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Malpractice Suits Driving Out Doctors

If you haven't yet heard of Sen. John Edwards, the junior Democrat from North Carolina, you soon will.

Elected in 1998 over the stodgy conservative Lauch Faircloth, Edwards is a rising star, sporting boyish good looks, a populist message and a handsome Southern drawl.

People magazine named Edwards America's "sexiest politician," and a gushing Nicholas Lemann recently profiled him in the New Yorker. He's considered by some to be the Democrats' best hope for knocking off George W. Bush in 2004.

Edwards largely funded his own Senate campaign with a $20-50 million fortune he earned as a trial lawyer, winning huge medical malpractice and products liability claims. Some (including Al Gore's 2000 campaign staff) might consider Edward's career path a liability to his aspirations for higher office.

But Edwards doesn't.

Should he run for president, Edwards intends to wear the trial lawyer label conspicuously and proudly. On Meet the Press last Sunday, Edwards told host Tim Russert he built his considerable estate "representing people who were in very difficult places in their lives and trying to give them a shot. And I'm proud of what I did …"

Edwards might want to rethink his strategy.

The United States increasingly faces a health care crisis. Many doctors, faced with ever-mounting malpractice insurance premiums, have gone out of business. Others are retiring early. Some are moving to states that have enacted tort reform, while rural states without significant tort reform are losing doctors hand over fist. Their poorest citizens can't find medical help where they need it. Trial lawyers like John Edwards are a big reason why.

Huge awards in malpractice lawsuits over the years have caused many insurers to abandon medicine. Others have had to raise premiums to rates that effectively prevent doctors from staying solvent. Obstetricians — the most likely to be sued — have seen premiums increase from 20 to 400 percent in the last few years. Some have had their policies cancelled altogether. The trend has hit general surgeons and emergency room physicians too.

In Mississippi, where annual premiums for OB/GYNs can range from $40,000-$110,000 (far more than many doctors in the state make), physicians are fleeing in droves, leaving poor, rural women without doctors to deliver their babies. One medical school in Nevada had to close because no insurer in the state would grant it coverage. In parts of Florida, malpractice premiums for individual doctors can exceed $160,000.

In Edwards' home state of North Carolina, health care costs are also soaring. Consequently, awards in malpractice cases have grown too, as compensatory damages necessarily reflect current health care costs. Of course, higher damages mean higher insurance premiums, and higher insurance premiums in turn lead, once again, to higher health care costs.

It's a nasty cycle, and all the while, malpractice lawyers continue to siphon off generous contingency fees, sometimes as much as 30 percent.

Prominent Raleigh trial attorney Mark Holt told North Carolina Lawyers Weekly in a 2000 article that "… when you go against a medical provider, how much can be paid hinges directly on the amount of insurance coverage."

In 1997, a botched childbirth resulted in a state record $23.5 million award, setting off a runaway train of jury malpractice awards in North Carolina. John Edwards was the plaintiff's counsel. He broke his own record that same year with a $30 million award.

North Carolina avoided Mississippi's dearth-of-doctors fate by putting caps on punitive awards with a law that took effect in 1997. Mississippi has yet to enact any such tort reform, and continues to lose doctors.

Some doctors and hospitals have found a solution to insurance costs by requiring patients to sign waivers submitting any claims to private arbitrators. But trial lawyer lobbyists are trying to nix that remedy, too, and have begun to push Congress for anti-arbitration legislation.

This lobby is closely tied to Edwards. According to the Capitol Hill newspaper Roll Call, 86 percent of the $1.39 million raised by Edwards' recently formed political action committee came from fellow trial lawyers. Roll Call writes, "No other Congressional leader or potential presidential contender has such a heavy reliance on a single industry for their leadership PAC."

Additionally, Edwards was a chief co-sponsor of the "Patients Bill of Rights" legislation. The Edwards-sponsored version of the bill would have permitted patients to sue health care providers for punitive damages in federal court — allowing lawyers to circumvent state court caps on punitive damages like those enacted in North Carolina. The Employment Policy Foundation estimated at the time that the Edwards bill would result in 56,000 new lawsuits per year, a $16 billion increase in health care costs, and nine million more Americans with no health care coverage at all.

Trial lawyers, of course, loved it.

Edwards' background wouldn't be so important to his presidential ambitions if he weren't so blatant about mischaracterizing it. He talks about "helping the helpless," but in fact, he built his fortune and paved his way to politics chasing doctors out of the medical profession. Lots of those "helpless" people he mentions live in low-income areas without access to the health care they need.

Radley Balko is a writer living in Arlington, Va., and publisher of The Agitator.com.

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