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North Carolina Senate Bill 33

On February 2, 2011, Senate Bill 33 (the medical malpractice reform bill) was filed with the North Carolina General Assembly, and so began the epic battle between healthcare providers, insurance companies, attorneys, and yes, even the general public. The topic of healthcare reform has been a major hot button throughout the country for some time now. Governor Perdue vetoed the bill on June 24, 2011, however, Republicans in the senate are trying yet again to push this bill through the General Assembly and override the governor’s veto. The final vote will be occurring today in the house.

So what does this medical malpractice reform bill actually mean for North Carolinians?

The purpose of the bill was to reduce the costs associated with medical liability. These costs include high prices for medical malpractice insurance for healthcare companies and large sums of money paid by insurance companies for jury verdicts and settlements in medical malpractice cases. The idea is that the money the healthcare providers save with these changes will “trickle-down” and make healthcare more affordable and accessible to everyone.

One of the first things the bill implements is less liability for emergency room workers. It raises the standard to which a plaintiff must prove that the emergency worker was negligent. The plaintiff must show that the emergency worker more likely than not failed to meet the standard of care and this failure was grossly negligent or intentional. The reasoning behind this is that it should save money for healthcare providers by reducing the number of frivolous medical malpractice cases and lowering the price of malpractice insurance.

Another component of the bill is to introduce a $250,000-$500,000 caps on noneconomic damages awarded by juries in medical malpractice cases. Noneconomic damages are the damages given for pain and suffering, disfigurement, loss of limb and basically anything that has to do with the resulting mental anguish. Money awarded for noneconomic damages can vary greatly depending on juries and this unpredictability causes malpractice insurance to skyrocket.

The third component of the new medical liability law is to take away lump sum payments and implement periodic payment of future economic damages that are more than $75,000. This could help healthcare providers by not requiring them to pay out large sums of money at one time and providing affordable periodic payments. However, if the patient dies the payments are no longer required and the company may not have to pay the full amount.

Sounds like a great plan to save money and improve healthcare for everyone right?

Wrong! It seems this bill mostly benefits healthcare and insurance companies. Is the money saved really going to “trickle-down” to everyday patients? Or is it more likely that it will stay with the healthcare and insurance companies? What about the injured person’s rights?

Does restricting the liability of emergency workers really encourage a higher standard of care? Holding people responsible for their actions encourages them to perform more efficiently and even motivates them to improve services and products. This responsibility encourages companies to compete with each other to be the most desired and in turn win the most customers. Taking this responsibility away could make workers more complacent and actually produce more injuries to future patients.

Raising the standard of proof so high for this special group could make it virtually impossible to sue them. This could interfere with a person’s right to a trial. If we give emergency workers less liability then who is next? All doctors? Instead of protecting this group from liability the focus needs to be on setting new standards and regulations to improve the way care is given. If you reduce the number of people injured by medical negligence then the number of medical malpractice cases has to drop. That saves everybody money and suffering, which is a win for both sides.

A cap on noneconomic damages definitely saves money for the healthcare and insurance companies, but what does it actually do for the injured party? A cap on damages only restricts the jury’s ability to decide how much the plaintiff’s suffering is worth. People in this country have a right to a jury trial and caps are taking away that right by interfering with the jury’s ability to do its job.

There are many variables that make this cap unfair. For example, people with higher economic status will receive more from economic rewards because they can show higher wages, etc., but people with lower economic status, including children and the elderly, won’t be able to do the same. They will receive substantially smaller rewards and will be forced to turn to a disability or other programs. This puts more of a burden on an already strained tax system. Yes, healthcare companies save money, but the general public will pay the price in the end.

Medical malpractice cases can cost a lot of money to take through the trial process. Some people simply may not be able to afford the trial process and medical bills without receiving noneconomic rewards. Though jury verdicts are subjective and can vary widely in their rewards, the pain, and suffering that some plaintiffs endure due to negligence can be catastrophic and it seems unfair that a blanket cap can make that determination of value. Everyone deserves the right to get a fair judgment from the jury.

These problems can be further exacerbated by the implementation of periodic payments. People who already received a minuscule judgment are then forced to wait for payments. These people often have many bills to pay, families to care for and often need further medical treatments to try to alleviate or correct the problems caused by medical negligence.

It seems Senate Bill 33 has many financial benefits for the healthcare and insurance companies, but it restricts the benefits and rights of the victims of medical malpractice. Many of these provisions have already been passed in other states and some people are finally starting to measure their outcomes. It seems that caps and other restrictions are not as effective as policymakers had hoped. An article in the New England Journal of Medicine looks at the effects of all of these reforms and even proposes some new directions.

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