The decision to overturn the cap on non-economic damages in medical malpractice cases adds more uncertainty about the future of health care in Missouri, but most are taking a wait-and-see approach. Missouri’s highest court threw out the $350,000 limit on July 31st in a case involving a baby born with brain injuries, ruling that the cap is unconstitutional. The cap was part of a larger malpractice tort reform bill that was passed in 2005. The other components of the tort reform remain unchanged.
The original jury in the case, Watts v. Lester E. Cox Medical Centers, had awarded the family of the infant $1.45 million in non-economic damages, which is often referred to as “pain and suffering.” Juries are not usually informed of the cap, but the $350,000 limit is applied by the judge after the trial. In addition, the jury awarded the plaintiff $3.3 million in future medical damages for care of the child. The Supreme Court also ruled that the trial court had abused its discretion in the payment schedule for future damages because it did not assure the family full compensation considering the number of years involved in the schedule, the low interest rate, and the rising cost of health care.
Various reactions surfaced immediately following the court’s action. Physicians are trying to determine what the change means for their practices going forward. Business leaders consider it harmful to the state’s economy. Gov. Jay Nixon is reviewing the decision, but has not commented on the chances of reinstating the cap. Former Gov. Matt Blunt, who signed the 2005 tort reform package while he was in office, expressed his disappointment in a recent interview and claims it will destroy Missouri’s ability to create jobs. Because of the ruling, a constitutional amendment is the only route to reversing the decision, and because this is a highly politicized, controversial issue, an amendment is not likely.
Most medical malpractice insurance companies have been watching this case closely and, considering the current political climate in Missouri, are not surprised by the decision. Executives and underwriters at some of the larger insurance companies don’t believe the change will have an immediate effect on payouts since malpractice cases take several years to complete. Companies have been preparing financially for this possibility for several years as the Watts case made its way through the court system, so do not expect any immediate rate reaction from malpractice insurance companies. It is advisable that physicians look carefully at their insurance company and make sure coverage is with a strong, financially stable carrier doing business nationally and having experience in states that have overturned tort reform.
There is no doubt that with all the changes ahead as a result of the Affordable Care Act and the concern over defensive medicine, those in the health care field will be carefully following the change.