Medical, workers' comp reform will have lasting effects

In March 2005, Missouri Gov. Matt Blunt, flanked by Cape Girardeau-area doctors and lawmakers, touted a new tort reform law at a ceremonial bill signing at a local hospital. Blunt said the law makes wide-ranging litigation and medical malpractice reforms to address what he said was a medical crisis in the state.

Blunt also said the legislation sets a new standard "in our efforts to prevent physicians from being forced from Missouri" because of soaring medical malpractice suits. The legislation also contains, he said, workers' compensation reform to address the threat of job-killing legal awards hanging over the heads of businesses.

Republican lawmakers made the bill a top legislative priority last year. Various associations of trial lawyers opposed it. Blunt signed the law March 29, 2005, and it took effect Aug. 28.

Has tort reform had an impact yet? It has, according to Michael Grote, vice president of governmental affairs and general counsel at the Missouri Chamber of Commerce and Industry. Grote said a national study has moved Missouri up five places (from 40 to 35) in terms of state liability rankings by the U.S. Chamber Institute for Legal Reform.

"The mere passage of such legislation has allowed Missouri to be recognized nationally as being on the right path to fixing its tort system," said Grote.

The legislation guarantees a right of those truly injured to bring a claim, but prevents the legal system from being abused solely for financial gain, he said. It also takes a strong stand against venue-shopping -- the practice by plaintiff lawyers to try a case in a jurisdiction where an injury may not have occurred, but where jurors traditionally award extremely large amounts of money. This, he said, drives up the costs of medical malpractice insurance, which adversely affects doctors, and workers' compensation insurance premiums, which can be a great burden to businesses.

"This bill has one of the strongest venue provisions in the country," said Grote, adding the only unforeseen drawback is not going far enough with the legislation. "It is imperative to continue to reform the system."

Cape Girardeau obstetrician Scot Pringle praises the legislation, but says the tort reform will take some time to filter down to the medical community.

"I think this law has the potential to affect our insurance premiums effectively," said Pringle. "It passed last August, but my premium rolled around in December and there was no change. I'm hoping next December there will be a change, a lower premium."

Pringle said that prior to tort reform being signed into law, an unusually large number of lawsuits were filed. He said there now has been "a huge slow down" in filings. But the backlog in lawsuits will delay insurance carriers lowering their premiums. He thinks it may be a year or two until physicians see lower premiums. Pringle said the medical tort reform of 1985 took several years to have an effect.

"A good thing happening now is that more indemnity carriers (liability insurance provided by major companies) are now moving into the state," he said. "By the time the reform passed we were down to three carriers, and now we have more. When the cost of liability became too high, many carriers left because of potential risk. A big judgment raises everybody's ticket on a carrier."

Pringle said a very big benefit of the legislation is it stops lawyers from venue shopping -- moving cases to areas of the state such as St. Louis where "juries are soft" and award plaintiffs extremely large amounts of money. He said the reform also puts caps on punitive and non-economic damages.

"Previously, lawyers would have multiple filings for non-economic filings and have about 10 different pleadings on a case, and judges would allow $597,000 be awarded for each pleading," he said. "That's been eliminated. The law now caps the award at $350,000 total. Insurance companies run from things like multiple pleadings."

Pringle said he and other doctors are waiting to see how much of a difference the tort reform will make.

"We're hopeful," he said.

Dr. Kevin Vaught, a Cape Girardeau neurosurgeon, said the tort reform "represents a good start." He said there has been a decade-long malpractice crisis that has caused numerous problems for health-care delivery.

"These include the escalating cost of defensive medicine whereby a physician orders additional tests and procedures to protect themselves from lawsuits rather than helping the patient," he said.

Vaught said there has been a decline in the number of surgeons and specialists willing to perform high-risk procedures. Also, recruiting new physicians has been difficult because many other states are far ahead of Missouri in terms of tort reform legislation. He said Missouri still has a malpractice crisis.

On workers' compensation reform, Ed Dust, director of economic development in Sikeston, said he thinks the new legislation is working.

"The concept of the new bill is going very well," he said. "None of the industry people I deal with have said anything bad about it."

In Poplar Bluff, Ken Parrett, president of the Chamber of Commerce, said workers' comp tort reform has been very beneficial to chamber members. He said the new law better spells out how a worker qualifies for workers' compensation and better addresses the issue of what constitutes a work-place injury.

"The change in venue shopping is a great benefit," he said. "Previously, there could be a lawsuit filed on the Wal-Mart here, and the suit would be tried in St. Louis. Not any more. Many of our chamber members have commented on the good benefits of the tort reform."