
Letters to the 107th Congress
July 23, 2002
The Honorable Michael Bilirakis
Chairman, Subcommittee on Health
Committee on Energy and Commerce
U.S. House of Representatives
Washington, D.C. 20515
Dear Mr. Chairman:
On behalf of the American Bar Association, I write to express the
concerns of the ABA regarding H.R. 4600, legislation to pre-empt
portions of the state medical professional liability and product
liability laws. I ask that this letter be included in the record
of the hearing that was held July 17, 2002, on health care liability
legislation.
The ABA opposes enactment of H.R. 4600 because it would pre-empt
state medical professional liability and product liability laws
and because it would restrict the rights of injured patients to
be compensated for their injuries.
Federal Pre-emption of State Tort Laws
For over 200 years, the authority to promulgate medical and product
liability laws has rested with the states. This system, which allows
each state autonomy to regulate the resolution of injury actions
within its borders, is a hallmark of our American justice system.
Because of the role they have played, the states are the repositories
of experience and expertise in these matters. If enacted, H.R. 4600
would pre-empt the rights of the states to continue to administer
these laws. In addition to the policy reasons why this long and
effectively-functioning system should not be altered, it should
be noted that the constitutionality of H.R. 4600 will surely be
challenged based on Constitutional separation-of-powers grounds.
In addition, provisions in H.R. 4600 such as the proposed cap on
non-economic damages have been held to be in violation of the constitutions
of a number of states.
Currently, states have the opportunity to enact and amend their
tort laws, and the system functions well. Congress should not substitute
its judgement for the systems which have thoughtfully evolved in
each state over time. The Supreme Court, in the recent decisions
of Pegram et al v. Herdrich and Rush Prudential HMO, Inc.
v. Moran, continued to recognize that it is appropriate
for the states to handle health accountability matters because health
care is an area traditionally left to the states to regulate.
The following provisions of H.R. 4600 are of special concern to
the ABA.
Caps on Damage Awards
The ABA opposes caps on pain and suffering awards. Instead, the
courts should make greater use of their powers of remitter and additur
to set aside excessive or inadequate verdicts. Medical professional
liability expenditures account for less than one percent of national
health care expenditures. Provisions contained in H.R. 4600 to cap
non-economic damages would not eliminate the less than one percent
of health care costs attributable to medical professional liability
since very few people are the subject of such caps. Any savings
in the cost of health care would be a small fraction of the less
than one percent figure.
However, it is obvious that those affected by caps on damages are
the patients who have been most severely injured by the negligence
of others. No one has stated that their pain and suffering injuries
are not real or severe. These patients should not be told that,
due to an arbitrary limit, they will be deprived of the compensation
they need to carry on. Yet H.R. 4600, if enacted, would result in
the most seriously injured persons who are most in need of recompense
receiving less than adequate compensation. Since capping non-economic
damages would have a de minimis effect on the cost of health care,
such proposals would not have a measurable impact upon the overall
cost of health care. Such proposals, however, would impact severely
and dramatically upon the persons who are most severely injured
by medical malpractice.
Joint and Several Liability
H.R. 4600 would abolish the doctrine of joint and several liability
in health care liability cases. The doctrine of joint and several
liability makes it easier for injured patients to be compensated
for their injuries since they do not have to prove the precise degree
of responsibility for negligent defendants. It also recognizes that
if each of the defendants had not contributed to the combination
of events that caused the injuries, the injured patient would not
have incurred the losses due to the injuries. Defendants may occasionally
pay more than their share of damages because another defendant does
not pay his or her share. However, on balance, the ABA believes
that it is preferable that a patient injured by someone else’s negligence
not be deprived of compensation for his or her economic losses.
Thus, the ABA supports holding defendants jointly liable for economic
losses.
On the other hand, the ABA believes the balance is different for
non-economic losses and that it would be appropriate for the states
to consider enacting legislation to amend the doctrine of joint
and several liability so that it would not apply to non-economic
losses when the defendant’s responsibility is substantially disproportionate
to liability for the entire loss.
We appreciate this opportunity to express the ABA’s views on these
important matters.
Sincerely,
Robert D. Evans
Director, Governmental Affairs Office
cc: Members of the Subcommittee on Health
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