WEEKEND EDITION: June 16, 2002
For the first time since Nevada experienced its latest medical malpractice insurance dilemma, physicians, insurers and lawyers will sit around the same table in search of answers.
The informal gathering Monday in Las Vegas, with Gov. Kenny Guinn presiding, is expected to draw 12 to 15 people. Guinn has said that if the participants can reach a compromise within 45 days, he'll call a special session of the Nevada Legislature to vote on their proposal.
"He is not going to prescribe how many meetings there should be or who will be at them," Guinn chief of staff Marybel Batjer said. "At this time he doesn't plan to be at any more meetings."
Expected to represent the physicians are members of the Nevada Medical Liability Physicians Task Force, an umbrella organization formed in January that includes the Nevada State Medical Association, Clark County Medical Society, Clark County OB/GYN Society and other specialties.
Their representatives will include political adviser Pete Ernaut, who was Guinn's former chief of staff, task force chairman Dr. Robert McBeath, a Las Vegas urologist, Dr. Ikram Khan, a Las Vegas surgeon, and Dr. Weldon Havins, special counsel to the task force and chief executive officer of the Clark County Medical Society.
At the top of the physicians' wish list is for Nevada lawmakers to adopt a tort reform law passed by California in 1975. Among the law's features are a $250,000 cap on non-economic damages such as for pain and suffering and limits on contingency fees that attorneys may collect in malpractice cases. Physicians say the law has stabilized liability insurance rates and kept doctors from leaving California.
Larry Matheis, executive director of the Nevada State Medical Association, said that California passed its law in the midst of a medical malpractice insurance crisis "and they haven't had a repeat of that crisis."
"Doctors in Los Angeles pay half of what doctors in Las Vegas pay for insurance," Matheis said. "You have to say that what they passed has something to do with that success. That law has had a 30-year track record so it would make sense for us to start there.
"Right now we have doctors that can't get insurance at any price."
Las Vegas attorney Jim Wadhams, a lobbyist for Nevada's insurance industry, will attend on behalf of insurers. It is possible that individual insurance company representatives will also be at the meeting.
Wadhams said he supports California's tort reform law but does not believe that that law would solve all of Nevada's problems. He said he supports any proposal that would attract more insurers to Nevada, which would make the industry more competitive and help hold down rates. One suggestion he has is to deregulate medical liability insurance rates, which are currently under the purview of the Nevada Insurance Division.
He also said he favors requiring plaintiffs in malpractice lawsuits to carry bonds that will help pay for litigation costs in the event the defendants win the case. And he favors a system of predictability that makes it easier for insurers to know how much to charge for liability coverage.
"One of the problems we have had is a system that sometimes keeps rates artificially low," Wadhams said. "When insurance companies are asked why they have not raised rates it's often because the state will not let them raise rates from time to time.
"Big insurance companies write so little medical malpractice insurance in Nevada that it doesn't hurt them to leave here. I would like to see more locally controlled companies that will take better risks and hire better lawyers to defend the doctors."
The Nevada Trial Lawyers Assoiciation will be represented by Reno attorney Bill Bradley, a past president of the organization and one of its lobbyists. Also expected to attend is Las Vegas attorney Dean Hardy, another past president of the association and co-chairman of its political action committee.
The lawyers oppose the California law, saying it is unfair to malpractice victims and has done nothing to stabilize insurance rates in California. One of their proposals is to prevent insurers from raising rates if they are forced to pay a large jury verdict that could have been much smaller had they settled with the plaintiff.
"We want to hold insurance companies accountable for their unreasonable and arrogant decisions in settlement negotiations," Bradley said.
Bradley also said that medical professionals who know of malpractice should be compelled to reveal that information before the matter becomes a lawsuit. Often, he said that information will not come out until there is a trial. He said such information should be revealed before the state's Medical Dental Legal Screening Panel, which is designed to weed out frivolous lawsuits.
"At the present time there is a conspiracy of silence," Bradley said. "We would also like hospitals to report medical errors."
As of now the only area of consensus is a desire to make the screening panel more efficient. There is agreement that the panel, which often takes 18 months to rule on a potential case, should reduce that time frame to between three and six months.
The six-member panel consists of three doctors and three lawyers who serve as volunteers and hear cases on a rotating basis. There has been talk about making panel members more permanent.
Of the claims filed since 1998 that the panel determined involved no malpractice, 65 percent still resulted in lawsuits. Doctors see that as evidence that the panel is not working as intended.
"We want to explore ways to discourage claims from being filed in court when the panel finds that there was no malpractice," Matheis said.
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