Friday, October 15, 2004

Measure 35
Oh this is one of the big ones. Measures 33 and 34 have their hot moments, but 35 and 36 are generating real furnace heat.
The measure reads: AMENDS CONSTITUTION: LIMITS NON-ECONOMIC DAMAGES (DEFINED) RECOVERABLE FOR PATIENT INJURIES CAUSED BY HEALTHCARE PROVIDER'S NEGLIGENCE OR RECKLESSNESS.

The text of the bill seems fairly straightforward. It limits lawsuits of patients for non-economic damages. That is pain and suffering, loss of companionship, emotional suffering, interference with stuff other than job related. Stuff like that. It still allows unlimited recoverable reward for medical costs, past and future, and income lost from inability to perform while under medical care.
One paragraph says that the limit is $500k, but later there is a section that determines the annual increase of this limit using some sort of equation that most normal humans don't understand.
The text defines economic and non-economic damages in sections 6 and 7.

Now I like the motive behind this bill. I don't like how lawsuit happy this country has become, and the damage done to our legal system by people who want to sue for every scratch they get is pretty abysmal. The rational they get for trying to pry millions from insurance companies are pretty lame as well.
However, I also believe that if a healthcare provider is truly negligent you want to hit them so that they are forced to change what they are doing, make it economically preventative for them to continue doing something that, while efficient, is detrimental to patients (because of course, MORAL pressure to change is worthless effort, right?). The standard way to do that is to let courts impose huge awards to the plaintiffs for reasons of "mental anguish" and the like.
Really, this measure is not the answer, but I don't know what is. Ironically, I heard some fresh stuff (fresh to me, anyway) from John Edwards in the vice-presidential debate last week regarding lawsuit reform. It involved making the lawyers more responsible for the outcomes of the cases. I'm not sure if that's the answer either, as lawyers may be more skittish about providing services if they get seriously penalized for losing, but at least its another idea.

Bill Kettler of the Jackson County Mail Tribune has an article that lays out both sides of the argument well, including the players and some state by state comparisons:
Proponents of the measure — a coalition that includes physicians, hospitals and insurance companies — say it should pass to ensure that Oregon has enough doctors to deliver babies and treat patients with life-threatening injuries. Opponents — a group that includes trial lawyers, senior and consumer advocates and many labor groups — say it should fail in order to preserve citizens’ rights to trial by jury.
Caps on jury awards are nothing new. Oregon had a cap from 1987 until 1999, when the state Supreme Court ruled it unconstitutional. About 20 other states have caps, including California, Idaho, Colorado, Utah and Texas. Many of those states’ caps are under Oregon’s proposed $500,000 limit, which would be adjustable to account for inflation.
He points out what happened to insurance costs of doctors after the previous cap was removed in 1999.
One of the points in there, as well as this advertisement is that controling the size of lawsuits will help east the rising insurance costs in the medical profession. Premiums have skyrocketed in the years since the cap was removed. That may be partially true. The Oregonian (see the add link) points out that caps on damage awards do not directly affect insurance premiums, and the link is uncertain.

Insurance is a game of guessing and statistics. One thing is certain and that the health care industry is under pressure from high insurance costs. There may be plenty of doctors in Oregon, but the costs of insurance premiums are generally passed on to the consumer, and seeing your doctor costs much more that it needs to. The argument for having caps in place is that, as witnessed by the caps that used to be in place, insurance companies don't need to overcompensate when they know the boundaries of how much each claim is going to be. It's not a direct coorelation, but would it make it better?
I'm not sure about all the coorelations. As I said above I'm not sure this is the best way to change the system and reform things. I might just vote against it because I had changing the constitution, when a law might do just as well.

Here's another FOR editorial from the Oregonian

Former Governor Kitzhaber, a former Doctor, and current Governor Kulongoski, a former trial lawyer, are on opposite sides of this debate. Guess which is for and which is against.

The Portland Alliance has a lengthy document against the changes.

Here's the Yes on 35 website.
Here's the official no on 35 website.

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