Governor unveils reform package

Friday, July 26, 2002 | 11:19 a.m.

Gov. Kenny Guinn this morning formally proclaimed a special legislative session and offered a proposal to help curb skyrocketing medical malpractice insurance rates.

Speaking at a press conference this morning, Guinn would not reveal the main item in his package: a proposed cap on damages for pain and suffering. That has been the sticking point between doctors and lawyers and Republicans and Democrats.

"I will not discuss the specific dollar amount of the cap because the Republicans and Democrats in the House and Senate are still discussing the amount of the cap," said Guinn, who has been meeting with lawmakers to discuss the issue. "I will probably wait until Sunday to recommend my own cap."

Assembly Speaker Richard Perkins, D-Henderson, said Democrats met with Guinn for three hours Thursday night to discuss each side's proposal.

"We're still talking," Perkins said.

Negotiations revolve around the level of the caps on pain and suffering jury awards, and are expected to last through Monday morning when the special session convenes.

Elements of the proposal include limiting a doctor's payment for damages to his percentage of the liability for those damages, shortening the time period for medical malpractice lawsuits to be filed, educating district court judges to handle malpractice cases and penalizing attorneys monetarily for unreasonable conduct related to civil litigation.

In addition, the governor is recommending the following:

The special session is set to begin at 10 a.m. Monday in Carson City. Guinn said he hoped the session would last three days, but he added, he has the authority to extend that time.

Guinn said calling the Legislature to the special session "is not something I take lightly." He called on the lawmakers to work quickly to address "the reforms that will preserve the health care needs of Nevadans."

"What I am proposing will make Nevada a model for the rest of the nation to follow in medical malpractice reform," Guinn said. "The inability of Nevada's doctors to obtain reasonable malpractice insurance rates is causing our physicians to consider leaving our communities and endangering the ability of our hospitals to operate with full services.

"It is critical that Nevada's Legislature enact laws that address this problem."

Speculation abounds that Guinn will propose a cap for damages on pain and suffering in the range of $250,000 to $500,000.

"I think the governor's proposals are heading in the right direction," Dr. Ikram Khan, a Las Vegas surgeon, said.

The cap is expected to split lawmakers. Republicans have traditionally been in favor of caps and reforms, while Democrats have not, citing a person's right to sue for medical malpractice. The hottest issue of the session is expected to be the proposed cap on damages.

Guinn attempted to round up legislative support for his package by meeting with Republican state senators in Reno on Thursday morning, followed by the meeting with Democratic Assembly leaders in Las Vegas.

Both sides are essentially in a game of chicken, with each willing to reach a cap, but with Republicans and Democrats offering either higher or lower caps to see how the other side reacts.

While Guinn has been involved in the talks through today, the focus of the negotiations now shifts to talks between Assembly Democrats and Senate Republicans.

The debate over medical liability rates was triggered late last year when St. Paul Companies of Minnesota, which had covered 60 percent of Nevada's doctors, abruptly pulled out of the market. Doctors were left scrambling for insurance coverage and some specialties -- such as OB/GYNs, neurosurgeons and orthopedic surgeons -- saw their rates go up as much as 300 percent over the past year.

"It's a health crisis," Guinn said. "We do not have the doctors for the thousands of pregnant mothers we have here in Clark County."

Doctors formed a task force to push for tort reforms, encouraging Nevada lawmakers to adopt something similar to the Medical Injury Compensation Reform Act that went into effect in California in 1975. Guinn's proposal contains some of the same features found in MICRA, which has a $250,000 cap on non-economic damages.

The physicians say that the severity of malpractice jury awards and settlements have gotten out of hand. By capping damages for pain and suffering, they hope insurance rates will stabilize and even go down.

But plaintiffs' attorneys dispute the impact malpractice cases have had on insurance rates and instead have blamed the problem on the insurers. The attorneys say the insurers raised rates to make up for steep investment losses when the nation's economy turned sour.

Over the past few weeks the rhetoric between the doctors and lawyers has escalated. It reached a fevered pitch on July 3 when county-run University Medical Center was forced to close its trauma center after all but one of the hospital's 58 orthopedic surgeons resigned. The surgeons said they resigned because they could no longer afford to treat the hospital's high-risk patients because of the insurance dilemma.

Lawyers fired back, criticizing the doctors for holding the community "hostage." The trauma center reopened on July 13 when surgeons were offered temporary employee status that permitted UMC to extend its $50,000 liability cap to those doctors. But those contracts expire on Aug. 26 and the trauma center's status remains tenuous, with surgeons who returned stating that they are short-staffed and stretched thin.

Meantime, lawyers and doctors have been pelting each other with newspaper and television advertisements.