Governor hopeful he can bring doctors and lawyers together

Erin Neff

Tuesday, June 11, 2002 | 11:12 a.m.

Gov. Kenny Guinn expressed cautious optimism Monday that the disparate sides in the state's medical malpractice crisis can come to a consensus in the next 45 days.

"If so, I will call a special session of the Legislature," Guinn said Monday at a press conference in Las Vegas packed with doctors, lawyers and insurance representatives.

But that consensus will not be an easy one to reach on one key issue -- capping so-called pain and suffering damages awarded in medical malpractice cases by juries.

"I haven't heard anybody say they are 100 percent opposed to anything," Guinn said.

"With caps, maybe it's not the issue but the number. Should it be 250 (thousand dollars), 150? Is 250 the right number for today?"

If the different parties -- who will hold their first joint negotiating session June 17 -- come up with consensus on a host of minor reforms, but not on caps, Guinn said he does not know if he would convene the Legislature.

"I'm going to wait until we see it," Guinn said. "When you start talking about a specific (cap) number, it might not be at the heart of what today's market is.

"We have to find out if they come to some number in concert with other reforms and find out how would you treat it if you're an insurance company."

Guinn also said he would not convene the Legislature for anything other than a quick "vote up or vote down" on a reform plan.

Bill Bradley, a lobbyist for the Nevada Trial Lawyers Association, said his group has been critical of caps based on what has happened in other states that have limited non-economic jury awards.

In those states, he argued, neither insurance premiums nor health-care costs have been reduced.

But, Bradley said, trial lawyers are looking forward to the talks.

"We've wanted to sit down for a long time," Bradley said.

"We're interested to see what the insurance industry, in particular, thinks."

Jim Wadhams, a lobbyist for the insurance industry who will participate in the talks, said he believed the negotiations will be helpful.

The groups could start hammering out consensus on several minor issues, including the state's medical dental screening panel for malpractice cases, he said.

Ultimately, he said, consensus "may not mean the level of the cap, but that you have a cap."

A total of seven different doctors groups, including the Nevada State Medical Association and the Clark County Medical Society, have formed a task force with their own lobbyists and public relations firm, Mark Brown & Associates.

Dr. Ikram Khan, a general surgeon who serves as Guinn's liaison to the task force, said doctors have reached consensus within their profession.

"I'm glad to hear that caps are on the table," Khan said.

Khan said he was not sure if the different sides can reach agreement on caps and other malpractice reform issues, but he added: "I think we don't have a choice for the people of Nevada."

The state's medical malpractice crisis erupted last December after the St. Paul Cos. -- the largest insurer of the state's doctors -- pulled out. Doctors were quoted astronomical rates if they could find replacement insurance, and many threatened to leave the state.

Guinn created a state-run insurance underwriting association, which to date has received 895 applications from doctors. Guinn has also amended the rates offered by the state's insurance plan to include coverage for acts committed under the old insurance and to eliminate a tiered structure of rates for obstetricians based on the numbers of babies they deliver each year.

Some doctors groups have demanded that Guinn call a special session of the Legislature, which is not set to convene until Feb. 2.

Recent calls for a special session and criticism by some health-care professionals about Guinn's handling of the crisis, resulted in unusually testy statements from the governor Monday.

"I've worked very diligently since Jan. 23, when it was first brought to my attention," Guinn said. "I think I acted as quickly as I could have under the law.

"This is my schedule and the way I work, not the way other people would have me work," he added.

On June 18 Guinn will take another step toward a short-term fix to the problem when he asks the Interim Finance Committee for $215,000 in emergency appropriations to hire four additional employees for the state's medical dental screening panel.

Pamela Mackay, the state's deputy insurance commissioner who is in charge of the screening panel in Las Vegas, said it is very difficult to manage the caseloads and convene the doctors and lawyers for up to 20 hearings a month.

"I've even offered to baby-sit for them during the hearings," she said.

The additional staff would be a short-term fix to handling the cases, Guinn's chief of staff Marybel Batjer said. Currently the state has three employees assigned to the screening panels, two in Las Vegas and one who splits time between Reno and Las Vegas.

Over the next six days, representatives of doctors groups, trial lawyers and insurance companies will determine who will sit at the table beginning Monday. It is hoped the representatives will come to consensus on some of the issues even before Monday's first meeting.

Guinn said he will attend the first meeting to explain his expectations to the group. The group will give status reports to Guinn and to state Sen. Mark Amodei, R-Carson City, and Assembly Majority Leader Barbara Buckley, D-Las Vegas.