Soaring medical malpractice insurance premiums are creating crises in many states as physicians abandon or limit their practices because of costs. In Mississippi, the legislature will hold a special session soon to tackle the issue, and theres growing public pressure for action.
Three weeks before her due date this summer, Carol Roark got bad news from her obstetrician.
Thankfully, it wasn't about her baby. But it was about her doctor's practice: he was shutting his doors for lack of medical malpractice insurance, forcing Roark and other expectant mothers in the rural Mississippi Delta town of Cleveland to scramble to find new doctors and sign up with new hospitals.
"Really, trying to get in as a new patient anywhere with only three weeks is not easy,'' said Roark. "It was very scary.''
One day before the clinic was to close its doors, 37 weeks into her pregnancy, Roark began feeling mild contractions and she and her doctor decided to induce delivery. "We were afraid if it came the next week, we wouldn't know what to do,'' she explained
Roark's experience was frightening for the town as well. The two-doctor practice was responsible for nearly all of the 600 births a year at the local hospital -- Bolivar Medical Center -- which houses a maternity wing with 300 employees. Beyond that, city fathers worried about the future. Recruiting new industry to a community without basic obstetrics services are dim, at best.
The clinic has since reopened, finally obtaining insurance with a physician-owned company here, and paying higher premiums. But stories like this and real reductions in some high-risk specialties such as neurology at other hospitals -- have brought the annual tort reform battle familiar in statehouses around the country to the forefront of Mississippi's political consciousness.
"I think the lawsuits have gotten way out of hand,'' said Roark, an art teacher. "I see it as much in small town papers . . . they're littered with these ads (on behalf of plaintiff lawyers). It's almost like `call me and we'll find a way to sue somebody.' And then you see these settlements they're getting.''
Barbara Ray-Hall, an obstetrics nurse at Bolivar Medical Center, said "the government needs to get off it and address this issue, immediately.''
Doctors and business groups allied in a failed push for caps on punitive and non-economic damages during the 2002 regular session, which ended in March. They argued that Mississippi has become a Mecca for lawsuit abuse and eye-popping jury awards.
Trial lawyers have countered that the cyclical nature of the insurance market and lost investments in the stock markets by insurers -- are the primary reason medical malpractice premiums are soaring. And, they note, other states are enduring similar problems.
"The public is up in arms over something that was created by big insurance companies and greedy corporations,'' said David Baria, president of the Mississippi Trial Lawyers Association.
Since lawmakers adjourned, the issue has only intensified.
The U. S. Chamber of Commerce issued an extraordinary warning earlier this year that out-of-state businesses faced legal peril in state courts.
Both sides have bought television time to trade accusations, and the debate here is widely seen as a precursor to 2003 statewide elections when the governor and the entire 174-member legislature will face voters.
Gov. Ronnie Musgrove, a lawyer himself, has promised to call a special session of the Legislature later this month or in early September. But in carefully choosing his words, the first-term Democrat with friends amid both the plaintiffs bar and the business community, has shied from using the words "tort reform.''
"In May, we discussed the crisis of the affordability and accessibility of medical malpractice insurance in Mississippi. I said I would call a special session on medical malpractice insurance by the end of the summer,'' Musgrove said recently in an attempt to urge lawmakers into some action. "The urgency of the situation to make certain our people have access to quality health care remains.''
The business community has long complained here that the plaintiff bar had numerical advantages on the key House and Senate committees that consider tort legislation.
But as the public pressure has mounted, the Senate leadership -- led by Democratic Lt. Gov. Amy Tuck who is elected statewide -- is pushing for broader changes than were considereding by lawmakers earlier this year before they adjourned in March.
A special joint study committee of House and Senate members have been holding hearings around the state, with each side rehashing predictable anecdotal arguments and pointing to statistics they say bolsters their own cases.
Senators on that committee are now recommending caps: $500,000 cap on non-economic damages and $3 million or three-times compensatory damages, whichever is greater, for punitive.
It is a significant departure from the Legislature's posture just months ago. And there are signs House leaders are already preparing to kill many of the proposals if they make it out of the full Senate.
Tort reform opponents may find a measure of political cover from an unexpected quarter Wall Street. Though tort-reform advocates were aggressive and organized as early as last fall in this push, opponents are now betting the litany of Wall Street scandals has dampened the typical pro-business mood among voters.
"In the court of public opinion, it has sort of reawakened people to what realliy happens in some of these boardrooms,'' argues the trial lawyers' Baria. "For us, thankfully, it turned attention away from system of civil justice and back to where need to be focussed making corporations responsible."
Insiders are betting a compromise -- one that would offer some relief to physicians facing medical malpractice suits but not the general business community -- is the most likely result. Many plaintiff lawyers even shrug off the idea of caps on punitive damages against doctors, noting that juries are rarely inclined to award those anyway.
Most concede that even if lawmakers enact caps on damages against doctors, such moves won't have an immediate impact on insurance premiums. And to that end, Musgrove is also promising to suggest some kind of immediate relief, hinting that he will propose a state-administered insurance pool for high-risk specialists.