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Cox's Legal Reform Bill Scores Hit With Doctors at AMA Convention : Law: The measure's limits on punitive damage awards are described as a bar to the rising costs of malpractice insurance, helping physicians stay in private practice.


ANAHEIM — Hoping to garner support for his tort reform bill, Rep. Christopher Cox told a gathering of 900 doctors here Sunday that his efforts to limit punitive-damage awards will help physicians and other professionals stay in business.

The Newport Beach Republican, speaking to delegates at the California Medical Assn.'s annual convention, said the "Cox amendment" that he will introduce in Congress this week would set a $250,000 cap on punitive-damage awards in all civil cases and help doctors and others cope with skyrocketing insurance costs.

The California Legislature passed a similar law in 1975, called the Medical Injury Compensation Reform Act, or MICRAs, but it dealt only with medical suits. Under that law, injured patients in the state may recover damages only up to $250,000 for pain and suffering. Patients can also sue for economic damage such as lost wages and costs of treatment and physical rehabilitation.

"Even with MICRA here in California, health care lawsuits are hugely expensive," Cox said. "But in New York, where they don't have MICRA, it's far worse. The average New York family pays over $5,500 each year for health care, while the average California family pays less than $4,500."

Although insurance reform legislation dealt at first with product manufacturers only, Cox and other Republicans have since tried to include "any civil action brought in any federal or state court on any theory where punitive damages are sought."

Cox, who is chairman of the House Republican Policy Committee, said his bill also seeks to replace "joint liability" with a "fair share rule" by which those who do something wrong pay for the damage they caused.

"Under joint liability, if you're 1% responsible but the other person who's 99% responsible is out of cash, you pay the whole thing," Cox said.

Throughout his speech, Cox said money-hungry attorneys are much to blame for the nation's rising medical costs.

"What do lawyers do?" Cox asked the physicians. "Well, they bring in lawsuits. And who are the targets of these lawsuits? Well, I'm sorry to say that you are. Health care providers are sued more often than any other class of professionals."

About 40% of all doctors, 50% of all surgeons and more than 75% of all obstetricians can expect to be sued at least once during their careers, Cox said.

"And what does all this litigation mean?" Cox asked. "Well, it's driven medical (liability insurance) premiums sky high."

As Cox made his speech, physicians in the audience applauded and cheered loudly.

"Mr. Cox is really addressing something that not only affects physicians but the whole society," said Ralph Ocampo, president of the California Medical Assn. The costs of insurance against malpractice suits "are driving a lot of good physicians out of practice," Ocampo said.

Cox said rising insurance costs often hurt the poor the most because they tend to require the most high-risk procedures and medical care. Because of the high cost of liability premiums when treating such patients, many doctors have stopped performing high-risk procedures, he said.

"A survey by the American College of Surgeons discovered that 38% of those surgeons refused to accept risky patients because of the fear of lawsuits," Cox said. "When unqualified personnel are therefore left to handle the poorest and neediest patients, lawsuits become an even bigger problem."

The annual convention is the policy-setting session of the medical association, with 38,000 members.

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