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May 31, 2004

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Ted

Evan, you and I both know that the bulk of medical malpractice claims get resolved in settlements based on both attorneys' perceptions of what a judge will permit a jury will deliver. So why do you persist in this transparently bogus use of a "verdict" statistic (which the newspapers are happy to repeat whenever a plaintiffs' attorney feeds it to them, including in the April 15, 2004 Belleville paper). First of all, it's simply not true that there is no data on settlements: it took me 90 seconds of googling to learn that the Edwardsville Intelligencer reported on March 15 that ISMIE Mutual has collected $26.6 million in premiums from Madison and St. Clair Counties in the last five years, but has paid out $33.5 million in claims. Even if its CEO worked for free, that translates into losing money. The average plaintiff payout in 2000 was $276,000, and jumped to $495,000 in 2003, and Madison County policyholders are 25% more often sued than other Illinois doctors. Anderson Hospital will be forced to turn away pregnant mothers, because it has lost 4 OB doctors in the last year. (The same article even mentioned your "never-mentioned" stat of eleven verdicts.)

So: doctors are leaving; payouts are outstripping premiums; insurance rates are going up to account for the increase in expected payouts; and uncapped damages and a runaway court system has resulted in a near-doubling in settlement costs over the course of three years. Sounds like a problem to me, unless you think Madison County doctors are particularly incompetent, and have gotten nearly twice as incompetent in the last three years.

Evan

Ted: In my post, I complained that Madison County is being unfairly blamed for a malpractice insurance "crisis" that apparently is happening throughout the country. Your comment proves my point, since the "statistics" you cite, which apparently come from this article, lump Madison County together with St. Clair County. St. Clair County is a separate county and is barely mentioned in the Post-Dispatch article.

I also said there is inadequate information about the cases filed in Madison County. Your numbers don't help. We can speculate on sound footing that some of the cases filed against doctors in Madison County were settled, but the vast majority were undoubtedly dismissed without the doctors' paying anything, since that is the nature of medical malpractice lawsuits--in the beginning, the plaintiff's lawyer is ethically and legally bound to sue every doctor involved in an incident, lest the lawyer blow a limitations period on a responsible doctor. Those doctors are later dismissed after the discovery stage of the lawsuit. Since the majority of payouts from doctors to plaintiffs is $0, the ISMIE's numbers about average payouts, which you cite, obviously do not include all cases, but are an average of payouts only in cases that settle. The true average is much, much less (and back to my initial point--why aren't these numbers published?)

Moreover, the verdict information I cite is very relevant because it serves as an indicator as to what juries will award in real cases, which is critical information to use in settling cases. In Madison County, juries are more friendly to doctors than to victims--as is true throughout the country.

Finally, the information about payouts outstripping premiums that appears in the article you cite is wrong (and aren't the numbers I was asking for, anyway): as ISMIE's website makes clear here (PDF), the numbers claimed to be "facts" in the article you cite are only estimates. Since medical malpractice claims often aren't paid out for many years after the claim arises, the premiums associated with the claims are held and invested; these days, the shortfalls are due more to low bond yields than anything else, in addition to incorrect estimates by the insurance companies.

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