jinian | initiative 330/336 kerfluffle (Reply)

(Thank Wim for his fine proposition post if you like this one, since he started it.)

Initiative 330: Capping noneconomic damages for patients and allowing them to be paid out periodically rather than as lump sums. Yes, I read the whole thing. I don't like either camp on this; the statements for and against are both alarmist and misleading where not actually false.

I agree with some things in this initiative, such as the limitation of responsibility for a doctor who wasn't actually involved in whatever mistake yielded a suit against a patient's medical practitioners, but nothing is said about how to determine whether a particular doctor is supervising, or whom you do get to sue. A medical-injury lawyer would be able to tell me, I'm sure. That lawyer's fees, by the way, would be limited in a way that strikes me as okay under this initiative, though I doubt juries are credulous enough to think a whole settlement amount they name will go to the patient.

I don't understand what is accomplished by the repeated inclusion of "don't tell the jury there's a maximum awardable amount," so it seems remarkably fishy to me. Furthermore, it sounds like the main reason people are meant to vote for the initiative is so insurance premiums will go down; do they think that's going to work? Paying lump sums to patients who have already gone into debt to pay medical bills seems perfectly justified, and allowing insurance companies to pay over time could be a real detriment to patients in that situation. While ceasing to pay periodically upon patient death unless there are dependents makes sense, I really don't like that those dependents would have to petition the court specially to get payments continued. And I find the "heirs might get a WINDFALL if a patient gets a lump sum and dies right away, so we have to stop that" idea petty and stupid. God forbid anyone get an inheritance reflecting a settlement their parents had, those poor people don't know how to deal with money at all.

Voting against.

Initiative 336: In which several totally different things happen. These two are set up as opposing initiatives, so supposedly if I don't like 330 I will like this one. And I do like most of it. I'm suspicious of some bits. What is the problem with multiple initiatives exactly?

Good ideas:

Patient advocacy representatives have to be included in the state medical quality assurance commission.

Patients get more rights to see and keep their own medical records.

Possibly good ideas:

The state gets into the "supplementary" malpractice insurance business -- I wonder how often this would be useful and whether it would really support itself, and if it does support itself that's weirdly socialistic for this state.

Public notice of malpractice insurance rate changes -- how useful is this really going to be, even with cash bonuses for people who help the courts in some unquantified way?

Doctors losing three malpractice suits in ten years can have their licenses revoked, but the licensing agents can decide not to revoke them if they can justify that by way of rehabilitation or reeducation for the doctor. This actually seems pretty even-handed. I just wonder why licensing agents don't revoke licenses in these situations already.

Suspicious ideas:

Limiting the number of expert witnesses in a medical malpractice trial to two, "except upon a showing of necessity." I see no good reason for this. Are courts plagued by overlong trials due to expert witnesses now?

Requiring a "certificate of merit" to be filed for some kinds of lawsuit -- I don't know what "under this chapter" means here. Frivolous lawsuits only, or all malpractice?

Undecided. I'll think about it in the morning.