Opinion: Changes to MICRA will hurt consumers, state’s finances
By: Roger Peeks, MD, Chief Medical Officer, Valley Community Clinic, North Hollywood and Ellen Rothman, MD, Chief Medical Officer, St. John’s Well Child and Family Center, Locations Throughout LA County
Consumer Attorneys of California, the trade group representing personal injury lawyers, would like to change California’s successful Medical Injury Compensation Reform Act (MICRA).
They want to make it easier and more lucrative for lawyers to file lawsuits alleging medical negligence against doctors, hospitals, paramedics, nurses, community clinics and other healthcare providers.
Changing MICRA will limit patients’ access to healthcare, particularly care provided by community clinics which serve mostly communities of color, low-income Californians and rural patients. Also affected will be access to specialty care like OBGYNs, neurosurgeons and other specialists.
Further, a change to MICRA also will increase health care costs by billions of dollars each year. These costs will be passed along to consumers, the state’s general fund, and taxpayers.
Between the two of us, we oversee multiple community health centers in L.A. County. Our physicians and staff each year see more than 175,000 patients, ranging in age from babies to the elderly. We provide medical, dental and mental health services, and have facilities in schools to serve thousands of students in the L.A. Unified and Compton School Districts. All our patients are low-income, most are from communities of color.
We struggle daily to patch together funding to provide care and medication to our patients. Any additional costs our clinics incur due to changing MICRA will come directly from patient care. We strongly support MICRA as do community clinics statewide. MICRA sets forth legal guidelines when a patient is injured in a medical procedure. MICRA ensures injured patients receive fair compensation for all economic losses, while limiting speculative, meritless lawsuits that drive up health care costs and reduce patient access to care.
MICRA provides full recovery of all economic or out-of-pocket costs. Past and future medical bills are covered on an unlimited basis as are past and future lost wages. Patients can sue for unlimited punitive damages. MICRA even provides up to $250,000 in non-economic damages (pain and suffering). Finally, the law sets forth an attorneys’ fees sliding scale to ensure more money goes to patients, not lawyers.
The reasonable $250,000 cap on non-economic damages is a fair way of limiting meritless lawsuits and keeping health care costs lower. But it’s a target of the personal injury lawyers because it restricts runaway payouts and the contingency fees they can collect.
If the cap on non-economic damages is doubled (some rumors have the lawyers going for a quadrupling of the limit), it would add more than $9 billion annually to the cost of health care in California. Increasing MICRA’s cap means:
Consumers will pay more for health insurance coverage. A recent study found that doubling MICRA’s cap will increase the cost of healthcare for the average family of four by approximately $1000 per year.
Doctors, hospitals, clinics and all health care providers will pay significantly more for medical liability coverage, and could be forced out of business. California already suffers from an acute shortage of physicians. OBGYNs, rural doctors, specialty doctors and clinics serving low-income patients are particularly vulnerable to spikes in liability costs. Changing MICRA and the resulting increase in medical liability rates would make the state even more inhospitable and further limit patient access to care.
Negative impacts will be felt disproportionally by low-income and rural Californians, and communities of color. These Californians are the least able to absorb increases to health insurance costs, and already have fewer health care options to begin with. They will be disproportionally and negatively impacted if MICRA is changed to allow more lawsuits.
Costs to the State General fund will increase by hundreds of millions annually – decreasing funding for health care, schools and other services. The cost to provide health care for current and retired employees covered through CalPERS will go up. Other state budget areas hit: Medi-Cal, Healthy Families, Department of Mental Health, Department of Corrections, Department of Developmental Services. The total estimated cost to the state ranges in the hundreds of millions.
Local governments will be hit twice. Public hospitals and health facilities self-insure against claims. Any dollar spent defending against a meritless claim is a dollar not spent on care provided to California’s neediest residents. Local governments also provide health benefits to current and retired employees. Those costs also will go up.
There is no legitimate policy reason to change MICRA. California has a $28 billion dollar deficit. Unemployment is in the double digits. The economy has not recovered. There is no public outcry (except from personal injury lawyers) to change MICRA.
That is because MICRA is working. And why groups including the Community Clinic Association of Los Angeles County and community clinics throughout California, along with the California Medical Association, California Hospital Association, California Dental Association, Planned Parenthood, California State Association of Counties, and more than 400 other groups support MICRA.
We join these groups because it is far more important to preserve patient’s access to affordable, quality health care, than it is invite more lawsuits just so personal injury lawyers can have a bigger payout.