Senate Defeats Effort to Limit Medical Malpractice Awards

WASHINGTON â€”  The Senate blocked legislation Monday that would have limited jury awards in medical malpractice cases, shunting aside one of President Bush’s most sought-after domestic policy objectives.

In procedural votes on two separate bills, proponents of the caps on damages failed to cut off debate. The defeat means that the effort to restrain malpractice awards -- stalled in the Senate for two years -- is unlikely to move forward in Congress unless Republicans increase their numbers on Capitol Hill in November’s election.

The bills would have limited damages for pain and suffering to $250,000 in most instances, with an upper limit of $750,000 for cases involving multiple medical facilities. One bill would have applied to healthcare providers generally, while the other sought to shield obstetrician-gynecologists. Foes say such caps are unfair because they would fall disproportionately on people who suffer the most severe injuries.

The bills’ Republican backers fell far short of the 60 votes needed to end Democratic-led stalling tactics. The vote to end debate on the broader legislation was 48 to 42; the tally on the second measure was 49 to 44.

“I am disappointed that the Senate has yet again failed to pass real medical liability reform legislation,� Bush said in a statement. “... This is a national problem that deserves a national solution. I have called on Congress to pass responsible medical liability reforms, and the House of Representatives has acted. It is time for the Senate to put the needs of the American people ahead of the interests of trial lawyers.�

The House passed its version in July.

The skirmish over malpractice opened a week devoted to healthcare issues in the Senate. Today, the chamber is to consider legislation to make it easier for small businesses to pool together to buy health insurance for their workers. The small businesses would be exempt from some state requirements for coverage plans.

Democrats want to broaden the week’s legislative scope to include votes to lift the restrictions on federal funding of embryonic stem cell research and to extend the May 15 signup deadline for the Medicare prescription benefit. But it seemed unlikely that Senate Majority Leader Bill Frist (R-Tenn.) would veer from the schedule he had set.

Monday’s votes came as broader debate over malpractice appears to be shifting away from limits on jury awards to other sorts of reforms, mainly alternatives to litigation.

These include state-sponsored programs that encourage doctors and hospitals to promptly own up to mistakes, apologize, offer restitution and make corrections to safeguard future patients. Also, some are calling for the creation of specialized administrative courts in which a judge with expertise in medical matters, not a jury, would hear cases and decide on compensation from a predetermined table of damages.

“There are really two different debates about malpractice,� said William M. Sage, a Columbia University law professor who is also a physician. “This persistent debate over caps is really a debate over personal injury lawyers, and whether what they do is good or bad for America.�

Trial lawyers lost two major fights since the 2004 election, failing to block measures that limit class-action lawsuits and provide liability protection for gun manufacturers. But the lawyers battled hard to stop the malpractice bills.

The Assn. of Trial Lawyers of America warned that the Senate legislation would have had dire financial consequences for plaintiffs consigned to a life of disability because of a doctor’s neglect.

For example, the $250,000 cap is based on a limit imposed by California about 30 years ago. If adjusted for inflation, that sum would be close to $1 million.

“The Bush administration talks about deterring frivolous [malpractice] cases, but caps by their nature apply only to the most serious cases which have been proven in court,� said Sen. Edward M. Kennedy (D-Mass.). “It is absurd to suggest that $250,000 is fair compensation for a person paralyzed for life.�

Doctors supporting the legislation say that high malpractice insurance premiums are driving them out of the profession, in effect denying services to patients in some communities. They point to studies that suggest that premiums are lower and more stable in states that have enacted caps on malpractice damages.

Opponents cite other studies indicating that malpractice awards have not risen dramatically and suggest the explanation for premium increases may have more to do with insurers’ efforts to recoup investment losses.