COMMENTARY: Time for Change

By A. Vince Colella

It has been more than 30 years since the Michigan legislature imposed “caps” on medical malpractice cases. Since that time there have been only a few challenges to the law. In fact, the paucity of challenges is rather curious, especially given the rather flimsy constitutional grounds on which the law sits.

Putting aside the legal merit of limiting recovery on damages, from a public policy perspective, it just doesn’t make sense. In the late 1980s early 1990s, when states were adopting laws capping damages on mistakes made by doctors and hospitals, studies over the following decades suggested that the industry-proclaimed “health crisis” was not rooted in reality and was likely the product of fear mongering to lower insurance premiums for health care professionals and limit exposure to legitimate claims of injury and death related to sub-standard health care.

For example, one study from the Center for Justice Democracy at New York Law School found “indisputable” evidence that “caps” on damages in medical malpractice cases (euphemistically referred to as “tort-reform”) produced more medical errors and higher health care costs.

Perhaps more importantly, the study determined that the adoption of damage caps did not increase the number of physicians, shattering the myth that doctors were unable to enter the practice of medicine due to the high cost of insurance and exposure to significant jury verdicts.

Still, notwithstanding data to the contrary regarding them, Michigan joined a number of other states in the passing of reform placing caps on damages.

Following the legislative enactment, medical malpractice cases began to percolate through the appellate system centered on the constitutionality of the new law. In Zdrojewski v Murphy, the first appellate panel to address the issue — in an unpublished opinion — the court embraced the propaganda of a “perceived crises in the health care system” and found the public policy for “reducing medical malpractice liability” (the purported impetus behind the law) was sufficient to pass constitutional muster.

While the special interest of protecting doctors and their insurance carriers from having to be held fully accountable for medical errors influenced one panel of judges, the Court of Appeals quickly reversed course. In Wiley v Henry Ford Cottage (a published opinion) the court was outwardly critical of its predecessor opinion and re-emphasized Michigan’s Constitutional guarantee to a trial by jury did not end at determining liability but extended to the determination of damages. The Wiley court aptly pointed out that the fatal flaw in the Zdrojewski opinion was that the existence of a medical malpractice claim is not a creature of the legislation, therefore not subject to legislative abolishment. In other words, “while the Legislature may take away what it has given, it may not take away what the Constitution has given.” The fundamental unfairness of the caps is simple: arbitrarily reducing the amount of damages awarded by a jury handicaps its ability to provide full justice.

Unfortunately, the Wiley decision did not stand. Under the steady hand of a Michigan Supreme Court regime criticized for wreaking havoc on the rights of personal injury victims, Justice Clifford Taylor penned an opinion that would lead to three decades of discounted justice. Interestingly, the case that cemented the constitutionality of medical malpractice caps did not involve medical malpractice! In Philips v Mirac, the issue before the Supreme Court was whether a statutory damage cap on lessors of automobiles, i.e., rental cars, for injury caused by the negligent operation of the vehicle) was constitutional. In Phillips, the Supreme Court demonstrated its keen ability to perform the legal gymnastics of a proper constitutional analysis while pivoting toward a retrofitted opinion that protected the economic interests of the insurance industry. In finding caps to be constitutional, the court provided statutory examples of limitations on recovery. Of course, none of the anecdotal illustrations involved pure common law causes of action independent of statutory origin. Conspicuously absent from Justice Taylor’s opinion in Phillips is any reference, analysis, dissection or even mention of the Wiley decision. Perhaps in her dissent, Justice Elizabeth Weaver said it best: “No industry should be allowed to shift its burden of responsibility and accountability to the shoulders of the severely injured merely because it claims to be in crisis.”

The time is now.

Caps on damages have the ulterior consequence of de-incentivizing doctors to behave carefully. Lowering the risk of malpractice lawsuits weakens the deterrent factor necessary to maintain responsible care, judgement and decision making of medical professionals.

A jury verdict is not an “award” or “compensation,” these are terms associated with things we achieve or earn. Rather, a verdict is a monetary measurement of human suffering. The idea that caps lower insurance premium costs, increases the number of health professionals and creates greater access to health care has been debunked.

The only true consequence of placing a cap on recovery for those who have had the unfortunate experience of unimaginable suffering due to mistakes made by doctors and hospitals is cheating victims of their right to fully recover what has been lost or destroyed.
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A. Vince Colella is a co-founder of personal injury and civil rights law firm Moss & Colella.