I-330 and I-336: In general, I think that lawsuits are a poor way to control medical errors and to compensate those who suffer from them. The choice to sue appears to be affected by many irrelevant factors, including the area of the practice and the personalities of the medical professionals. The winners of the lawsuits often appear to be as much lucky, as victims of bad practices. Or perhaps not so much lucky as the beneficiaries of clever lawyers, such as the former senator, John Edwards. And the medical complexities in many of these cases are simply beyond the understanding of many jurors, especially given the rules that limit how much they can investigate themselves.
So I favor almost all efforts to reduce lawsuits in this area. And might even be willing to see them eliminated almost completely. Since I-330 promises some small reduction in these lawsuits, I will vote for it.
I-900: Performance audits for our state agencies are a good idea — even if they have the backing of the Seattle Times. (Some will be reassured by the Seattle PI's opposition to I-900.) Although I must add that I have lower expectations for performance audits than some others do.
I-901: If the United States were to ration food, as most European nations did during World War II, we would improve our health significantly. And we could also improve our health by requiring everyone to exercise regularly. But both of those measures go too far in limiting our freedom for me, and, I suspect, most people. For similar reasons, I oppose 901, even though it might discourage smoking and improve our health, on the average.
I-912: I explained why I will be voting for I-912, though somewhat reluctantly, here.
King County Proposition 1: If this is worth doing, it should be in the regular county budget.
King County Executive: Ron Sims has failed as a manager and at setting priorities for transportation. He has attacked the rights or minorities living in rural areas to a disturbing extent, treating those living in rural areas more as inhabitants of a conquered province than as fellow citizens.
And the failures of his appointees in the elections office are reason enough, by themselves, to oppose his re-election.
Though I would vote for Mickey Mouse rather than Sims, if that were the choice, we are fortunate in having a capable and decent candidate opposing Sims, David Irons. This is the easiest choice on the entire ballot.
County Council: In general, I would vote for every plausible Republican candidate over their Democratic opponent. Only in District 1, where the Democratic candidate is Bob Ferguson, is the choice even close.
Sheriff: Sue Rahr seems to have less to explain about her record than her opponent does about his record.
Port of Seattle: It is time, I think to throw the rascals out. Not that the incumbents are complete rascals, but they have demonstrated that people can shrink in office.
Posted by Jim Miller at November 07, 2005 02:26 PM | Email ThisBut at what cost?
My initial reaction would also be for this type of tort reform. However, you end up throwing out the baby with the bathwater. It isn't like the folks writing I-330 were a couple of doctors sitting in a conference room. This was written by (or at least in consultation with) the insurance industry.
Are you really comfortable with the idea that bad doctors can hide in the system?
Do you really want to force people to give up their right to sue? Sure, it is "optional" to sign away the right, but what provider won't include that language?
Posted by: Mark on November 7, 2005 02:44 PMDo the explosion of silly lawsuits cause you any personal or private cost? I hope that is not to intrusive into you business. But thats what I had to ask myself. And since my insurance company has done nothing to gurantee my rates would be lowered as a result of 330 passing, I really have NO incentive to vote in favor of it. OH AND DON"T GET IT TWISTED. It makes me puke to think I am helping lawyers get what they want: defeat of i330. I am inclined to believe the individual stories of doctors stressed by high premimums. But lets not kid ourselves who is at the bottom of this (i330): HMO and insurance companies. I cannot stand lawyers!!! at all. so I am caught. The Legisture needs to figure out this complex issue.
Posted by: Once AT City on November 7, 2005 02:49 PMInstead of focucing on that, they simply do not want to pay for the consequences when they injure someone.
I am sure everyone who has ever caused someone financial injury through their bad behavior would like to be sheltered from liability. Doctors should be held to the same standard as everyone else.
Also, people who are severaly injured with no money end up going on public assistance on the taxpayer tab when the wrongdoer should be the one paying for it.
Both 330 and 336 are bad initiatives. Vote no on both.
Posted by: Erik on November 7, 2005 02:56 PMMy current doctor will be voting for I-330.
Posted by: Sarah of WA on November 7, 2005 03:02 PM
I support I-330. I oppose I-336.
Vote yes on 330 and 336. Put them both out of our misery.
There shouldn't. However, doctors do screw up sometimes. It turns out a few of them are causing most of the damage. Letting them off scott free when the bottom 5 percent of the profession doesn't help anyone.
I-330 is great as long as you willing to have little or no recourse should you be injured.
Posted by: Erik on November 7, 2005 03:17 PMAnd NO, she didn't sue. In fact there are many people who are egregiously harmed by incompetent doctors that travel from one state to the next, that never sue. Anyone who thinks it is a walk in the park to sue, even on contingency, has never actually been through the process.
That is why I am voting NO in I-330 and YES on I-336. Doctors do not testify in court against bad doctors. The medical profession has been on the honor system for too long. It is time to hold them accountable.
Posted by: pbj on November 7, 2005 03:42 PMWhile I think some lawsuits are incorrectly decided, and jury verdicts are sometimes "too high" - do we ever hear about the incorrectly decided jury verdicts that are "too low" ? If not, why not?
Please reconsider your stance on allowing a person to have access to justice.
Posted by: Elliott Johnson on November 7, 2005 03:57 PMLet me start by saying that I believe that we could improve our care significantly and that, often, doctors and hospitals block those improvements. But, I also believe that our lawsuits -- in this area -- are little more than lotteries. There is not much relationship between medical errors and lawsuits, or awards. (And I have seen, from time to time, considerable evidence for that conclusion.)
So I want to limit medical lawsuits, because I believe they do not improve care or compensate the right people. But I would strongly support other ways to improve medical quality -- and to take care of people who have great losses from medical mistakes.
Posted by: Jim Miller on November 7, 2005 04:06 PMHow often do you hear what the results of the appeal are, or how much the judge reduced the claim? One of these almost always happens.
Personally I do not trust insurance companies or lawyers to come up with something that would help the population. Does some governor and other politicians come to mind as far as lawyers?
No on both.
Posted by: fred on November 7, 2005 04:06 PMThe premiums are high because the insurance industry is still recouping losses from their investments during the collapse of the tech bubble.
NO on I-300!
Posted by: pbj on November 7, 2005 04:11 PMI-330 would allow the insurance industry to pay the money they owe you over a period of twenty or thirty years or longer. If you died before they paid you all they owe, the insurance company would get to keep your money instead of paying it to your family.
The insurance industry is raising rates while making record profits. But even if I-330 passes, they don't have to lower their rates. In fact, insurance rates aren't even mentioned in I-330.
Under I-330, HMOs, insurance companies, hospitals, nursing homes, and emergency rooms could make you sign a contract -- before you can get any medical care or a prescription -- that waives your right to a court trial.
I-330 would put a cap on the damages you could recover in all cases of medical negligence, regardless of how bad the negligence or how serious the injury -- no exceptions even in serious cases of medical negligence resulting in brain damage, loss of limb, permanent paralysis, or death.
The few doctors in Washington state who repeatedly cause serious injuries continue to be shielded by secrecy -- and I-330 does nothing to change that.
Thanks Jim.
However, why have the public welfare pay for the care of these people injured when the doctors who screwed up should pay for them?
Right now, there is a huge portion of the populace on Social Security Disability. This is basically a federal welfare program for people unable to work....ever. It is one of the largest federal tax expenditures.
I-330 simply shifts doctors and insurance companies from having to pay for injuries to the government paying for the disabled ex-patients.
What doctors need to really do more is to weed the few bad apples out of the profession and there would not be so many injuries. If they removed the bottom 2 percent, there would be a great improvement next year.
Posted by: Erik on November 7, 2005 04:36 PMI appreciate your comment above, but you've entirely avoided two big issues. First and most important, is the fact that if I-330 passes, you will have little choice but to give up your right to sue if they maim you. That's right, NO lawsuit if they negligently kill your child. Also, it does nothing to bring medical malpractice out into the open. Lawyer discipline is entirely out in the open. You can't say the same for doctors.
If you want to oppose I-336, go ahead.
But don't ignore the real reason I-330 is being put up there. It isn't to cut rates or improve service. It is a Negligent Doctor Shield Initiative (with a little "tort reform" sugar to help the medicine go down).
I can't say that I've read the entire text of the initiative, but I've read enough. Have you??
Posted by: Mark on November 7, 2005 04:48 PMIf you supported the "three strikes" law for repeat criminals, can you really be against similar provisions that are within I-336?
Ken's comment, above, about settlements instead of jury verdicts, is counter-intuitive. Yes, doctors would want to settle to avoid a third jury-verdict, but no, they would not want to settle and immediately have their insurance rates go up. A "three strikes" provision adds an extra incentive to not commit malpractice.
Why should good doctors have to pay higher insurance rates for the mistakes of repeat-offenders?
Posted by: Elliott Johnson on November 7, 2005 04:51 PMBut Jim, cutting off injured people's right to get compensation when they can no longer work does not help them. Why would suggest that?
The only avenue left is welfare for injured people if they cannot recover from those who screwed up.
Posted by: Erik on November 7, 2005 04:56 PMI-330 has a loophole that allows doctors to refuse treatment unless patients consent to the arbitration if anything happens. Also, its definition of economic loss seem way to vague. What basis do they use to calculate economic loss for a fulltime mom or a child? How would one know if a child who got harmed was next Bill Gates? Well, these two reasons alone made me decide to vote against it.
Anytime a special interest group gets an initiative going, chances are that its sole goal is for its benefit.
Posted by: C. Oh on November 7, 2005 05:12 PMJim, why not rethink your position on 912? The state enacts so many regulations under the guise of public health that really don't demonstrably protect public health; but this initiative actually will protect public health. It protects workers who must either be exposed to toxic second-hand smoke or quit their jobs (and their industry). It is an honest act by the people for honestly good reasons, rather than the usual dishonest action of government to limit the damage caused by smokers - enacting punitive and exorbitant taxes on cigarettes. Since smokers disproportionately cost society (health care costs for themselves and those they make sick with their smoke), and irritate the hell out of people who just want to enjoy a drink and an appetizer at a bar without having to have it all turned into the sour taste of some inconsiderate smoker's cigarette smoke, it is far better for we who are the victims to simply ban their use of cigarettes when they are near us, than be satisfied when government chooses to extort money at the expense of smokers' addictions. And finally, this is not be the same as food rationing - it would not prohibit smokers from smoking in their own private areas. On the contrary, it regulates this harmful activity (OK for state to do so) by prohibiting it only in areas where smokers harm others. This is a GOOD initiative.
Posted by: srogers on November 7, 2005 06:43 PMOf course they won't. Their damages will be limted to $350,000 even if they are 20 years old with a family of 4 to feed and nee long term care.
Read the initiative.
Posted by: Erik on November 7, 2005 07:20 PM
Doctors can say that they won't treat someone unless they agree to arbitration. I have no problem with that; I'd consider it a red flag.
I can confidently say that if lawyers are for something, I'm probably against it. I just need to listen to the arguments they put across to be reminded why. That's why, I think, some of the pro-330 people named an informational website, "If their lips are moving..."
That's why I'm for 330. It defunds vulture class attorneys.
That's why I'm against 336. It was written by lawyers, and has the effect of making filings more likely. We can write an initiative to address doctor accountability.
Is there a problem with having no limit on economic damages? Do you even know what economic damages are? Did you know that we don't even have punitive damages in this state? (Oh wait, unless you're a corporation, then you can get punitive damages from an individual).
So, what you're saying is that it should be ok for doctors not to treat someone unless that person agrees (beforehand, even if they're unconscious?) that the person can never, ever sue the doctor? Do you think that doctors will be more careful, or less careful, armed with this knowledge?
Posted by: Elliott Johnson on November 7, 2005 08:37 PMHere are some more facts for you:
Percentage of malpractice cases that go to a jury that result in the plaintiff getting ZERO = 90.
Percentage of doctors who commit about 60% of the malpractice = five.
The government keeps a database on problem doctors called the National Practitioner Databank. It is illegal for the NPDB to release any information about a doctor to a member of the public.
Yet another example of the laws being written to protect those with deep pockets without regard to the other 99.9% (who, incidentally, have seen their incomes drop under Bush. But don't let me confuse you with the facts.)
Posted by: Critical THINKER on November 7, 2005 08:38 PMHmm . . . sounds like the insurance industry's gambling is to blame for the "malpractice crisis." Why is nobody cleaning out their desks, I ask? Anyone stupid enough to invest in Internet stocks deserves what they got. Also sounds like I-330 is a special-interest money grab so some billionaires can become trillionaires.
Posted by: Critical THINKER on November 7, 2005 08:48 PMRegarding other concerns, if I do not trust a doctor or do not like their business practices...I find a different one. If feel no obligation to retain any physician I do not like. If you don't want to sign their form, just go somewhere else, doctors are even more numerous than lawyers.
Having actually been through the arbitration process, I have no problem with it. Our situation was solved quickly and fairly.
Posted by: dl on November 7, 2005 09:19 PM901 is the smoking ban. ***NO on 901***
("First they came for the ...(smokers?)
and I didn’t speak up...
Then they came for me, and by that time there was no one left to speak up for me.")
No one is coming for the smokers, cough, cough. Why would they?
People just want to be free from the smokers forcing everyone to inhale their carcinogenic smoke that they insist on blowing everywhere indoors.
Smoke to your own delight three packs a day if you wish.
Yes on 901! The measure is favored by republicans and democrats alike in this election and is going to pass.
Posted by: Erik on November 7, 2005 09:54 PM This initiative also places a statute of limitations on when action may commence at three years or one year after knowledge is ascertained, which ever time frame is shorter. If you do not become aware of the malpractice until after the three year mark you have no recourse. If you are disabled (e.g. in a coma) and cannot for any reason file within this time frame, you have no recourse. This is much more restrictive than other types of civil suits.
The payout for non-economic damages will almost never be a lump-sum.
Part of a new section.
‘In any action for damages for injury occurring as a result of health care or related services, or for the arranging for the provision of health care or related services, the court shall, at the request of either party, enter a judgment ordering that money damages or its equivalent for future damages of the judgment creditor be paid in whole or in part by periodic payments rather than by a lump-sum payment if the award equals or exceeds fifty thousand dollars in future damages.’
There is too much wrong with this initiative to cover in one comment on this thread. The prior comments relating to the waiver of the ‘constitutional right to a jury’ are in this initiative. It is the wrong answer to the problem it is being presented to address. I’ve skimmed I-336, but stopped when I got to the point where taxpayer dollars may be used to pay off claims of malpractice. These are both bad answers. I suspect that Jim and Stefan have not clearly read initiative 330 and given it careful thought as they have to the other topics of their posts.
You wrote "Of course they won't. Their damages will be limted to $350,000 even if they are 20 years old with a family of 4 to feed and nee long term care."
Non-economic damages are not the same as economic damages, and only economic damages are limited by the initiative. Non-economic damages are damages awarded for pain and suffering, loss of consortium, negligent infliction of emotional distress, etc, where there are no actual damages, ie, damages that come with a receipt or an invoice, or can be calculated by, say, projecting out a gradually increasing salary over the balance of a working career. In the initiative, economic, or actual damages, are unlimited. Whatever actual economic loss the patient demonstrates at court or in arbitration will be paid if the physician's negligence or malpractice is proven to have caused the loss.
So Erik, your statement is flat out wrong - if a patient proves they have lost a million dollars in earnings due to a physician's malpractice, they can recover a million dollars, plus the actual cost of treatment due to the medical effects of the malpractice.
On the other hand, someone who is not employed or has no income can't very well say that they have lost their future income due to an injury caused by a physician. They can have all of the cost of their health care taken care of (even their "long term care"), and thus will be no worse off than they were before they sought out the health care that went awry. But being a victim of malpractice is not free pass to a life the victim did not have prior to the accident. Its just life - it might not seem fair to you, but it seems fair to me.
In between the poor and the rich are the rest of us, and we can purchase insurance, if we wish, to supplement the $350,000 cap on non-economic damages.
The last thing to remember is that medicine is as much an art as a science, and each patient is different. It is impossible to guarantee good outcomes in medicine, and actual malpractice (a surgical sponge left in a patient, for example), is very rare. The cost of these rare events is vastly inflated and passed on the rest of us in the form of charges to cover insurance premiums, and the inflation is caused by the 35% to 40% of the damages that go straight to the pockets of personal injury lawyers as contingent fees. I've been to law school; I've seen these blood suckers at the moment of their creation. I've listened to the crap that passes for a disciplined evolution of tort law - its all about income redistribution and preservation of the million dollar incomes of the successful lawyers, and very little to do with taking care of your unfortunate 20 yr old with a family of four. Call me jaded, but at least I'm speaking from experience, not your hypothetical emotionalism.
cc - Thanks for catching my mix up, I did mean 901, not 912.
Posted by: srogers on November 7, 2005 10:41 PMYou can SAY that the jury trial waiver is optional, but what prevents doctors and hospitals -- as a whole industry -- from implementing the waiver? Liability waivers are optional for dangerous sports. Do you know of any that DON'T make you sign the waiver? Heck, even your hockey ticket says that you waive the right to sue if you get hit by the puck.
Trust me. Within one year of I-330 passing, there will be forums at medical conferences called "Universal Liability Waivers, an idea whose time has come." They'll strongly "encourage" all doctors and hospitals to include the waiver so that nobody sticks out -- especially the doctors and hospitals who DO have something to fear.
As for non-economic damages, what does the 65-year old person on Social Security get if they are scarred for life? Nowadays, they'll live to be 80 or 85 or 90. They didn't lose income, but maybe they can never play in the yard with their grandkids. Maybe they can never go on that cruise because they can't venture more than 2 hours from a hospital. What is that worth?? What is it worth if a little old lady has a permanent gash on her face and has lost half her hair -- and now too ashamed of the disfigurement to go out in public... for the last 20 years of her life??!!
The doctor who did it? S/he gets to go on with his/her life. Sure, they pay a little more in premiums, but they get the rest of their life! They get to keep their tennis memberships and trophy wives.
Doctors and hospitals should be held to the same PUBLIC disciplinary standards as lawyers. OPEN cases. Let the public know who screws up.
I-336 was written by lawyers. I would bet that I-330 was written by lawyers, too... for the insurance companies, HMO's and hospitals.
I tell you what... Which of you that are voting for I-330 will let me permanently disfigure you for $350,000?
C'mon. If I can get enough people to pony up the money, which of you will let me carve up your face or chop off a leg in exchange for a $350,000 check (and payment of your initial medical bills)? Maybe I can do a bit of research and find a way to damage some internal organ and get you on a permanent waiting list for a replacement. Sure, your medical is covered. But is the loss worth only $350,000 to you? For the rest of your life??
Posted by: Mark on November 7, 2005 10:43 PMYou mention that bout 5% of doctors account for about 60% of malpractice suits. Those numbers, while apparently true, are also somewhat misleading.
What percentage of the doctors in the state of Washington practice high risk specialties? Certainly not 100%. What percentage are surgeons? What percentage are obstetricians?
I'd expect that fraction of Washington's doctors to account for a disproportionate amount of malpractice suits, because by choosing to do a dangerous and risky task in order to help others they've exposed themselves to recriminations when they fail.
I would urge you to read Doctor Bob's recent experience with surgery gone wrong and then to reconsider your stance on the "deep pockets".
Erik,
I have read the initiative, and I note that it limits the noneconomic damages to $350,000. Non-economic damages are subjective, nonmonetary losses, such as pain and suffering or emotional damage. Economic damages remain unlimited.
I also note that the "future periodic payments" that would lapse with the death of the victim are limited to damages awarded for future medical payment, care or custody, loss of bodily function and future pain and suffering. All other awards, including lost wages, would still have to be paid.
Posted by: Nathan Azinger on November 7, 2005 11:03 PMOf course, they think that is adequate. I'm sure each of the sponsors of I-330 has sold his/her own soul for less. Why wouldn't they devalue everyone else? And they wonder why people think doctors are arrogant...
Posted by: Mark on November 7, 2005 11:28 PMLets examine a typical tort dispute, on one side we have the attorney, who is part of a profession that has been actively attempting to make law impossible for a lay person to navigate without a lawyer for more than a century. In order to become a lawyer, one must be indoctrinated into the practice through three years of law school where one learns to think like an attorney (Scary). In order to get into law school, you must have a LSAT score of 167 or above, which also qualifies you to get into Mensa, so the people that are eligible to practice law are some of the smartest people in our society.
On the other side, we have the jury, in order to serve on a jury, you have to be to dumb to get out of jury duty.
It isn’t a fair fight, letting the legal profession whose practitioners have IQs two standard deviations higher than the average jury member craft cases so complex that juries have to guess at the right answer. This country would be better off if we only had 10% of the lawyers we have practicing today, that’s why I’m voting yes on 330 and no on 336 in an hour or so. I’m tired of letting lawyers pick the pockets of the insurance industry, because we I pay the premiums that the insurance industry uses to pay losses, that means those lawyers are taking money out of our pockets. It’s darn well time we took some money away from the lawyers.
1. There are lawyers on both sides. A ggod lawyer makes a case simple enough for a layman to understand, not too complicated.
2. A woman from this state recently beat Farmers Insurance in the State Supreme Court without a lawyer.
3. I-330 is far more harmful to injured patients than it is to lawyers, who can choose to simply not take medical malpractice cases.
Posted by: Wayne on November 8, 2005 08:13 AMInsurance companies are gouging the docs on one end while low-balling them on the other.
No on I-330/ yes on I-336.
Who do you trust more? The insurance companies or your lawyers?
Posted by: EastHill on November 8, 2005 01:14 PM