CALPAC and the Liability Crisis

At the August 2002 meeting of our Medical Society Board, CALPAC Chair Dr. Robert Hertzka discussed the Medical Injury Compensation Reform Act of 1975 (MICRA).
MICRA reformed the medical malpractice insurance system in California through implementation of a $250,000 cap on non-economic damages, a limit on attorney fees, full disclosure of collateral sources of compensation and periodic payments for awards over $50,000. It has kept the doors of medicine open and has protected the health care safety net in our state by keeping medical malpractice insurance available and affordable.

I will try to summarize Dr. Hertzka’s comments. He believes that the foes of MICRA could soon be successful in their campaign to change MICRA and triple the cap. They have the votes in the Senate but need 41 votes in the Assembly. The trial lawyers raised $3 million in less than three weeks before the last elections. In three to five races, candidates who supported MICRA were defeated by those candidates who feel increasing the cap is appropriate. CALPAC recognizes that seats will open up in the Assembly because of term limits and they must have at least $400,000 to fund the defense of MICRA.

He further reported that the California Dental Association revised their dues statement by adding $60 to county and state dues. The effort was successful and they didn’t lose members. He asked us to participate in a pilot project that would raise funds for MICRA defense by adding a separate line to the dues statement that reads “MICRA Defense $50.00.” His comments lead to our Board’s action to modify our dues statement to include a separate line for MICRA defense ($50) followed by a separate line for CALPAC ($100).

I agree with the Board action. MICRA has been the single most significant factor in keeping California malpractice insurance rates under control. The “average” San Bernardino County Physician with MICRA pays $40,000 less than if he or she were practicing outside of California. (review the spreadsheet-specialty-by-specialty comparison on page S3.). The Trial Lawyers want to raise the cap on non-economic damages and/or apply a retroactive cost of living adjustment to the cap. A MICRA cap increase ranging from $350,000 to $500,000 will have a significant, adverse effect on the cost of your malpractice insurance - resulting in thousands, if not tens of thousands, of dollars in increased malpractice insurance premiums per physician. The calculus in the California Legislature is simple. A shift of fewer than ten legislators will result in the MICRA changes that will directly and adversely affect your malpractice insurance.
The most recent CMA statewide mailing to California physicians garnered only $35,000. We cannot save MICRA if we are outspent 100-1. We need to level the playing field with the Trial Lawyers.
“ Outrageous – I can’t afford another $50,” you say. How then will you afford the thousands more in premiums? SBCMS dues, among the lowest of the large counties, have not been raised since 1989. Your $50 MICRA Defense contribution comes to less than a dollar a week to ensure that your malpractice premiums don’t swell by thousands or even tens of thousands a year – seems like a pretty compelling tradeoff!
“Well, what about the rest of California Doctors – aren’t they doing their fair share,” you say. The fact is that a voluntary approach is not working. We cannot afford to wait until after the train wreck to act. SBCMS decided to take the lead and show the rest of the state how it's done. Four other counties have already joined us. And spending less than a dollar a week to save MICRA is a small price to pay for leadership.
“ Congress will protect us,” you say. Just like they are protecting your Medicare reimbursements…. The California cap trumps any Federal limit – but if Congress enacts a cap greater than $250,000, then Trial Lawyers will really push for “MICRA parity with the Feds” – and raise your insurance rates. We cannot win elsewhere and lose in California.
The SBCMS Board felt that sticking our collective heads in the sand was no longer an option. Actions speak louder than words. Join us in saving MICRA! Stay in the fight. Encourage your peers to protect themselves and all of us by joining in the battle. We need every San Bernardino County physician with us to win this war.