Inside Politics: Tort Reform is Back in Denver
By Rebecca Boyle
Two issues with a familiar four-letter word are resurfacing down in Denver, and might make more work for state lawmakers already trying to contend with an under-funded transportation system, education costs and other issues.
Tort reform is again a catchphrase when it comes to payments for medical troubles. And there is such a thing as good tort and bad tort, at least if youâ€™re a member of a political party.
One bill, shepherded through the Senate this week with the sponsorship of Senate President Peter Groff, D-Denver, would change the upper limits for malpractice lawsuits.
Supporters, including several Democrats, argue that patients should have some ability to right medical wrongs.
In this case, they say the bill is only intended to adjust the current lawsuit caps for inflation. The bill adjusts a definition used in lawsuits and increases the cap to $300,000 in cases involving awards for pain and suffering. Its intent, according to the bill, is to align caps for injury in a malpractice case with the caps already present in other civil cases involving injury.
More frequently, the phrase â€œtort reformâ€? is used to describe the need for lowering those lawsuit limits, not raising them, as Republicans say they drive up costs and only help lawyers.
Republicans and at least one Democrat said the bill would drive up costs in the medical profession by requiring doctors to get more expensive liability insurance.
That would cost patients in the long run, as doctors charge more to cover their expenses. Opponents argued that doctors may even perform extra tests, which are expensive, just to guard against a lawsuit.
Sen. Josh Penry, R-Grand Junction, said on a Senate Republican Web site that the bill moved health care problems in the wrong direction.
â€œThe crisis in health care is a crisis in cost,â€? he said. â€œThis throws gasoline on the fire.â€?
Another tort reform issue is also likely to make the rounds again this year, this one regarding auto insurance coverage for medical claims.
A gubernatorial study found this week that Coloradoâ€™s tort auto insurance system has hurt consumers and trauma care providers.
In 2003, Colorado switched to a tort system for auto insurance coverage rather than a no-fault system. Under the former system, a driver injured in a crash would have his medical expenses covered by his own insurance, even if it wasnâ€™t the driverâ€™s fault. Under the newer system, the at-fault driver is responsible for payment, and before payment can be made, someone has to determine whose fault it was.
Often, health insurance will cover injuries incurred in a motor vehicle accident, but many people have high insurance deductibles. Drivers who donâ€™t have health insurance can buy protection against uninsured motorists who might injure them, and they can add a personal injury protection plan onto their auto insurance. But some drivers who donâ€™t know about that or donâ€™t buy enough coverage canâ€™t afford their medical bills. They can sue the at-fault driver, but that might not matter if the person at fault doesnâ€™t have much money.
Insurers have said the old system was rife with abuses, including injured motorists who received auto insurance payouts for things like massages and even an aquarium in one case, which were considered rehabilitation. Since the new system went in place, auto insurance premiums have decreased throughout the state, up to 35 percent.
But at the same time, trauma care providers are often unpaid because the injured motorist canâ€™t afford to pay.
The Trauma Care Preservation Coalition said the system has cost hospitals and ambulance companies millions of dollars in unpaid bills, and that translates to higher costs for patients who can afford to pay.
Sometimes, patients simply canâ€™t pay for their care; in other cases, providers will negotiate a lower price because less money is better than no money.
The governorâ€™s policy office hired a consulting firm to examine the system, and the firmâ€™s report found that hospitals and ambulance companies have seen a drastic drop in the money they are paid for providing emergency care. In 2002, under the old system, hospitals were reimbursed for about 60 percent of the care they provided to motor vehicle accident patients. By 2006, that number had dropped to 36 percent, the report found.
At the same time, many ambulance companies and fire departments are not being compensated for their services.
In Weld County, that has even led to unfilled positions.
Dave Bressler, director of Weld County Paramedic Services, said in a press release that his and other EMS agencies are â€œcaught between a rock and a hard placeâ€? because motorists with no health insurance canâ€™t pay.
â€œAs a result, in more and more cases weâ€™re not paid for our services, and weâ€™re left with no means to recoup our costs. Our patients face bills they cannot pay,â€? he said.
The report recommends that the legislature again mandate that all Coloradans carry medical payments coverage on their auto insurance. But that would essentially revert back to the old system.
A similar attempt to require medical payments coverage failed last year at the Capitol, and itâ€™s not clear yet whether the new report will spark renewed interest in changing the system.
But it does mean that tort reform will remain on lawmakersâ€™ minds.