice, we decided to start buying insurance again and we joined a company called CAP/MPT. That stands for Cooperative of American Physicians/ Medical Protection Trust. It is a non-profit cooperative of doctors who are self insuring. We each deposited $20,000 into a trust fund. We were than assessed an amount each year according to our specialty. Surgery is higher risk than General Practice, for example. My assessment remained at about $6,000 per year for the next 20 years.

I was sued several times although most were nuisance suits. For example, when we did apply to CAP/MPT, I learned that I had eight wrongful death suits filed against me. When we investigated, we found that these were ER patients, mostly trauma cases, that had died. Some, I had not even been involved with their care. I wrote letters to each law firm asking them to dismiss the suits or be subject to a suit by me for malicious prosecution. All were quickly dismissed. I was threatened with suits a couple of times by disgruntled patients. One woman kept coming back complaining because she had a tiny scar from a varicose vein injection. I couldn’t see it from ten feet away. I finally (a mistake) asked her why she was so obsessed with this scar that no one else could see. She had been warned that these injections can cause scars. I even asked her if she was having personal problems, with her husband, for example. That was a big mistake. She threatened to sue me but she could never find a lawyer to take her case.

Ironically, she had originally come to me because I had saved her mother’s life. Her mother, a smoker, had been in California to help her daughter with a new baby. While here, she had a catastrophic vascular accident that resulted in her entire small intestine dying. I put together her duodenum and colon but did not expect her to live. She had no remaining bowel that could absorb nutrients. Also, the connection of the bowel was tenuous because of the poor blood flow. Amazingly, it healed but she had no way to absorb food. We put her on total parental nutrition and she did well but there was no known way to keep the catheter from getting infected. They had never been used for a chronic IV nutrition situation.

I had been to the American College of Surgeons meeting a couple of months before and had seen a new catheter that was intended for long term IV use. It was still experimental. I called Belding Scribner, who had invented the first shunt that allowed chronic dialysis for renal failure. He was the one at the meeting who was showing the new catheter. He told me the name of the small company that was making them and they agreed to send me one. They are now commonly used for chemotherapy but this was probably the first use for a patient who lost her entire small bowel. It worked and she went home to Bethesda, Maryland after we taught her husband how to care for it. I called the National Institutes of Health to find someone who could help the husband with the care and she did well for several years, finally dying of a heart attack. Ten years later, her daughter sued me for a 2 mm scar.

I had a couple of other suits, one of which went to trial and I was exonerated, including being awarded the court costs. In 1994, after a major back operation for an old injury, I retired. A couple of years later, my $20,000 trust fund contribution was refunded. Court is lying about the malpractice situation in California and trying to puff up the role of his anti-insurance Prop 103. There was no refund until I retired and that had nothing to do with Court and his Naderite pals.

The fact that the left has to lie to support their position is excellent evidence that they have nothing else on their side.

Tags: insurance, malpractice

This entry was posted on Friday, February 26th, 2010 at 8:51 am and is filed under health reform, medicine, politics. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.