State tort reform ballot wins set stage for further battles

Voters approved physician-backed initiatives in Florida, Nevada and Wyoming. Doctors hope the approach spreads to other states.

By Tanya Albert, AMNews staff. Nov. 22/29, 2004.

Doctors in four states mired in liability insurance problems took tort reform directly to voters on Nov. 2. They were met with victory in some states but more battles are expected.

Nevada physicians had the most to celebrate. Citizens passed California-style reforms that are set to go into effect immediately. The package includes a strengthening of the state's existing $350,000 noneconomic damages cap. At the same time, they rejected two amendments advocated by trial lawyers.

Florida physicians cheered a win for their proposal to limit attorney fees but are left figuring out the impact of two trial-lawyer-backed initiatives that also passed.

Results were mixed in Wyoming, where voters backed the idea of a medical review panel but rejected a constitutional change that would allow a noneconomic damages cap. In Oregon, voters narrowly defeated a constitutional amendment that would have enacted a $500,000 noneconomic damages cap.

The American Medical Association lists all four states as being in the midst of a medical liability insurance crisis that has physicians leaving the states, retiring early or cutting back on services because they can't afford or obtain liability insurance.

Physicians at the state and national level have been pushing tort reform, including noneconomic damages caps, as a way to stabilize insurance rates for years. The AMA has been fighting for Congress to pass a $250,000 cap. Trial lawyers disagree with this approach and instead have backed reforms that include insurance industry changes and patient safety measures.