In Washington State, Medical Malpractice Lawsuits
and Costs Have Not Increased;
Limiting Citizen Access to Courts Is Wrong Cure
"Repeat Offender" Doctors Threaten Patient Care, New Report Shows
SEATTLE - No increases in the total number of medical malpractice lawsuits and payouts to injured patients in the
state of Washington, or in the size of payouts, exist to justify restricting patients' rights in
court, a report released today by the national consumer advocacy organization Public Citizen concludes. In fact, the number of payouts
decreased between 1993 and 2001, and the monetary size of payouts per doctor has dropped dramatically since
1997, when adjusted for inflation.
Physicians' groups, hospitals and their political allies are pushing state lawmakers to impose a $350,000 cap on the
amount juries can award patients injured by medical malpractice for non-economic damages - that
is the pain and suffering caused by serious injuries resulting in paralysis, brain damage and disfigurement. They claim there has
been an explosion in medical malpractice litigation. But data from government and private sources refute this claim,
and a cap would do nothing to improve patient care or relieve doctors of high premium rates.
"The facts show that the legal system is not causing a malpractice insurance problem. A rise in rates may be caused
by the economics of the insurance industry, but the number of lawsuits or the amount of damages
awarded to injured patients are not to blame," Public Citizen President Joan Claybrook said. "Rather than asking state
lawmakers to take away citizens' legal rights, doctors should be demanding that the medical
board do a better job of weeding out their dangerous colleagues."
Each year, Public Citizen ranks the performance of state medical boards based on their rate of serious disciplinary
actions per 1,000 doctors. In 2002, the Washington State Medical Quality Assurance Commission took
serious actions against only 36 of its 16,154 doctors, for a rate of 2.23 actions per 1,000 physicians - making Washington
41st among all 50 states and the District of Columbia. That is less than one-fifth the
rate of discipline in Wyoming, the top-ranked state. In six of the past seven years, Washington has been ranked 36th or worse.
Claybrook released the report, Medical Misdiagnosis in Washington: Challenging the Medical Malpractice Claims
of the Doctors' Lobby, today at a press conference in Seattle. According to the report (available on
the Web at http://www.citizen.org/congress/civjus/medmal/articles.cfm?ID=9492
):
- Malpractice insurance premiums paid by Washington health care providers decreased by 1.4 percent from 1991
to 2001, even while overall costs of medical care increased by 58 percent nationally, according to
government data. The recent spike in premiums that incited doctors' demands for caps is tied to poor investment returns in the
insurance industry, not lawsuits. Washington's premiums represent the median in the nation, with half the states
having higher average premiums and half having lower average premiums. Also, the state's malpractice insurance
market remains competitive compared with markets elsewhere.
- The number of medical malpractice payouts to injured patients per year has declined. According to the federal
National Practitioner Data Bank (NPDB), there were 225 payouts in Washington in 2001, which is 16
fewer than in 1993 and just below the average over the past nine years. The number of lawsuits filed also has remained steady
– there were only 3 percent more lawsuits filed in 2002 compared to 1994, an increase
of only one-fifth the rate of Washington's population.
- Caps on non-economic damages have not benefited doctors or patients in California. A comparison of the rates
charged by the largest insurers in Washington and California shows that the malpractice insurance rates
for doctors are about the same, indicating that a cap on damages does not lower doctors' malpractice rates. Moreover,
Washington patients benefit from not having a cap, as the average award for an injured
patient is 54 percent higher in Washington than in California.
- The cost of medical negligence and errors to Washington's patients and consumers is considerable. Based on
findings by the Institute of Medicine, Public Citizen estimates that there are 920 to 2,048 deaths in
the state each year due to preventable medical errors, costing residents, families and communities $355 million to $606 million.
The total cost of malpractice insurance to Washington health care providers, by comparison, is only $109.9 million per year.
- Despite the large amount of malpractice that occurs, health care providers are not being faced with dramatic
numbers of lawsuits. Nationwide, as many as 98,000 people are killed each year by preventable
errors in hospitals, but only one in eight injured patients or families sue.
- "Repeat offender" doctors are responsible for a large portion of malpractice payouts to injured patients in
Washington. NPDB data show that 3.5 percent of the state's doctors, all of whom have made two or
more payouts, have been responsible for 42.6 percent of all payouts since September 1990. Just 31 doctors, who have
made five or more payouts, account for 7 percent of all payouts in the state since 1990.
- Malpractice insurance premiums are an insignificant expense when compared to overall health care expenditures
in the state. In 1998, those premiums accounted for only 0.54 percent of the $19.3 billion in
total health care spending.
- No evidence supports the Washington State Medical Association's claims that doctors will abandon their
practices because of malpractice premiums. The state's doctor population is increasing at a faster rate
than its overall population, and there are now 3,720 more doctors practicing in Washington than there were in 1993.
"Damage caps hurt those who have been most severely injured by health care provider negligence. They
discriminate against those with lower earning potential and they take away everyone's legal rights," Claybrook
said. "State lawmakers must not cave to the demands of the special interests when no evidence supports their claims."
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Conflicts of Interest Demand that Wife of Virginia Senator
george Allen Decline Appointment to Dominion Resources Board
Statement by Tyson Slocum, Research Director of Public Citizen's Critical Mass Energy and Environment Program
Today's nomination of Susan Allen, the wife of U.S. Sen. George Allen
(R-Va.), to the Dominion Resources' board of directors presents an unacceptable conflict of interest. Sen. Allen's campaign and personal
finance connections to Dominion Resources now make it difficult to ensure that the public's interest - rather than his
personal financial interest - will be served. Public Citizen therefore urges Mrs. Allen to
decline the directorship. If she does not, Sen. Allen should recuse himself from voting on any legislation that would have a significant
impact on Dominion Resources.
The Allens have signed an agreement to not discuss issues involving Dominion, but it's anyone's guess how such a
"Chinese wall" would be maintained behind closed doors. Sen. Allen's spokesman has said Allen
would recuse himself from voting on legislation in which Dominion is treated differently from "any similarly situated utility," but that
does not resolve the conflict. By recusing himself, Allen will be denying his constituents their voice in the Senate on
matters involving a powerful political player and economic force in their state. By voting, his
decisions will be tainted by his wife's connections and his family's financial priorities.
Sweeping energy legislation currently being considered by the Senate Energy and Natural Resources Committee
includes significant nuclear provisions that would directly benefit Dominion. For example, the bill
endorses the U.S. Department of Energy's fledgling Nuclear Power 2010 program under which Dominion is one of three energy
companies that would be funded to pursue plans for new nuclear reactors.
According to the Center for Responsive Politics, a political action committee in which Dominion is involved,
donated $24,400 to Allen's campaign in the most recent election cycle, ranking Dominion as the
ninth largest campaign contributor in his Senate career.
Other congressional spouses - such as Susan Bayh, wife of Sen. Evan Bayh (D-Ind.); Ruth Harkin, wife of Sen.
Tom Harkin (D-Iowa); Richard C. Blum, husband of Sen. Dianne Feinstein (D-Calif.); and Anne
Bingaman, wife of Sen. Jeff Bingaman (D-N.M.) - serve on corporate boards. However, Mrs. Allen's position with Dominion
would create a relationship surpassed only by Enron cheerleaders Phil and Wendy Gramm., in which a
Congress member's spouse holds a position of power in a corporation that both enjoys a significant presence in the member's
home state and has made important contributions to the member's campaigns.
Allen's recent voting record on energy issues has consistently prioritized corporate profits over the public interest.
Last year, he voted in favor of the controversial Yucca Mountain nuclear waste dump,
an extension of Price-Anderson insurance subsidies for nuclear operators, and the failed energy legislation of the 107th Congress.
All these votes were opposed by public interest and environmental advocates but supported by Dominion's trade
association, the Nuclear Energy Institute.
Mrs. Allen herself lacks expertise in the energy sector, and her close relationship to Congress would consistently
undermine her duty of scrutinizing Dominion's activities for shareholders. Mrs. Allen's
compensation for her year-long term would be about $55,000. This could call into question the objectivity of her decisions, and her
appointment suggests political payback. Her familial conflicts should compel her to
decline this position and take a step toward ending the uncomfortably close relationship between Congress and corporate America.
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Public Citizen is a nonprofit consumer advocacy organization based in
Washington, D.C. For more information, please visit www.citizen.org.