ATLANTA – In my 50-plus years in medicine, I have seen dramatic changes in U.S. health care – most for the better, but some significantly for the worse.

Medical technology and patient care have improved dramatically. We know exponentially more about many diseases and their treatment than we did a half-century ago. But one major trend – the trend toward more and more frivolous lawsuits – is threatening to destroy much of the progress we’ve made in medicine.

I assure you this is not an exaggeration. Consider these facts:

The American tort liability system is the most expensive in the world. According to a recent Tillinghast-Towers Perrin study, it cost $205 billion in 2001 alone. That’s like an invisible tax of $721 for every American citizen. And less than half of that actually goes to claimants. Lawyers walk away with 30 percent to 50 percent of any jury award. The rewards give these lawyers an incentive to recruit “victims,” many of whom have not even suffered any harm. These plaintiffs clog up the court system and make it harder for patients who have been truly harmed to get compensation.

There are instances in which medical professionals or medications are at fault, and in those cases fair compensation is clearly in order. But the current system, with its strong incentives for deception and numerous litigation-friendly courts, has led to a well-documented cascade of medical lawsuit abuse.

The enormous costs of litigation have changed the health-care system in a myriad of negative ways. For example, huge punitive and compensatory damage claims against doctors, hospitals and pharmaceutical firms have hiked health insurance rates for individuals and companies. The result is that 41 million Americans are completely uninsured, and 75 million were uninsured at some point during 2001 and 2002. And being uninsured often means being untreated or inadequately treated.

People without routine medical care are much more likely to wait until serious complications arise and then go to the emergency room. Emergency rooms must treat anyone, even if they can’t pay, and this drives up the cost of medical care for everyone. In addition, doctors have found it increasingly hard to afford or even obtain malpractice insurance.

Many have fled states identified as “judicial hellholes” by the American Tort Reform Association, leaving major geographic vacuums in health care. And those practicing in certain high-risk fields like my own obstetrics and gynecology have relocated or stopped providing services all together by retiring early.

Many doctors in training have avoided the field altogether. But this problem is about much more than medical malpractice and effects more than just doctors. Take the example of Hilda Bankston – former owner of Bankston Drug Store in Fayette, Miss. In 1991, the Bankston Drug Store was named as a defendant in a large class-action lawsuit for the sole purpose of keeping the case in Jefferson Country – a county known to be a plaintiff-friendly jurisdiction. Three weeks after being named in the lawsuit, Mr. Bankston died and in 1999 Mrs. Bankston sold the pharmacy, which was promptly closed down by the new ownership.

To this day, there is still no pharmacy in Jefferson County because of continued fear of litigation. Prescription drugs and medical technologies are also under the gun from frivolous litigation. Well-established treatments have gone off the market and promising products have never even come to market in the United States because of lawsuits based on spurious “science” manufactured by lawyers.

For example, before Congress passed the Biomaterials Act of 2000, the fear of frivolous litigation and outrageous jury verdicts caused 75 percent of foreign suppliers of biomaterials used to make medical implants to ban sales to U.S. manufacturers. Today, numerous medical device producers still choose to remain overseas due to litigation threats, putting the 7.5 million Americans saved by or improved through implantable medical devices or products like pacemakers and stents at risk of losing vital therapies.

The steamroller of frivolous medical litigation is flattening everything in its path, reducing our access to quality health care across the board. Congress is working on legislation to reform the tort liability system, and reform efforts are also under way in many states. We urgently need for our elected representatives to take action. Otherwise we may find our health-care system not “world class” but “third class.”

Elizabeth B. Connell is senior counselor to the Sick of Lawsuits Campaign, www.sickoflawsuits.org, conducted by Citizens Against Lawsuit Abuse. She is professor emeritus of OB/GYN at Emory University School of Medicine in Atlanta. Readers may write to her at 3159 Marne Drive NW, Atlanta, Ga. 30305.

This essay is available to Knight Ridder/Tribune News Service subscribers. Knight Ridder/Tribune did not subsidize the writing of this column; the opinions are those of the writer and do not necessarily represent the views of Knight Ridder/Tribune or its editors.

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(c) 2003, Elizabeth B. Connell

Distributed by Knight Ridder/Tribune Information Services

AP-NY-09-26-03 0617EDT

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