Medical malpractice tort reform bills were recently introduced in both chambers of the Iowa legislature. According to a January 30 article in the Iowa Capital Dispatch, the bills are fast-tracking through various subcommittees after being touted by Governor Reynolds in her Condition of the State address.
This new version of tort reform would put a $1 million hard cap on noneconomic damages in lawsuits against healthcare providers for cases of substantial or permanent loss or impairment of a bodily function, substantial disfigurement, or death. Noneconomic damages may include awards for pain and suffering and emotional distress.
Supporters of tort reform – hospitals, physicians, malpractice insurance companies – say there are too many frivolous lawsuits that cause ‘runaway’ and ‘shock’ verdicts that are out of control. The argument is that this causes a shortage of healthcare providers in our rural communities and drives OB-GYN clinics and hospitals out of business.
Not to be lost in this discussion, the New England Journal of Medicine recently published findings on the estimated progress of patient safety, using a sample of hospital admissions in 11 Massachusetts hospitals in the pre-COVID year of 2018. At least one adverse medical event was identified in 23.6 percent of the admissions, and 9.0 percent of the admissions included an adverse event that was rated as serious, life-threatening, or fatal. About 23 percent of the adverse events were judged to be preventable.
These findings are disturbing, yet should not be surprising. The results serve as notice that all other states – including Iowa – are not exempt from having similar results. For example, in 2018, I released an Iowa report that found nearly one-in-five Iowa adult patients experienced medical errors in the past five years, either for themselves or for someone close to them.
A seminal report in 1999, “To Err is Human: Building a Safer Health System,” estimated the annual number of lives lost to medical errors was up to 98,000 in hospitals alone. Subsequent estimates put this number much higher at 250,000 to 400,000 annual deaths.
Has progress been made since ‘To Err is Human’ was published? Donald Berwick, noted physician and former Administrator of CMS, indicates the safety movement has, at best, stalled.
The campaign effort in Iowa to thwart ‘excessive’ tort awards is a tired approach that continues to ignore the true facts. The medical establishment would rather spend their efforts and financial resources to chase tort reform protections rather than fixing the inherent problems that cause egregious medical errors in the first place.
Numerous studies continue to prove that tort reform does little to nothing to entice more physicians to practice in states that have implemented tort reform. In January, the Center for Justice & Democracy (CJ&D) released a briefing book, “Medical Malpractice: By the Numbers,” which provides a wealth of information that disputes many tort reform arguments. One 2019 analysis summarized, before and after tort reform was implemented: “Texas, like many other states, faces a challenge in attracting physicians to rural areas. But we found no evidence that tort reform lessened that challenge.”
Six top medical researchers found that “tort reform” does not reduce “defensive medicine” or healthcare costs. In fact, tort caps may actually increase costs.
According to a December 2020 edition of Medical Economics (found on page 17), Iowa has been identified as having the eighth lowest medical malpractice rates in our country. Iowa’s Governor and elected officials can make a true impact by proposing and implementing legislation that holds hospitals and medical providers more accountable for the dismal patient safety results.
Iowans should not have to rely on arbitrary caps established by special interest groups who benefit at the public’s expense. It is now time to serve the entire public, rather than a handful of those unwilling to practice safe and effective care. Tort reforms merely mask the real problem that politicians are unwilling to confront.
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