Miller's Court; Tort Reform

Miller's core it is brought to you in part by the Wyoming State Bar to regulate the practice of law assist attorneys in providing competent and ethical legal services and educate the public about the legal system. Hello I'm Arthur Miller I teach at the Harvard Law School maintain an active law practice and I'm pleased to work with PBS from time to time on special programs such as the one you're about to watch. We're here today to explore the area of tort reform a proverbial hot topic with politicians these days. And something that the United States

Congress and many state legislatures are considering new laws to address. Their actions will impact all of our lives. I've asked directly if we become parties to a tort based lawsuit or indirectly in the premiums we all pay for insurance or in the prices we pay for goods that are marked up by the companies that make them to pay insurance premium. What exactly is tort reform. Well first of all a tort a tort is a private or civil not criminal wrong. Or injury to an individual's person property or reputation for which the injured party seeks compensation and perhaps punitive damages to punish the wrongdoer. Some see this kind of lawsuit as an unfair litigation where individuals seek unreasonable sums for civil injuries. One study concluded

that the cost of the United States court system in the year 2002 was two hundred and five billion dollars. That works out to seven hundred twenty one dollars for every citizen in the country. Others see tort actions as an efficient method for compensating victims and for punishing perceived wrongdoers and for encouraging people to be more careful and manufacturers to make safer products. We're here today with a very distinguished panel of experts and we're going to explore first whether there really is a problem with tort based litigation. And second if there is a problem how should laws regarding torts be changed. So joining me now for the next 90 minutes in Miller's court. And you can be the judge. First let me have this panel introduce. Himself or herself.

Mary I'm Mary Alexander. I'm past president of the Association of Trial Lawyers of America and I represent people consumers who are injured. Personal injury in San Francisco. Dr. Richard Anderson I'm a medical oncologist and chairman of the doctors company the doctors company is a physician on medical malpractice suits who are operating in all 50 states senators slash Doctor John Barrasso orthopedic surgeon in Casper Wyoming and also a member of the Wyoming State Senate. Yes. I'm an attorney with the Casper law firm of Brown drew and Massey and I specialize in the defense of tort actions. A big part of my practice is the defense of medical malpractice actions. Timothy Hallinan I am a practicing physician in Gillette Wyoming where I've been practicing for the last. 21 and a half years. And I'm also a member of a hospital board of my community.

Justice Marilyn Kight. I practiced law in Wyoming for a number of years and I currently serve on the Supreme Court. Rob. I'm. Rob Shively. I practice in Casper Wyoming. Both plaintiff and defense. Of Al Simpson are retired U.S. senator and practicing keeping my two sons alive in practice. I don't have a firm of a Bergsten Eldridge Hirsche and Giardina and Simpson Keppler and Simpson Gerry. I'm Gerry Spence. I represent people against the non living corporate entities and I represent people who have been charged by the massive power of the state. I'm Rhonda Woodard. I practiced law in Cheyenne Wyoming. I represent people who've been injured and I've also been involved with the Weinman Trial Lawyers Association in lobbying in the legislature against tort reform.

So you see we have the entire spectrum represented and we even have some people whose judgments may be balance. Now. Marry. Do like the words tort reform I don't like the word because I think that it misrepresents what we're talking about. We need to in this country make sure that people's rights are protected. Their ability to go into court and seek redress when they are injured by other people and tort reform makes it sound like it's something that's good. And in fact what we should be calling it is tort reform taking away the rights of people. And we see for example in the state of Wyoming and also in the United States Senate and House that they're trying to take away people's rights to go into court when they are severely injured by doctors to put a cap. And that's what they're calling tort reform to put a one size fits

all cap on what people who are most severely injured by the by doctors and to say to people like Linda McDougal who had a double mastectomy when she had didn't have cancer that her injury is only worth $250000. Are the parents of Jesica Santillan who died as a result of a botched heart lung transplant. Our young men in my state of California who went in for a simple operation for a hernia got an infection that wasn't diagnosed he went into a coma and he woke up and they had had to remove all four limbs because he got gangrene. These types of injuries Congress are people who are interested in tort reform. They want to say one size fits all for all of these the most severely injured and guess who it hurts the most. People who are most severely injured seniors children women of this country.

So I guess this means you don't like the word support. Is that a fair restatement of your position. To be blunt. No I don't. OK. Now now Doctor how can it. She's talking about the American way the ability to go to court to redress your grievance. That's American It's apple pie it's baseball. You have any objection to that. Well I really don't have a speech prepared. Like my when I distinguish coed panelists here I think that was definitely a speech. I noticed you didn't call a colleague what I would say is that. To balance out the American way is also to be able to go to your family doctor and get medical services or go to your community hospital and get the services that you need to take care of whatever ails you. And there's one of the doctors here in the audience today tonight out here a

colleague of mine from Newcastle in that community the insurance rates have gotten so high that there is no obstetrical coverage within 60 miles of that community. So you have to balance these American Pie rights on one side and you have to balance that against the community need. And I think those of us who believe. I don't know if tort reform is the best word for it either. I don't think most people know what tort means but certainly my students if there isn't some balance in this in this crisis then on the one hand people are going to lose medical services and on the other hand I think that if tort reform. Doesn't come about some of the awards and things that that we believe and I agree that people have a right to recompense when they have an injury. But if there is I think the way it's going now that system is going to go bust. So I think we need to have

reforms to bring some balance into that system. I don't know what the best way is but I think it's needed now. Alan this has really become politicized hasn't always been. And it's it's a brutal thing now. I don't like the word tort reform. I like reliability justice. That when you go to court there's going to be a reliable commonsense result not the lottery award of the Year from you know a big hit. And for every one of those stories that my colleague speaks I can tell you the other one is the kid who goes to summer camp and comes home sunburned because the counselor could not rub the stuff on the kid's arm or be charged with unlawful touching. I mean there is a bizarre a.. I mean coffee is hot. You know I mean what the hell doesn't anybody know that coffee

is hot. And I think we've reached absolute wretched excess. And I was formed up look at you. Did you see that. Look he's he's we. We formed the Wyoming trial lawyers together but I don't ship. Well aren't aren't both you and Mary at a certain level just talking about anecdotes. You obviously were referring to the McDonald's coffee cup cake. Which was just as much of an anecdote as the sad events that Mary were count. That's what you learn in politics if they're going to use things on you of emotion fear guilt or racism you learn to play the same game because those who use that have gotten away from facts. If you lose facts that you got to know is there guilt for racism. Oh now we're going to be bothered by the fact that.

The facts are that in this country the number of lawsuits that have been filed in federal court have remained the same per capita since. Seventeen seventy six. And that the number of lawsuits per capita is not increased nor has the actual not only verdict but payouts by insurance companies. What has happened in the tort reform is that we have not looked at the actual facts and that in this and we we look at it the pay outs for insurance companies and medical malpractice has been only one hundred thirty five thousand dollars per case. And what we see is that has been driving this is the insurance company's profits have gone down to just one hundred and five dollars I said in my opening you calling me a liar. Of course it's not my theory. No it's a tort reform thing here. And you know what I thought of when you said that. What is the per capita for

each person in this country for the Enron debacle. I've heard figures of $60000 per person for the mismanagement and the fraud and the deceit that went on in Enron. She got me. Yes. I is it moderate. I know I have you know dumping out those cute little you know figures and I'm thinking of my pal over here. My my junior colleague Mr. Simpson Senator Simpson and his coffee cup analogy do you remember the real facts of that case. One of my students tried that case. I want to tell you the truth. The fact is what you wouldn't understand because it burned her vagina about three levels of burning of the vagina. Not at all. You do. How do you know I've done this before. But bring up all of it. Get this jury of the Nation on your side howling is not what we have do but we have to really get to the situation to Donald.

You've got to give me a chance. McDonald's. Has been burning people for I don't know how long and knew it and had had a head case after case after case and finally somebody says maybe McDonald's ought to quit burning people who don't know what's going on. In fact there were seven hundred complaints. So yeah. Listen to that 700 come back. I never heard of that. Well I know you don't listen to it. I'm listening. Oh those the only of the fact of the only facts you want to get. Well I just needed to kind of straighten that young fella out. 74 and I'm 72. We've done cases together we didn't lose any of that. What is there to resolve these claims. And in the state of Wyoming what we find is that that reliable source is the jury and the facts in Wyoming show that our juries are conservative.

Our juries are made up of people who are neighbors who are friends who are co-workers and they listen to the facts and they decide based on each particular case what is right is there. And our jurors are the ones meant members of the citizenry that have elected year after year. My friend Al Simpson so you know how conservative they are. Is terrible. I think our goal. Here is what happens to medical malpractice premiums. They don't here the availability of of care to the Acampora County for instance where there's been three physicians that have been denied medical malpractice insurance. They don't hear those things and I agree that I'm a supporter of the jury system. I'm a trial lawyer myself. I think we need to continue this debate as far as towards in front of a jury. That

the fact is that it's not just the jury awards. In fact as I said I don't think the plaintiffs part here can ever say we don't have a million dollar award in Wyoming and a medical malpractice case there was one for nine hundred ninety nine thousand nine hundred ninety nine dollars which is a million dollars just what two or three weeks ago. So that was a word that I think really highlights the problem and that is my understanding that there were very few special damages. This woman didn't have a lot of lost wages. All of that almost the entirety of that near million dollar verdict was for non economic damages the very thing that we're talking about and we talked about caps is that where the beef is it's not with the the the real economic damages the medical expenses it's with what does the euphemistically called pain and suffering. Exactly.

It was when Mary was talking about this this person who had the four levels removed. That person will be able to recover under a system with caps will be able to recover all the economic damages could be millions in past and future lost wages could be a million easily or more millions in past and future medical expenses. They could be compensated very well for that. The issue is the non economic damages the pain and suffering and so forth that frankly money isn't going to return those legs and that I agree that money is the only way to compensate for some of those things. But I agree with Dr. Helen in that we need a balance and that's really I think what this debate is all about. What is the appropriate balance. I think if if my fellow panelists want to argue that it's OK for an 81 year old woman to drive a car with a hot cup of coffee between her legs I

think we're probably not going to reach agreement on that. I don't think probably it would be a particularly good idea for someone to drive a car. It's a hard sell. People who are 71 something that I'm I recognize recognize that fighting maybe you're fighting demographics but I would take it a step further. I don't think it's a particularly good idea to drive a car with a cold cup of coffee between your legs. But let's let's let's. Let's go back to the issue of facts as they relate to the issue of medical malpractice today. It is a fact that if you're a neurosurgeon in the United States today you have a 50 percent likelihood of the reporting of malpractice claims every year. It means that on the average every neurosurgeon in the United States today everyone is sued every two years. If you're an obstetrician delivering babies if you're an emergency room physician if you're a trauma trauma surgeon if you're a general surgeon one third of

all are specialists in those areas you'll be sued every year. The average practitioner or the average specialist in those groups will be sued every three years. And what is the nature of those suits. We find that 70 to 80 percent of all those suits are without merit. So we have a tidal wave of litigation. In fact there is a tidal wave of litigation we have 700000 doctors in the United States today as we speak. There are more than a hundred and 25000 open claims against our 700000 doctors and new claims are being opened at a rate that exceeds 12000 a month. It's a fact that 70 to 80 percent. Are without merit. It closed with no payment. And it is a fact and incontrovertibly fact that over the last 25 years the medical malpractice industry as a whole has paid out a dollar 20 for every dollar of premium it has collected and in the

last two or three years that figure is a dollar 40 for every. Don't feel overwhelmed Rhonda. You know I don't feel overwhelmed. The fact is that there is a big question about what is actually a claim. Oftentimes if that doctor gets a phone call saying I want your records about something that they call their insurance company that may be a claim. And truly no injured person is going after that doctor. If I may define claim a claim is a demand for money. It is not a medical records request it's a demand for money but not necessarily a lawsuit. Not necessarily a lawsuit. It is a demand for payment. And the fact is in the state of Wyoming and I'm sure that this is true in all other states in the country in order to pursue a lawsuit against a professional you have to have another professional in that same specialty area that is saying this doctor Nast it we file a

lawsuit against the doctor for medical malpractice if we don't have an expert on board ready to say yes that the doctor messed up then we're going to be thrown out of court. And in our state we don't see any evidence that there are those kinds of cases being filed where they're being filed without having an expert on board. So somebody in that field in that profession is say yes there is merit to this claim otherwise we won't be in there. Seems to me that what Dr. Anderson just gave us was proof that the system really works if we take is true and it is a fact that I have heard really since I started practicing law that in that the number of lawsuits has not increased per capita really almost since the inception of the nation. And if they're handling that number. Of claims however they are defined each year. And I didn't hear Dr. Anderson say that they're not making a profit.

Sounds to me like the system of you you hear me say it then let me say it. We're not making a profit in what year. I'm really sorry about the doctors company not making a profit but overall. In this country there is a 6 billion dollar. Fund. From which only four billion dollars have been paid development medical malpractice. And really we ought to we ought to put this case and this whole thing in perspective. This isn't the issue of doctors against lawyers or doctors against the patients. This is an issue about people against corporations and corporations against people in order to forward their own profit interests. I'd like to put up. Some statistics here. First of all the general accounting office. Of the United States which is that impartial area that reports to court. Has just come out with this statement. Its latest gee a report says that there is no medical malpractice crisis that they have American Bar the

American Medical Association has misled the public and the legislatures and the media and even the doctors saying no paraphrasing I'll paraphrase. Oh that was nice of you to ask me that because now I can quote from my seven pages of the General Accounting findings among which it says. That the problems that we are are dealing with are limited to scattered often rural location and that we quote We also determined that many of the reported physician's actions and hospital based service reductions were not substantiated or did not widely affect the mental health care of the physical health care. So there you have it. I have seven more pages of good luck here. I actually run a report right here just to check. Let me just say you're working in Congress.

We tried to abolish the GA. No I don't doubt that at all. There was there was a reason for it not this issue. There there were with Ted Stevens who was the chairman of the Appropriations Committee the GSA all came out with stuff which was so bizarre through the years that the motion was made to abolish it. And I've been the target of some of their stuff for immigration. But I have to tell you something but I wake up early in the morning. On days. I am dragooned into this kind of work and I try to contemplate the range of things that will come up that never in my wildest dreams did I think that we'd be talking about the abolition of the G-8. I guess I'm getting very narrow. Well this this is a time. For the subject of tort reform the issue is do we need. Will what the doctors are proposing do anything for what he's

complaining about. And the answer is No. Putting caps on pain and suffering has not and will not do anything but what they complain about which is their premiums and access it reduces pay. What I assume is the aren't. Actually it does not and we have six shot that well let's take California because I'm from California practicing for 20 years. And that's what they want to do is put it into law in this state of Wyoming and the country what we have in California and have since 1975 which is a $250000 cap on pain and suffering. What is the history. Speak to the senator. I hope you think intention. What we have seen in California. Is that the premiums that the doctors have paid have remained about the same over the years and in fact we are just slightly like 2000 higher than states that do not have caps. What happened in California in 1975 we passed the cap of $250000 and you

know between that in 1988 people are surprised to learn that the doctor's premiums went up. Are you ready for this. Four hundred and fifty percent. The cast didn't do anything to keep their premiums down. What happened in 1988 the people of California passed insurance reform prop 1 of 3 and that call for a roll back of 20 percent of their insurance premiums for doctors. It called for that. Insurance companies would be no longer in California. Subject to exempt from anti-trust laws. Did you know Arthur that insurance companies and major league football are the only corporations in this country that are exempt from antitrust laws. That that means insurance companies can get together collude set prices at their premiums. They can't do that in California since 1988 and that meant that they also had to come in and ask for increases in their premiums they had to justify them. So that's what if anything stabilize premiums in California since

1998 but they don't want to talk about that. They just want to say California California $250000 or out now. Now we have a three legged race. We have the doctors the lawyers and the insurance company. I don't think you do I think you have a search for truth and in my humble opinion that that statement was breathtaking in the distance it took us from reality. I have this very subtle way of speaking and I must be the wine. Let let let's talk about some of the things that Ms Alexander said. Mike Rowe the fundamental tort reforms that are present in California that do include primarily are fundamentally a $250000 cap on noneconomic damages only and in a single run on sentence. It is important to emphasize that there is no cap whatsoever on total damages in California we get 20 30 $50000000 verdicts in

California. The only thing that is count are the pain and suffering damages that that's important. Point number one point number two is that if you compare California to the rest of the country since 1975 through 2002 and it doesn't change in 2003 average insurance rates for physicians in California have gone up at one third the rate of the rest of the United States. Now Mr. Alexander talked about Proposition 1 or 3 Proposition 1 0 3 was a go to referendum was passed by the voters in California. It is the law of the land in California. It was passed primarily to control auto and homeowners rates. However in fact it did apply to every insurance company in the state of California. Now Ms Alexander wants to say that the relatively reasonable local malpractice premiums in California are a function of Proposition 1 or 3. The fact is that Proposition 1 or 3 was passed in 1989. By that time California rates were already dramatically lower

than the rest of the country number one. Number two the California medical malpractice insurers had their hearing with with the commissioner of insurance in 1991 as required by Prop 103 at that time the commissioner of insurance in the hearings ruled that the physician own insurance companies and the vast majority of California physicians as is true throughout the United States are insured by companies that they themselves on these mutual companies. We don't they're not responsible to shareholders. They're not looking for independent profit. Profit goes back to physicians themselves who own the company. If there is any profit in the form of dividends and the commissioner of insurance in 1991 ruled that in fact the dividend policy of the California insurers was such that no rate rollback was necessary and in fact until last week where by historical quirk there has never been a single not one medical malpractice premium increase that was overturned by Prop 1 or 3.

It is a fish to bicycle's comparison fish bicyclists like Davis. Schwarzenegger comparison possibly So how about. I just want to know Senator John how does this play to your legislative slash medical ear. I'm concerned for people who live in Wyoming who want to get to a doctor. People in this room have the connections to get to a doctor no matter what happens. But a lot of people around the state of Wyoming don't. Right now we're rated 47 of the states in terms of the number of doctors per capita for people that live here and we're seeing doctors either relocating retiring early or restricting what they do in terms of the family physicians who are no longer delivering babies because the cost of the premium of their malpractice to deliver the baby costs more than they can charge. To do the delivery. So the concern is health care availability for people in Wyoming as a physician I talked to the other day and

Senator Simpson's hometown 23 years never a suit. Now one suit hasn't gone to trial. No settlement nothing. He's already told that he's likely to lose his malpractice insurance here in Wyoming unless you pay some huge premium above that he's going to be very highly recruited to leave the state and delete Senator Simpson's community. And the problem is we're having a very difficult time recruiting people into many of the small communities around the state of. You know that jail part specifically says that. And they're referencing what physicians been saying what they A.M.A. says G.A.R. did not find access to these services widely affected. Based on the review of Medicare and other data the fact is that's not a riddle of why I think that's not you right America. Exactly. That's the issue. And it got worse for an issue of rural areas which is not affected by premiums is not affected by what doctors are saying that it has to do with insurance. That is a rural versus urban and they say that. So what we what we need is

insurance reform to make this happen. I cut you off before. I think we have to look at way over it. If we look at the surrounding states Montana has a $250000 cap on noneconomic damages Utah cap is 400000. Colorado is. Just went from 250 to 300000 recently North to South Dakota's 500000 each. They all have caps. And I. I know for a fact from experience with some of my clients three of whom left the state last year but because of this one. Continue to live in Cheyenne. When across the border to Fort Collins Colorado to practice doing exactly the same kind of practice probably had some of his say patients had his premiums which were cut in half and I would submit that that's the problem that Wyoming has it. If you have a physician who wants for lifestyle purposes to come to the

West and therefore they come to Wyoming and then they look at that Montana the surrounding states and compare what their premiums are there versus here. It's tough to keep doctors here when they can go across the border do the same thing and make it give themselves a pay raise. Let's assume everything you said is correct that there is a problem of a doctor drain. Mary's question is still on the table is capping the solution. Is it the appropriate solution. Are there other solutions. There may very well be other solutions we haven't talked about the real solution. If there weren't negligent doctors there wouldn't be any need for a lawsuit. So you're a five. Yes. That's the truth of the matter. The truth of the matter is is that. About 5 percent of the doctors in this country are responsible for about 53 percent of the monies that have been paid

in medical malpractice cases and insured. Ninety five percent of the doctors get sued. So I don't know how you reconcile those two things. Well I'm trying I'm trying to point out to you that I don't believe that statistic to begin I don't know if this is correct either but what it but it is close enough for government work. Where are we where we've finally come to as we pick up when you physically need the support. But I will. But but the truth of the matter is that one of us could possibly say that the way to take care of the medical malpractice problem is for the doctors to begin to discipline their own people. The discipline that's being taken is being undertaken by the medical profession is deplorable but less than one less than 1 percent. Of the doctors who are are responsible for almost all the medical malpractice in this country the monies that have been paid are ever discipline.

And so maybe we ought to start looking at home first. Start looking at our own profession. I mean lawyers ought to look at their profession. I think we are called upon to do that continuously. And I think we should. But I think doctors should as well. If there are things they have here in the state of Wyoming the person who is most likely to say if this person is not doing it right is somebody in the same specialty who is then most likely to benefit if that person is run out of town which then leads to the lawsuit that we've seen in Casper when such a thing was done and a suit against the other physicians on the board to the members of the medical the medical community against the hospital because they said This guy's no good will you fellows. And they tried to get rid of him. They had to settle with him because it was restraint of trade the guy ends up leaving the state and then goes to prison in the new state for what he was doing wrong. But we had a heck of a time because he had a very capable attorney defending him in his will and that is to get rid of all of the attorneys.

Right now I would be very capable of yeah that's a nice anecdote that John but as a practical fact that isn't what really happens. The fact is doctors in this state will not testify against doctors other doctors insisting it is necessary for the plaintiff and his lawyer to go out and get a doctor from some where else. That of course is that that expert is attacked on the basis that he's a Ferner coming into Wyoming. And that's the way it really works. Mostly if you don't believe me listen to the insurance companies themselves who have said over and over again. Tort reform will not bring down premiums. We will not tell you that tort reform will bring down premiums. They admit it. And recently in July they can't they won't put under oath in the Florida legislature and they said it there. And doctors came in and said no we don't have in Florida any decrease in the physicians No we don't have an access problem. We've been saying that but under oh

it's not true. We don't have an access problem. And so what we need is to go after the root of this problem which is the insurance reform. The reason why we haven't in the first place is that they lost money in the stock market. So they had to get their profits back in the Supreme with all due respect and with all due respect that's a canard. If you expect any reform in one year to cut rates the next year that's completely ridiculous. These cases are building over a period of years. They don't know. You can tell us how long the tail is on these cases. They take five seven years before they're finally adjudicated and award is made and the payment is made out. If there is a reform made of any kind to expect that in one year there would be a change. It's not going to happen over the long term over the long term. There has to be an explanation why every state around Wyoming that has a cap has lower malpractice rates. They don't have better doctors I

can guarantee you that. There's no question that that defective tort reform is lower premium rates. It's it's silly to argue that because it's so well established No that's what what what is what is true is that placebo tort reforms will not lower will not lower malpractice rates. And so that all tort reforms are not the same in Florida. The Select Commission on medical malpractice which was appointed by the governor of Florida to be above the fray the Florida Select Commission on malpractice consisted of no doctors no lawyers no insurance people nobody with any interest and no personal interest in this other than the public policy issue so who did he appoint. He appointed the five presidents of the University of Florida campuses including no less a personage than Donna Shalala who I don't think anyone would accuse of being a stooge of the insurance industry. And they concluded in reference to Florida

several things which are absolutely true for Florida and they're absolutely true for the rest of the country. And in Florida they concluded unanimously that five of them after 10 days of testimony hearing from more than 100 witnesses preparing a 361 page report which I would commend to anyone who would like to look at it. And 2000 citations they concluded several important things. They concluded that Florida's malpractice crisis was a crisis that was caused by the tidal wave of litigation in Florida number one. Number two they concluded that access to care in Florida was imperiled by this tidal wave of litigation. Number three they concluded that a $250000 no exceptions cap on noneconomic damages only would significantly reduce premiums in Florida. And number four they concluded after reviewing every other alternative because they weren't conceptually thrilled with the idea of caps. They concluded after reviewing every other

alternative that in fact. That was the only effective way to reduce malpractice premiums and also in Florida Aetna Insurance and St. Paul came in and did a study and they themselves said that the tort reform in Florida would not lower their premiums is me saying you know but you are quoting you quoting a report from 1986 on placebo tort reforms from 1986. It's not mean to the current debate. Yes. Well I totally I totally agree with with the doctor. And the head of that insurance company. In a 12 year period. This is the worst. Senator listen to me now. Start is I wanted to get this is the wife's reading. He It's one of the most respected you. Have you tried to abolish income trying to get all that kind as I can. OK.

Remember your torture statistics long enough they'll confess. Let me get let me give you some sense of the tortured statistics over a 12 year period. Not. My policy but 12 year period from the wife's rating. It says that over a 12 year period. Thirty two states have caps and 19 states do not. And that very interestingly enough over that 12 year period the states with caps. Have a slightly higher premium rate. In the case states with no one to say something about why this baby. I feel sad that. Our doctors in Wyoming are being used as the kind

of bait for insurance companies. Insurance companies say cap these cap these these. These damages so that so that ordinary people ordinary citizens Wyoming can't get pay. For what their damages are. But nobody says to the insurance company. We're going to make you. Pay a fair amount and charge you a fair amount for your premium. So we cap the damages. And then. They're free to charge anything they want to do with respect to their race. And that's what's happened across this world we pay the damages. Nobody can get anything that they're entitled under. And in the courts of law we put. The legislators a doctor we put the legislators sitting there in the jury box with the jurors who no longer are permitted to exercise their judgment. Case by case. And then the insurance company comes in. And.

Charges anything they want to to the doctors and that's been proven over a 12 year period. Why is it. It hasn't been proven at all. First of all insurance companies can not charge anything they want insurance as one of the most highly regulated industries in the United States and in virtually all states the insurance premiums need to be approved by the Commissioner of Insurance. Oh yes. Oh yes. Oh yes. It's a thing that will break me off a. But let me finish. Why it. Well what we're hearing today it's amazing how we're hearing selective citations from very limited sources of data. What what what the Weist report did was that you'd look at all caps and slow all caps were the same. Remember what I said before about placebo tort reform. If you put a million dollar cap. On Pain and suffering damages you know what I will testify that it's not worth anything.

And so when insurance companies say that caps will not work. The question the predicate of the question is not will a $250000 cap lower rates. The question is will any cap no matter how high or no matter how porous lower rates. And the answer is no. Well so again why isn't it information bicycle's comparison. All right let's look at some other states then on Nevada they passed a $50000 cap last year. Guess what premiums for the doctors went up. OK so now they're coming back. We have to have a lower cap. Let's talk about work in West Virginia. They put in caps and premiums went up. It didn't work in Mississippi. So they're saying both it won't work and we're seeing it in the states up. I simply want to know when was the last time the doctors come you received a subpoena from our insurance commissioner to put bring his bring its records to show any of this or is effectiveness here and say why our insurance commissioner is a

eunuch. And even what's needed is more power to regulate. With all due respect I don't see how some of the moderates are getting sick and tired of these one upset person ships on statistics. Let's broaden out. Number one everybody should remind itself. Even though we have several people on the panel we have certain precise interests that when we talk about tort reform medical malpractice. Is only a small piece of a much larger pie. And. It's the most emotional and it's the one that captures the headline. Yes. But it is a small piece of the universe. I want to climb the map. I want to go to Mount Olympus.

I want to go to the justice underneath all of this is a frequently heard cliched thought tort system is broken. You fix broken. No. I don't think it's broken. I mean I think I can speak from my own. Experience and the experience that I've observed in Wyoming. It is an important aspect of democracy that we have. That we turn our decisions and our fights over to. Our fellow citizens. And. The cases that we see it please. Don't show me that our juries have done anything. Irrational or not justified by the facts. Now we don't see all the cases. And we don't see the settlements that go on. But well

what I saw in in practicing in Wyoming and what I see now on the court is that juries usually come to. The right decision. And we've never had in my experience. What people would think of is runaway juries or. With ridiculous facts situations that anybody would react to and say this is silly. So I don't think the system across the board is broken. Something I think we need to put into this debate in terms of Wyoming specifically is is our Constitution and I'm. Not giving an advisory opinion here. I think everybody knows that I understand you are in jeopardy in jeopardy. Well everybody knows this issue I listened to the governor talk about it the other day so it's certainly on the table we have a constitutional provision. We have a unique constitution in Wyoming and it says right now that we can't do anything about these caps. We cannot put a limit. On somebody's ability to recovery in Wyoming unless we change our Constitution which of course we can and there are procedures to do

that. I think it's fascinating and and it would be interesting for the members of the panel to look at the records of our constitutional convention where you take the insurance issue out of it. This exact debate was going on. Should we limit our actions or should we not. We had the representatives of corporations we had legislators who were members of the convention who were saying the people need to be protected and they decided now this was 100 years ago plus. That they would impose a constitutional limit and prevent the legislature from doing just what we're talking about here. So this issue will get decided ultimately by the people of Wyoming. This system is working well. But Harvard actually does think it's work. You're a Yale man and I'm on the air although I actually did say nothing else.

Well I did a good fortune of my medical training at Harvard so perhaps that will allow me to the Harvard Medical practice study which which for selective misquotation is it is the unchallenged world record holder. Even beyond the the misuse of reports we've heard today. But the Harvard Medical practice study concluded in relation to medical malpractice specifically that there was no relationship whatever zero zip no relationship between the presence or absence of medical negligence then the outcome of medical malpractice litigation. Now that's not my. Paraphrasing of the Harvard Medical practice study. The authors of the Harvard Medical practice study what they concluded in trying to look at every possible variable that would be associated with jury verdicts. They concluded that the only thing that correlated with outcome in medical malpractice litigation was the degree of injury so that an individual with a severe injury or a paraplegic for example. At a very high likelihood of recovering whether or not the

injury had anything to do with medical negligence a person with a lesser injury has a smaller likelihood of recovering. Again whether or not independent of whether their injury was related to medical negligence that's Harvard's conclusion. Well at Harvard the Harvard physicians estimate estimate that it takes 80000 lives that physicians. Eighty thousand lives a year in hospitals alone. And that same studies says that. That the economic cost of this malpractice epidemic Harvard calls this malpractice an epidemic. Estimated by Harvard physicians over 10 years ago that cost our people $60 billion dollars a year. So let's give the whole study an example of the whole study out here. Now let's let's take a march look let's take a moment to talk about the Harvard Medical practice study Harvard Medical practice study was done in New York state in 1984 the original one and they reviewed 32000 hospital charts. The screening for any possible

evidence of medical negligence and they found they used 18 different screens 18 flags. And if any one of these flags was positive the chart was then given to two medical reviewers trained by Harvard for the study medical reviewers then were required to make a determination about whether this was an adverse event. Now words words that an event that was due to medical care as opposed to the ailments itself and if it was an adverse event whether it was a negligent adverse event and what they found was and then they found and so they found numbers. Now there's two things that we should know about the numbers. And again this is not torturing statistics this is fact. I'm just quoting to you from the Harvard Medical practice study. If you ask the question well how often did the two Harvard reviewers agree on a 51 percent likelihood. In other words not a legal standard not anything that would satisfy a court but on a toss of the coin standard How often did the two medical reviewers agree on the presence or alternatively the absence of medical negligence. And the answer is 10 percent of the time. It's

stunning. But that's their conclusion. They disagreed 90 percent of the time. Didn't stop them from getting a data point because they had a tiebreaking they had a way of getting a data point for every case. So with a 90 percent discordance rate they found a hundred and eighty people in New York state in 1984 who in their judgment had had died due to medical negligence. Those hundred and eighty people in New York state discovered by a classification system with a 90 percent discordant rate through the wonders of statistics became the 98000 Americans who die each year from medical malpractice. The sad fact is we're actually the happy fact is that the 98000 the legendary 98000 Americans who die every year from malpractice don't exist. And we have another statistic that taken that car. And. Another statistic to meet that with. Well I'm just reading from it and just simply says in plain English Harvard physicians

estimate that it takes eighty thousand lives a year just in hospitals not emergency rooms not clinics or physicians offices. Eighty thousand lives a year. And it says in plain English the economic cost of this malpractice epidemic estimated by Harvard physicians over 10 years to cost our people Sixty billion dollars a year. Now I don't know how do you how did you say that about doing with this type of torture if you torture it's long and long and eventually they will confess. I'll confess I'm going to have a very very very way from a public policy perspective. What does that say suggest to you about what should be done. I mean if there is even modest doctor or flight or doctor unavailability that's a serious problem. We have to deal with. It. Caps may not be the right. What are you do about that.

I wanted to start out my answer to that question by pointing out that our. Medical our legal malpractice insurance. In this state has increased 400 percent in the last three years. And and I don't I suspect that some lawyers are going to leave but I don't know where they're going to go to. But the truth of the matter is that. People who are doctors who are unable to pay the premiums ought not to be looking to the people and say Give up your rights. People. Like my medical malpractice premium is too high. So won't you please give up your rights to recover if you're injured or if you're hurt please give them up and that will help me stay here. The second thing that from a matter of public policy is that you either do or you don't

believe in the jury system in this country. So to cure this man these people want to say I want the likes of the good doctor from the Doctor's company. To use his influence to somehow make the legislators see it from the insurance company's point of view so that the legislators now can set this cap and can sit there and look here's the jury sitting here. Now all of a sudden this gentleman over here through the through the through and through the legislature comes down and sits down with the jury too. And the jury says what justice is to give them X number of dollars. And and they say well we can't really do that because that is what we decided. We talked to your Slaters to say I'm a little confused. Well I bet that you have been all along. It sounds to me like it sounds to me like you're offended by the Constitution. I thought that it

was the responsibility of legislators to make laws. And I think that we all have a great faith in the American jury system. I think it's one of the cornerstones of the gene that is American democracy. And therefore we should give juries good laws to enforce. And I have no doubt that when juries are given good laws to enforce that they'll do an outstanding job of doing what so good law a good law jury is possible in the situation of joe smith's Plec who the jury believes in the sanctity of that black box we call the jury room. They're sitting in there and they say we believe it is the sense of our community that this individual is entitled to a million dollars for pain and suffering for whatever reason. It's not enough. And then somebody says but the law as defined in Napa Valley. That it should only be 250 but

if you think that's an intrusion on the jury system he thinks that's the normal legislative process why have a jury. Why. Why have criminal sentencing. Why doesn't the jury just decide in his wisdom what the all good which we would like to talk about that. I it seems to me we're talking about the normal constitutional process in the United States. Well. Justice Skype pointed out our Constitution and our Constitution comes from history. I say we are not going to allow this strong the big corporations the people who have power the people who eventually find out of course can hire lots of lobbyists to go in and talk to legislators and talk to the legislators and convince them that somehow we should limit people's rights. Our founding fathers said we're not going to let that happen. That's why we have this constitutional provision and it seems to me that the panel discussion is a perfect example of why

these kinds of decisions need to be made by the jury in a courtroom where witnesses are under oath they are subject to cross-examination. But the real facts about that particular case come out because legislators are subjected to what we're all listening to today and that is different statistics and different arguments that can be of course you know buttress whatever the position of workers who were tortured is the word. And and what we need to do is we need to have our cases decided by real people who are listening to those facts. Let's go let's go. Let's. Let's go back to Wyoming's Constitution. If the people of Wyoming think. That the tort system the malpractice system in respect of medicine. Is broken if they think there's a problem there and I think

there's a substantial. Group of ordinary citizens not just doctors. Think there's a problem there. If the people believe that. They have to get the approval of two thirds of the legislature in the state. Now if I go down to the legislature and I see a doctor. Maybe one or two phases will turn around but if I say counselor everybody in the room darn near will turn around. So that's what I say your ass the people the people of California the people of Wyoming have been prevented from having their say in this matter by electing lawyers by electing lawyers that is not. Let me finish. And they are the ones who pay for this system. They are the ones who have a stake in this matter and the legislature has refused to allow them to have their say and

the legislature has decided the evidence. And you're wrong about your numbers the numbers of lawyers that are are in our Wyoming legislature are very very small at the most. They think it's about 10 percent at the most and the legislators over the years and in the 16 years that I've been involved in this process have listened to the information have listened to and rejected and rejected every single faculty and they've rejected it because the evidence in Wyoming does not we can't even get it out of committee. And you that is dominated by a turn out because of it. Wyoming does not support what is being asked for. That's what you think. But why don't you listen to the people of the state of Wyoming and let them have their say. Maybe they don't agree with you. OK. I just note here that these legislators they have put these legislators in office and they expect the legislators to do their job. And they

expect the legislators to look at the information and not be swayed by emotion and argument that look at the actual facts in Wyoming and the actual facts in Wyoming so that our jury verdicts are extremely conservative. We do not have runaway juries. There are people in our community are the ones who are making these decisions on what you say is there is no problem. Leave the system exactly as it is. There is no. That's what you're say. There is not a problem with the legal system. Now granted there are doctors I'm sure in rural communities who are having a real difficult time with their insurance premiums. Medical malpractice insurance premiums. And in those rural communities you don't have the population base you don't probably have the income base in order to be able to absorb those kinds of Pria What do you plan to do about that. Well then I think that what the legislature needs to do is they need to

look at the real problem in and decide what can be done to fix that. And one idea that I have and one idea that was proposed 10 years ago is that we have a fund of money where if a doctor if a community decides we want a doctor in that community who can deliver babies then we need to help that doctor with. His or her premiums. And what you do is you make that doctor. So with the income level is show what the practice is. And if that doctor cannot afford his or her premiums then the state helps with that. There are ways to help doctors in these rural communities and that's where the problem is. When did that about eight or 10 years ago. Right. How did you get on out of this zone dispensational interfering with the grass in a certain number of occasions and he did that after I wrote him a letter asking him to do it. I want to read all about some of these concepts. Now the other thing I'd say is if you want to do something

about it if you want to reform the system you've got to take some of the money out of it. That is being siphoned off. By insurance companies. By defense lawyers by plaintiffs lawyers when the biggest you know we can sit here and talk about statistics all we want and I can provide a lot of statistics and you can provide statistics but the fact is a lot of the money that we as doctors are the custodians of because the money that we get is not our money it's the patients money that goes into this malpractice fund and it goes in there for the benefit of patients. But the money is coming out of there. It's going to insurance companies. It's going to attorneys and the patients are not getting their fair share. Why. And that's why I say lately and that's why I say we need tort reform. All right. I'm going to I'm going to go down Tim's line. To get off this damage cap.

You've been on interminably. Isn't it true that lawyers make a hell of a lot of money. Sometimes I mean lawyers also lose a lot of cases and you're talking about plaintiffs lawyers plaintiffs we have the good grace to refer both lawyers and plaintiffs lawyers climb a feeding frenzy of sharks and look I think that lawyers on both sides are trying to do their job. They are trying to represent their clients on the plaintiff's side of it. If the plaintiff's attorney loses the case the place attorney gets paid nothing. That is a huge risk and that plaintiff's attorney has paid out a lot of money and expenses to pay for it hire the experts pay for the various costs. Defense lawyers make a lot of money I'm sure from defending doctors. But the system has to incorporate the lawyers on both sides to make

sure that it's fairly presented to the jury to the court and then that the jury decides what the damages are going to be. And that's exactly what is the case. Let's let let's face it. One thing left in the closet this morning. Is that aspect of quote tort reform that would reduce contingency fees in other words. We've talked about capping damages for the patient. There are also these proposals to cap fees. It is interesting that those proposals are only for the people's lawyers Well only for those who represent the patients or the consumers. There aren't any proposals for the corporations and the insurance companies. So here's the real money. We're already comparing a plan that's really breaks concerning what a defense lawyer makes. It's incredible. That's the reason. And if Micra I we prepared to hold a benefit for the defense bar.

I well let's let's talk a little bit about the contingency fee because I thought that that was a rather remarkable argument. The argument that I heard is I understood it in defense of the contingency fee is that because plaintiffs attorneys bring so much non meritorious litigation. In fact we know that in medical malpractice 70 to 80 percent of all the cases that are brought turned out to be without merit. That's the kind word frivolous would be the unkind word that the that it's them therefore to compensate for this flood of non meritorious litigation that in the few cases that are actually won they should win lottery like payments. That's a very strange argument. Now in terms of the California where there is a limit and it can turn and turn these contingency fees if there's a need to pass the hat for defense attorneys we can certainly pass the hat for the brother rather than in the bar in California because in the

under Micra in California a plaintiff's attorney who wins a million dollar verdict in California under my grip still takes on. Two hundred and twenty one thousand dollars plus all expenses. Two hundred and twenty one thousand dollars plus all expenses contingency fee limitation is the only reform that in fact does not benefit insurance companies at all. Directly does not benefit doctors directly because it doesn't change the amount of the verdict. The reward remains the same contingency fee limitation is the one pure reform that takes money from the lawyer and puts it properly where it belongs in the hands of the injured patient was the phone that is most opposed by the personal injury bar. I want to talk a little bit about this figure that. The good doctor brought up this says that 80 percent of these cases are frivolous. That means that what he's really saying is that 80 percent of the

cases are won by the insurance companies. And that is maybe true. I think that it's a very difficult proposition for an ordinary person particularly in Wyoming a small practitioner in this state to come up against the kinds of resources that these insurance companies give to their attorneys. I mean it becomes in my experience the average cost in a medical malpractice case in my office runs about $250000. By the time you pay for all of the depositions $4 a page on those transcripts all of the experts that have to be brought there tons of expenses that are involved are are not the monies that fall through the crack or the insurance company and that the insurance company lawyers who can simply say give me more give me more give me more. But the little practitioner in Wyoming who somehow has to come up with the

monies to bring his case to court. Has been very very difficult time in doing that and not only that but the insurance companies hire the likes of of some of our panelists. Janet raker. Who do this every day who are greatly skilled who know exactly how to talk to juries and who are very nice men and who come into court with these lovely smiles on their faces and say to you. I don't smile it's nothing that I should but I wasn't. But I want you to know that he comes up against the little guy who's making deals who's doing divorces. Who's doing who I come up against the guys like he used to be John Brooks that Robert and people from Gerry Spence

is for Rob Shively the best the state has to offer because typically in a medical malpractice case you're right. They're expensive. They're tough. And the best of the plaintiff's bar usually is handling those cases. So we're always up against very formidable opposition who have because of their success the resources to finance the case or they wouldn't be there. So he's still in there being a personal injury attorney who said that maybe you ought to sue your personal injury attorney for legal malpractice and leave the doctors alone. When you're out we're losing track of everything track and the people here that we're talking about people who were injured by medical malpractice. One of the problems with the cap is that because of the expense that Jerry was talking about yet that they can't the lawyers can't take the case. And if it breaks my heart and other of the attorneys in California who someone an elderly person comes into their office who's been severely injured doesn't have any weight loss because they're not working.

And because of the cost of bringing the case a lawyer has to say it can't even be brown. That's why insurance most wonderful they don't want the cases to be brought in most of the time you know they're very meritorious if you talk to the plaintiff's bar in this state and I've talked to a lot of them. Many of them were my good friends and we talk about these cases and they'll tell you that 90 percent of the cases that come through their door they reject not because they can't afford them but because there's no merit to the case. And yes you can have somebody that has damages that have been damaged but they determined that it's not because of a doctor's negligence and they don't take the case it's not because they're too expensive to take because there's always competent attorneys in this state who have the resources who can take a meritorious case and do some of the heavy malpractice and Mal occurrence and doctors take care of people all the time and everything isn't always perfect. Although you wish it were. And that's absolutely the case. And the fact is it costs money to figure that out. That's why it's it's a part of overhead that the lawyer hassle account for.

And so if you go limiting. What. An attorney for an injured person can take on the backhand you are in effect limiting his ability to screen out those other cases as well which has the effect of making him take the most serious cases just like Mary talked and the contingency fee actually works to make sure that those cases are properly screened. Jeff makes a very good point. We don't have a lot of meritorious cases filed in the state of Wyoming. Plaintiffs lawyers couldn't afford to do that. If you are on a contingent fee you have to make sure that you're only taking a case that has some merit or you're going to lose money. But in fact the fact of the matter is the fact of the matter is doctors have an advantage in front of our Wyoming juries. They are doctors when a vast majority of the cases that go to the jury

and it's not because that case lacks merit in order to go to the jury. We have to have our experts who have said absolutely there is malpractice here but the juries in Wyoming are going to more often than not give the doctor the benefit of the doubt. There is some very difficult cases and that's why. Very good then there is the lines for about a half hour and most probably must be driving you bad. You know how to keep him alive. For God's sake. Let me tell you. I'll tell you what. I've been on both sides. In fact when I switched to this group the common good and did a piece in The Wall Street Journal I got a call from an old pal of mine and he said have you turned to the corporate toadies now look gang we're never going to get anywhere. If it's that big corporate toadies and the greedy slobs in America on the other side that will get anywhere. And that's the way the American people see it because that's the portrait you have

painted. That's the way it is. That's not the way it is because I tell you it the way it is and forget forget medicine forget the other stuff. Let's go back to real life. Why are there no seesaws and playground equipment because of stupid stupid lawsuits. Why. Why do we have a lawsuit where the kid is in centerfield and forgets to flip down his sunglasses and he's 10 years old so the issue of the little league for not giving the kid sunglasses. Let me tell you we've got large busted kids running all over the country because they can go out and exercise because there's no equipment out there because some little guy got hurt. Teachers who sit in a class. Teachers should in the class with one of the most disruptive children you can ever imagine like Spencer and Simpson and they try to discipline them and they are sued. Ladies and gentlemen they can't do a thing. So what would you suggest I get back to common

sense for God's sake and get away from this absurd layering of Sue somebody take a cup dismiss it. Let me tell you I practice law I could've sued for doctors from Cody every other week and made ten grand just like that you're talking extortion. Yeah that's what it in many ways what it was but it was a little town. I said I'm going to do that just because you're a rude person because you didn't think you have any more children. That was his view not hers. He said if you get here you get back to common sense and not here there's a way to do it. You've got to inject some. Some people who are not lawyers not doctors not insurance people into the system and that's called a jury. Yeah. That is called a jury of my pal the difference when you're doing a jury trial and I've watched you I've watched him reconstruct a body in a wrongful death case. Nobody can do that. There there are Fred Astaire and then there are no Fred Astaire. This is Fred Astaire.

You want to be him and he can go to a jury and take them to the verdant valleys and over the Pacific of those cliffs into the green valleys. But let me tell you ladies and gentlemen there are damn few jury Spence's. And that's part of the problem. You can go hire the best and the jury the juries don't care about medicine they care about this passionate man and they're going to follow him. So what they care about justice. And I have to tell you you know tell you Alan that I'm surprised to hear you say these things. No because there is nobody in this country that really knows better than you that the jury system is the foundation of the American system itself. And to me based on facts not emotion and. Well but you know pain is emotion justice itself is like most facts. And and I think that without emotion somehow we would all end up being a. So I would agree you and I but again one is shrinking. John is a talented you're talking about front end

screening as well not simply with a jury am I really am told about that don't run them up front end screaming that somehow. Cases that are frivolous get abated early to reduce the cost to the defendant so they can keep the playground a weed legal profession are we doing enough about screening out the chaff. I like it when I was doing exclusively defense work. And while we had a screening system it was aimed only at physicians and medical malpractice cases. It was at least our experience of twenty seven cases in our office in the preschool stage. Only two. Went on the suit after that. I testified before the legislature the Judiciary Committee of the house today. Last were were on this very subject and said to them we've got to find a way to do that. It's a plus for it

for both sides. It reduces plaintiffs lawyers risks and I've seen cases even with brain damage babies go away because that is one of the solutions we need. Our problem with it is is that the statutes that created those review panels have twice now been declared unconstitutional. A way around that has to be found. And it's interesting that this case because the identical statute or one so similar to it it's hard to tell the difference has been declared constitutional in Montana. Would you advocate that across the board to deal with without Puder all pharmaceutical cases product cases. Similar case certainly across the professional board. I've thought about it across entire board. If it simply adds another layer of cost. Well but the thing that I think that concerns me is that first of all we haven't talked about putting

caps on insurance coverage. That's where we put caps on insurance companies failure to pay with the audit. And secondly don't we need a screeding a committee to screen insurance companies to make sure that they don't denied claims that ought to be paid. As a matter of fact. As a matter of fact the real problem that we're talking about. Has anything to do with lawyers has got anything to do with doctors and got very much to do with patients hasn't got anything to do ultimately with juries. It has to do with the failure of insurance companies to pay what they ought to pay when they are faced with it. I can't tell you how many times I have come with a just a case to an insurance company ask them to pay it and they won't do it. What you do but what doctors buy when they buy an insurance policy and what people buy. When they buy an insurance policy on their car. Is not

protection. They don't get protection. What they really get is an opportunity to sue the insurance company or have somebody else involved in litigation that they don't want to be involved in. You know that goes beyond statistics that get that close. First of all let's talk about who are the insurance companies. We make them sound like some sort of alien corporate bond. Yes the RC. Most of them were in the United States today are owned by the physicians that they insure. Number one. Number two the primary responsibility the fiduciary responsibility the legal responsibility of an insurance company is to protect the interests of the policyholders. A company like ours can not settle a claim without the permission of the physician. We can sell that around that contract. You know that it doesn't have to be there you put it in there yourself so that you can blame the

physician and you always blame the position where you know that. All right very very Don't don't hold back. Don't use it to be racist. You bet if we put it in the contract then we're very proud of that provision in the contract because what it says is that our insurance company won't make a won't pay off a nuisance claim against the interest of our physician. And your position is a remarkable position your position is that an insurance company that doesn't make an offer of settlement or reasonable offer of set that doesn't accept a settlement or you will not agree to an excess of a settlement against the policyholders interest or the policyholder won't agree. You know they can exchange for the doctor exercising his or her right to a day in court that the reward for the doctor exercising his or her day in court is to be subjected to an outrageous jury verdict that has nothing to do with the settlement value of

the case. That's an extraordinary is that the insurance companies have too much control over our health care system in this country yet that they have too much control over the doctors over the patients. What is paid out. So that's why the solution to this problem you asked what it is are there is insurance reform that they should not be able to put their reserves and the doctors paying money their premiums those reserves and they put it in the stock market. They put it in bonds and stocks their bonds went down 80 percent and they went Oh my goodness. You don't have profits which by the way are a few years we've been paying these doctors who are part of their insurance company. Lots of premiums not paying off for the patients in their claims. Well we need to make sure is that they can put those. Profits. It and lose the profits in the stock market like they have been. That they are subjected to anti-trust laws so they can't get together collude and that with insurance reform we can make this stop happening to doctors. Trial lawyers

don't want this to be happening to doctors. None of us do. Let's get to the solution of how to fix it which is not taking away the patient's rights not putting a cap on their damages. If I heard correctly over the last 90 minutes. The legislature should go out and reform the doctors reform the lawyers reform the insurance companies and probably reform the patients were up to it. You're right. Well we were basically out of time. That's about it for this session of Miller's court. I hope that we've answered more questions than we've created. But I have my doubts. Tort reform simply will be with us for years and it will impact all of us and we've just seen that even our distinguished panelists are at odds with the various approaches. It's important that you think for yourself how you feel about the

issues that we've discussed. And when you've done that please express your opinions on these issues to your legislators whether they be state or federal Wyoming or some other state so that the legislatures can make wise and present decisions in the months ahead. Thank you again for joining us Martha Miller from Miller's court goodbye. Miller's court is brought to you in part by the Wyoming State Bar to regulate the practice of law assist attorneys in providing competent and ethical legal services and educate the public about the legal

system