Posted on 10/25/2004 10:25:22 AM PDT by Dubya
Medical lawsuits issue hard for Kerry Bush makes simple argument; Kerry has complex answer
WASHINGTON | Dr. Ralph Nobo Jr. pays about $50,000 a year in malpractice premiums – and that’s with a 25 percent discount for a clean record.
The Bartow, Fla., obstetrician said his rates keep rising but he worries he would lose the discount if he ever gets sued, win or lose. “The insurance companies are raising our rates because of the possibility of being sued,” he said.
President Bush is making malpractice insurance a central issue in the health care debate, casting “junk lawsuits” as the driving force behind health care costs and even the reason flu vaccines are short this year.
“We will do something about the junk lawsuits that are running up the cost of health care and running good docs out of practice,” he said in St. Petersburg last week.
He told a crowd in Pennsylvania on Friday: “He put a trial lawyer on the ticket.”
“Boo!” was the response.
Sen. John Kerry of Massachusetts and Sen. John Edwards, the running mate from North Carolina who was a successful trial lawyer, concede frivolous lawsuits are a problem and have a plan of their own. But they don’t talk about it much on the campaign trail or in great detail when they do.
Analysts say Mr. Bush has a ready villain and a simple argument while Mr. Kerry’s malpractice reform proposals are too complicated to explain quickly and come with political traps.
“Go look at our plan,” Mr. Kerry told a crowd in Tampa last week. “We’re going to end frivolous lawsuits.”
Many analysts say Mr. Kerry went that far in Florida because the issue has particular resonance there. Voters will decide three malpractice ballot initiatives – one brought by doctors to cap attorney fees and two brought by lawyers to clamp down on doctors with bad records. Mr. Bush has bashed lawyers since Mr. Edwards began pursuing higher office, but it is now a campaign staple.
Dr. Nobo, who is president of the Polk County Medical Association, appreciates the help from Mr. Bush, but Mr. Kerry’s ideas do little for him. Some analysts say the Kerry campaign has done a poor job responding to an escalating attack on Mr. Edwards and an oversimplified diagnosis of why health care costs are skyrocketing.
“He understands the rhetorical advantage that Bush has on this,” said William Sabo, a political science teacher at the University of North Carolina at Ashe|ville.
When the subject came up in the second presidential debate, Mr. Kerry largely downplayed the role of lawsuits while generally supporting reform. In his debate with Vice President Cheney, Mr. Edwards went into detail about their plan but said: “I think the truth is that what they’re doing is talking about an issue that really doesn’t have a great deal to do with what’s happening with medical policy in this country.”
Mr. Kerry and Mr. Edwards would subject malpractice suits to panels that would decide if they have merit. Lawyers who file three lawsuits deemed frivolous would be barred from filing any more.
Mr. Bush would cap non-economic awards – typically involving lost abilities and pain – at $250,000 and would cap less common punishment awards at a higher level.
Several analysts said Democrats fear clashing on an issue that highlights Mr. Edwards’ former career and could alienate key donors. Lawyers have given $30.8 million to Mr. Kerry and Mr. Edwards, almost three times the amount they have given to Mr. Bush, according to the Center for Responsive Politics. Doctors have been more generous to Mr. Bush than Mr. Kerry by a ratio of 3 to 2.
Gary Shipman, a malpractice lawyer in Wilmington who has been active in Democratic politics, said Mr. Kerry and Mr. Edwards are in a bind.
“They’ve had to be very careful, quite frankly,” he said. “They’ve really got to walk down the center of the road, and Edwards especially, given that he’s a trial lawyer.”
The implications of this election for patients, doctors and lawyers are big. This is an old fight, however, and there is abiding disagreement about whether a malpractice “crisis” exists, as the American Medical Association contends, or who is to blame if it does.
Michael Martinez, who teaches political science at the University of Florida, said Mr. Bush’s approach on health care is like his approach on many issues.
“What Bush is trying to do is pick something that is relatively simple to highlight,” he said. But the debate about malpractice and its effect on health care costs is fraught with conflicting evidence.
The Democrats’ plan bears some similarities to the system in North Carolina, where Mr. Edwards made his millions, that includes merit review and pretrial mediation. State insurance officials say North Carolina is bucking trends that doctors cry about.
“We have heard those stories about doctors fleeing other states,” said Chrissy Pearson, spokeswoman for the North Carolina Department of Insurance. “North Carolina just simply has not seen it.”
That office provided figures showing the frequency of malpractice suits dropped in North Carolina after 1995, when the state required malpractice lawsuits to be certified by a doctor in the specialty at issue as worthy of court. Although malpractice losses and premiums began to spike in the late 1990s, the most recent data show steep reversals in 2002, which state officials say illustrates the cyclical nature of the insurance industry.
Data from the National Association of Insurance Commissioners shows North Carolina ranked 36th for the lowest ratio of costs from malpractice defenses and payouts against premiums that insurance companies earned in 2002. California, the model for Mr. Bush’s proposed $250,000 cap on non-economic damages, ranked 37th. A Bush campaign official said California has posted much smaller annual premium increases than states without caps, and that is the key.
Critics of tort reform argue malpractice rates rise and fall based on insurers’ stock and bond investments. Like several other studies, a report by the Government Accountability Office last year suggested malpractice lawsuits are the greatest factor in premium increases, but there are other causes, including the performance of insurers’ investments, and data is too sketchy to get at the whole truth.
In Tampa, Mr. Kerry said he and Mr. Edwards would be like President Nixon visiting China. The implication was that they have the credibility to break ground on malpractice reform because they are going against the party grain, as Mr. Nixon did.
Still, Sarah Bianchi, Mr. Kerry’s policy director, acknowledged Democrats are not responding to Mr. Bush’s malpractice drumbeat note for note because Mr. Kerry’s health care agenda is much broader.
“Our calculation is we wanted to spend time talking about all of our plan instead of talking about the one place where they have a plan and we have a plan,” she said.
BTTT for later
But I thought Kerry was su nuanced. Why is it so difficult for him to address the issue?
bump!
bump!
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