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Doctors and trial lawyers spent millions of dollars in an unprecedented, four-state election battle over limiting damage awards and attorney fees in malpractice cases. The voters’ verdict: a virtual stalemate reflecting deeply divided public opinion. Doctors vowed to keep pressing their cause, hoping President Bush’s re-election and Republican gains in Congress might weaken Democratic opposition to federal legislation capping malpractice awards. “We will continue to be relentless in our fight,” said Dr. John Nelson, president of the American Medical Association. “We look forward to working with President Bush to fix America’s broken liability system.” Both the AMA and the trial lawyers had hoped to come away from Election Day declaring that the public — given a rare chance to pass judgment on the dispute — was on their side. Instead, the outcome was indisputably a split decision. In Wyoming and Oregon, voters narrowly defeated doctor-backed proposals to implement caps on awards — results were almost 50-50 in each state. Nevada voters approved a cap and Florida voters supported limits on attorneys’ fees, but Floridians also approved two lawyer-backed proposals intended to benefit malpractice victims. Doctors argue that caps on awards for pain and emotional distress are essential to curb rising insurance rates that otherwise will drive many of them out of high-premium states and high-risk specialties. The lawyers advocate tougher controls on insurance companies, not on juries which may represent a malpractice victim’s only chance for justice. “The voting is done, but the crisis hasn’t gone away,” said John Barrasso, an orthopedic surgeon and Republican legislator in Wyoming. “The Legislature’s still going to need to do something to make sure health care stays affordable.” In Oregon, even opponents of the cap said politicians on both sides of the issue should work together to ease doctors’ financial burdens so that all parts of the state — especially rural areas — would be adequately served. “The public has told us what they think. We don’t need a cap,” said Democratic Gov. Ted Kulongoski. “This doesn’t mean we shouldn’t look at the issue of how we provide doctors with help obtaining malpractice insurance.” The defeated measure would have limited awards for non-economic damages such as pain and suffering to $500,000. E.E. Patterson of the Oregon Rural Health Association said insurance reform was necessary to stop an exodus of obstetricians from rural areas. “There’s no question that we’ll be seeing babies dead or dying because of it,” he said. In Florida, voters supported a doctor-backed proposal limiting lawyers’ share of malpractice settlements to 30 percent at most. But voters also approved measures to give the public more information about doctors’ mistakes and to revoke the licenses of doctors who make repeated medical errors. Mark Riordan of Floridians for Patient Protection, which promoted the two lawyer-backed measures, said malpractice victims were weary of struggling to get information about their physicians. “You can go online and find the safest toaster, the safest hairdryer and the safest car, but you can’t find that about the person providing your health care,” he said. The doctors fared best in Nevada, where voters endorsed a $350,000 cap on pain and suffering awards, and also rejected two rival proposals offered by the lawyers. “One thing that’s quite clear — people like doctors better than lawyers,” said Jeff Stempel, a law professor at the University of Nevada, Las Vegas. But Eric Herzik, political science professor at the University of Nevada, Reno, questioned whether voters’ decisions on liability reform were well-informed. “You’re asking the public to make a rather quick decision about a complex issue,” he said. “Then it boils down to the worst part of the electoral politics — can you capture the public’s attention with a catch phrase?” Caps of varying types have been implemented in 27 states, but a proposed federal cap, though successful in the House, has failed because of Democratic opposition in the Senate. Republicans strengthened their majorities in both chambers and intend to work again with Bush to impose a nationwide cap on pain and suffering awards. President Bush gave it high priority Thursday, telling a news conference, “We must confront the frivolous lawsuits that are driving up the cost of health care and hurting doctors and patients.” Copyright 2004 Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.

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