1. Is there a doctor in the house? NOT IN THE DELIVERY ROOM

2. NOT IN THE OR,ER, or TRAUMA CENTER Is there a doctor in the house?

3. NOT IN RURAL OREGON Is there a doctor in the house?

4. NOT IN THE FUTURE Is there a doctor in the house?

5. MEDICAL LIABILITY CRISIS Why?

6. Background 1985-1987, premiums increased ~50% 1987, cap on non-economic damages 1990, premiums reduced 50% 1999, struck down by State Supreme Court 1999-present, premiums increased by ~100%

7. Professional Liability Insurance Premiums Cap in effect

8. Claims “Paid” 123 claims/year prior to 1987 tort reform 67 claims/year 1987-present 46% decrease in paid claims

9. Claims “Paid” Cap in effect No increase in “bad medicine”

10. Claim “Severity” Cost of paid claims 1982-2002 average cost of paid claim increased $286,000 (~300%) Greatest increase Aug. 1999-May 2003 –113 claims paid over $250,000 –$92,286,400 paid

11. Claim “Severity” Cap in effect Claim severity increases without cap

12. Claim “Severity” Negative impact on multiple specialties

13. Number claims465 Average demand$3,225,206 Total demands$1,500,000,000 Claim “Pending”

14. $1.5 Billion Amount each Oregonian would need to pay…. $500

15. $1.5 Billion Amount each physician in Oregon would need to pay…. $330,000

16. Where’s the money going? Employment Policy Foundation Washington, D.C. Personal injury lawyers take majority. Patients receive ~38%. Caps on non-economic losses could save $54.8 to $97.5 billion annually. Controlling medical litigation could reduce health care costs 5%-9% without sacrificing quality.

17. Oregon Medical Association Physician Work Force Assessment 2003 33% of Oregon’s physicians are age 50-59. Increased cost of practice does not allow physicians to “slow down”. Early retirement –20% statewide –33% southwest Oregon –37% Oregon’s neurosurgeons

18. Doctors are moving out of state. 5% of Oregon’s physicians have moved. 15% of Oregon’s physicians are strongly considering a move. 20% of Oregon’s physicians under 50 yrs are considering relocating their practices. Oregon Medical Association Physician Work Force Assessment 2003

19. Patient care is negatively affected. Less high risk services are provided. Complex cases are more likely to be referred elsewhere.

20. Less High Risk Services

21. Increased Referral

22. The Crisis is Real! Medical liability litigation is out of control and destroying our medical system. Oregon is losing good doctors. Access to health care is at risk. Medical liability reform is needed now.

23. Medical Liability Reform Caps on non-economic losses. No caps on economic losses. Juries should decide on all economic damages and up to a reasonable cap on non- economic damages. Limit contingency fees of lawyers.

24. Medical Liability Reform Constitutional amendment General election, November 2004 Cost of $6 million

25. Medical Liability Reform What can you do? Educate your patients Educate your colleagues Give $1000 or more… Now.