Citizens Vote Yes on Med-mal Caps in Nevada; No in Oregon and Wyoming

Doctors triumphed over lawyers in Nevada when citizens passed a ballot initiative that limits noneconomic damage awards in med-mal cases to $350,000 with no exceptions and limits fees for attorneys, while voters defeated similar initiatives in Oregon and Wyoming.

About 59 percent of voters approved Question 3, according to unofficial results released by Nevada’s Secretary of State office. Question 4, which would have made Question 3 null and void if approved, and Question 5, another trial lawyer-backed initiative, were defeated.

“It was a good day in Nevada,” said John Lobert, state legislative affairs senior vice president at the Property Casualty Insurers Association of America (PCI). “I can’t say that the enactment will result in some named percent decrease in the cost of medical liability coverage, but anything that limits damage awards could have a beneficial effect on the cost [of insurance].”

Dr. John C. Nelson, president of the American Medical Association (AMA) was happy with the outcome in Nevada but was hesitant to conclude that premiums would go down dramatically. He said that up until the time the cap is enacted, many lawsuits would be filed against doctors.

“There will just be a spate of suits filed,” Dr. Nelson said. “Some of them will not be frivolous and some will. In the broken liability system, in spite of them being frivolous, there will still be some payouts. Until all of that shakes out, the actuaries can’t make a decision on what the premiums should be. But even if premiums stabilize, even that’s a mini-victory.”

Dr. Nelson said that caps on noneconomic damages appear to be successful in keeping premiums down.

“In states where limits have been enacted over the years, there are much lower premiums than states where limits have not been enacted,” he said.

According to AMA, 20 states are currently facing a medical malpractice crisis, with doctors either retiring early, relocating to other states or reducing services due to skyrocketing medical liability insurance rates.

“In my own case, my premiums doubled from $35,000 to $71,000 for no reason,” Dr. Nelson said. “They’re up to $81,000 now for me this year so I’m not delivering babies anymore.”

Other initiatives to place caps on noneconomic damage awards in Oregon and Wyoming were narrowly defeated. About 50.6 percent of citizens voted “no” on Oregon’s Measure 35, which would have enacted a cap of $500,000. In Wyoming, Amendment D needed 122,824 “yes” votes to pass, but only received 114,829, according to the Secretary of State’s office. Amendment D would have changed Wyoming’s constitution to allow for a cap on noneconomic damages.

Wyoming’s Amendment C, which allows the Legislature to set up a medical panel to review cases before they enter the court system, received about 1,300 more votes than it needed to pass.

“[Amendment C] will eliminate claims that aren’t meritorious,” he said. “A medical screening panel keeps cases out of the courthouse, and you’ve lowered the cost of the product.”
Dr. Nelson said that limiting noneconomic damages was only one step in the process to assuage the national med-mal crisis.

“The game is to get a system that works,” he said. “When 70 percent of the cases brought against doctors go away and when those that go to court are found in favor of the doctor 80 percent of the time, we find it highly inefficient and unfair. We will be relentless until we get a system that works for our patients. We’re still going to work at the federal level for some kind of limit. We’re disappointed but we’re not undaunted.”

Topics Oregon