PD Editorial: A cease-fire in California’s long-running medical malpractice war

In the spring of 1975, a war broke out between doctors and lawyers in California.

Physicians in the Bay Area walked off the job, protesting soaring insurance premiums that they blamed on excessive jury awards in malpractice lawsuits. The strike soon spread across the state.

With insurers threatening to cancel malpractice policies and stop selling new ones, Gov. Jerry Brown called the Legislature into special session, and a law was passed over the objection of personal injury lawyers to limit malpractice awards for noneconomic damages, such as pain and suffering, to $250,000.

The Medical Injury Compensation Reform Act, commonly known as MICRA, ended the crisis. However, it didn’t resolve the conflict between doctors and lawyers, who have continued skirmishing in Sacramento and on the ballot ever since. Meanwhile, inflation eroded the value of malpractice awards, making it harder and harder to pursue claims, regardless of their merit.

Finally, almost a half-century later, there appears be a truce between doctors and lawyers — with benefits for consumers, too.

With a costly ballot-box fight looming in November, groups representing doctors and lawyers agreed this week to raise the cap on pain and suffering awards to $350,000 beginning Jan. 1, then, over the next decade, to $750,000. In cases involving a patient’s death, the cap would double to $500,000 on Jan. 1 and ratchet up to $1 million over 10 years. Beginning in Year 11, the caps would increase 2% annually.

The deal still needs to be approved by the Legislature and signed by Gov. Gavin Newsom. If that happens, as is expected, an initiative that would raise the caps even higher will be removed from the November ballot.

At first blush, this might seem like just another political squabble between deep-pocketed special interests. But consumers have an important stake in the outcome.

The cap on malpractice awards was enacted to ensure that people continued to have access to medical care in California. Ensuring access to care was a necessity in 1975, and it still is now.

So is accountability. The vast majority of doctors are skilled caregivers, and most of us place great trust in our physicians and receive quality care. But when someone is harmed due to incompetence or negligence, they deserve justice. In our society, that often means filing a lawsuit.

Malpractice plaintiffs can collect for medical expenses and economic damages, which typically means lost income. But those who aren’t able to show economic losses — for example, children, retired people and stay-at-home parents — can’t collect much for pain and suffering, even when they are grievously injured. And because malpractice cases tend to be complex and costly to litigate, attorneys are deterred from pursuing claims.

The $250,000 cap on noneconomic damages was intended to strike a balance between access and accountability. But to match its value in 1975 dollars, the cap would need to be about $1.3 million now. However, such a big jump coming all at once could again send doctors’ insurance premiums through the roof.

Doctors and lawyers fought a running battle over the cap in Sacramento for almost 50 years before this week’s cease-fire. Their agreement looks like a good compromise: injured parties regain access to the courts, doctors should be spared from ballooning insurance premiums — and all of us can avoid a repeat of a 2014 ballot box fight that cost $70 million but didn’t end this long-running war.

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