I have been a med mal claims guy since 1985 and survived many attempts at reform. What usually happens is that the same deck of cards are shuffled, and play a different game of Rummy.

It is a good market for insurance with alot more carriers trying to make money, maybe some of the reforms have helped. The cost of litigation and the amount of money that injured plaintiffs get needs to be shifted to the plaintiff. Making the pot of gold bigger and bigger ignores the problem that the allocation of monies and timing of settlements should be the focus.

For the one subjective cause of action, pain and suffering, we need a cap. you pick the number, one that is good for both sides. Then tell me how you measure pain. Is it by the pound of length? This is why it is needed. No rational science behind it.

The med mal problem and how do we fix it:

- get more of the indemnity to the injured . They only get 40% on a cases total cost. Sliding fees ?
– mandatory insurance for docs, you need it to drive! No policy /no patients.
– Cap on pain and suffering awards, you pick the amount. You cant measure nor weigh pain by $’s.
– Loser of the case pays the costs of the other party. If the case is good, take it. If you don't , it must have been marginal to begin with.
– Structured settlements for all settlements over $500k- it helps everyone.
– Presuit affidavits from experts re liability, causation and damages. mandatory mediations.
– Arbitration – a jury of peers. Still your day in court, just a different forum.
– In court, a jury of peers , docs dont get them, how about a minimum of a bachelor degree to sit. Juries that understand will yield a higher degree of fairness. We want that right?

Please remember caps are usually discussed for the one cause of action, not the whole case. Loss on earnings past and future, and medical expenses can be measured. Pain – its the angels on the head of a pin argument. I have more great ideas, but lets be honest, there is too much money involved and nobody wants change, unless it is to increase the size of the prize.

Jim O’Hare VP med mal claims PIC florida

Jim O'Hare and PIC Florida apparently value quality of life only by the earnings of a person. I guess if you are retired or an stay-home mother, your injury doesn't deserve much compensation.

"For no problem at all. Claims are down."

But there is no evidence that actual malpractice is down, so there is a problem -- a tremendous amount of malpractice, most of which is not compensated.

The Institute of Medicine estimates that there are almost 100,000 deaths a year from malpractice. Yet in 2009 there were only 3,537 malpractice payments for cases involving death according to NPDB data.

The real problem isn't too many malpractice claims or payments; it is too much malpractice!

Physicians should be working to reduce malpractice rather than trying to limit their liability to the people they injure or kill.