The Issues
"If you've got your health, you've got everything." Little is more important to us than our health. When we get sick, we go to the doctor, at least those of us with insurance and/or money. We go expecting to be helped, and in most cases we are. Sometimes, however, we are not helped. And occasionally we are harmed by a medical professional who makes a mistake. These mistakes can be hardly noticeable, or they can cause the patient irreparable harm, even death.

When patients are not pleased with their medical care, they sometimes sue the medical provider for malpractice. If a jury (or sometimes a judge) finds that the provider has been negligent and that that negligence has caused harm to the patient, the jury or judge may award monetary damages to the patient. This money is to pay for the patient's out-of-pocket expenses related to the malpractice and to provide on-going care that the patient may need. These damages can also include an amount to cover the patient's lost income, over the course of his/her life, because of the injury. All these amounts, some of which are calculated on the basis of estimates, are for very tangible losses incurred or to be incurred by the patient. Sometimes the jury or judge also imposes damages for intangibles, such as pain and suffering, items whose costs can't be measured but which are nevertheless losses suffered by the patient.

And, because medical professionals are at risk of making mistakes every time they see a patient, they do what everyone who can afford it does to deal with risks; they buy insurance. Medical malpractice insurance is just part of the cost of doing business for doctors and other providers, though it can be a large cost.

There is no debate about the fact that medical malpractice insurance costs are rising (as are the costs of many goods and services, including health care generally) or the fact that this is putting pressure on some doctors. The debate is over what is causing the increases and what should be done about it. Doctors and insurers claim that the increases are being driven by suits and damages, especially very large ones. Lawyers and consumer groups claim that these are trumped up charges, and that the real reasons have more to do with insurance companies' investments (which, like everyone else's, haven't done so well in recent years) and doctors' reluctance to have their work critiqued in court.

The number of doctors statewide continues to grow and to grow at a rate faster than population growth. In most recent years, the cost of medical malpractice insurance has risen no faster than the cost of living and more slowly than overall costs of medical care. This year, however, premium increases were much higher.

There were only 608 medical malpractice cases filed in NC in 2002, down from 678 the previous year. Evidence nationally and at the state level indicates that most medical errors do not result in a malpractice claim and of those patients actually filing suit, 5% or less receive any monetary compensation.

Why People of Faith Should Care
The faith community, when true to its founding principles, has historically advocated for the common good over those of special interests. The faith community has also sought to be a voice for and a defender of "the poor, the orphaned and the widow". When the powerful in a nation or society oppress the poor in any way, the ancient prophets raise their voices. When Jesus began his earthly ministry, he read from the Book of the Prophet Isaiah, "The Spirit of the Lord is upon me, because he has anointed me to bring good news to the poor. He has sent me to proclaim release to the captives and recovery of sight to the blind, to let the oppressed go free…" (Luke 4:18-19). The Apostle John, in writing to the early church community, pleaded, "Let us not love in word and speech but in deed and truth" (I John 3:18). A cap on medical malpractice damages would harm the common good because it would bring greater suffering upon those who have been the victims of medical malpractice. It would have its deepest impact upon the poor, who can least afford to have artificial limits placed on the compensation that might be paid to them, and it would do so to the benefit of individuals and companies of much greater financial power.

Recommendations
The North Carolina Council of Churches believes that the malpractice system is an important protection for patients and that it provides them with much needed financial assistance when they are injured by a provider's mistake. We oppose caps on medical malpractice judgments unless other ways of dealing with malpractice issues have been tried and subsequently found not to be adequate. Specifically, we support the following measures:

For the insurance industry
" Use experience rating to set rates. This means that those doctors with the worst malpractice records would pay higher premiums.
" Create a stabilization fund which would insulate insurance premiums from stock market fluctuations.

For the medical profession
" Improve disciplinary procedures of the Medical Board to make it easier to note error-prone doctors.
" Mandate reporting and disclosure of malpractice claims paid.

For the state
" Re-instate an excess liability fund to improve availability of liability insurance to nursing homes, assisted living facilities, and rural hospitals.
" Create a Patient Safety Commission in the Consumer Affairs Office of the Attorney General.
" Provide a tax credit for doctors practicing in medically underserved areas of the state.
" Provide education for people who are disadvantaged on patient rights and available courses of action.