PRESIDENT'S MESSAGE

MICRA Under Attack Again!!!

ABOUT THE AUTHOR Raghunath Reddy, MD is the current president of the San Joaquin Medical Society and practices family medicine at Stockton Primary Care Medical Center MICRA opponents are at it again and have succeeded in making it a ballot measure as a proposition (# to assigned in July 2022) that will be on the ballot in the November election. Most of you may recollect the Proposition 46 of 2014 election year wherein we were successful in our campaign to defend MICRA. The trial lawyers are at it again to overthrow MICRA with a new measure named “FIPA” with disastrous consequences for the healthcare industry, physicians, and patients, if they prevail.

Our society has grown since 2014 and there are quite a few new, young physicians who may not be well versed on MICRA and how it has helped in keeping malpractice premiums, health insurance premiums at a manageable level, in addition to umpteen other benefits such as minimizing and/or eliminating frivolous lawsuits. Therefore, I feel it is time to revisit and educate about MICRA and galvanize the physician community to put up a united front to defend it.

MICRA- Medical Injury Compensation Reform Act (MICRA) was the result of a massive campaign in mid-1970’s spearheaded by the CMA, channeling the frustrations of physicians due to spiraling costs of Medical malpractice which were resulting from frivolous lawsuits, excessive jury awards, massive increases in

Malpractice premiums threatening the viability of many specialties practices

Physicians were left with few choices and none of them acceptable: Raise fees, drop their professional liability insurance coverage, leave the state, or quit practicing medicine.

The CMA campaign was successful in persuading the then Governor Jerry Brown to call for a special session of legislative hearings that resulted in enacting MICRA in Sep 1975.

According to Hamm-Frech-Wazzan report published in 2014 and revised in 2019.

(In agreeing to prepare the report, this committee insisted on, and were given, total control of methodology, findings, and conclusions, as well as complete control over the editorial content of the report. Findings and conclusions are the products of objective analysis, and do not necessarily reflect the sponsoring organization’s views.)

In 1975, the California Legislature enacted, and Governor Edmund G. Brown Jr. signed, the Medical Injury Compensation Reform Act, commonly known as “MICRA.” The

purpose of MICRA, as its author – Assemblyman Barry Keene – explained, was to address: . . . a persistent problem of enormously escalating medical costs [that have] evolved, in my judgment, into a crisis . . . [that] threatens to degenerate further into a catastrophe of immense proportions to the health care consumer.1 (Mr. Keene’s emphasis)

Primary findings and conclusions can be summarized as follows:

1. A cap on non-economic damages reduces health care costs, thereby making health care more affordable.

2. An increase in the cap on non-economic damages would significantly increase the cost of health care in California.

3. An increase in the MICRA cap would raise the annual cost of

California’s health care system by $11.4 billion. The increase in costs for the average California resident would be $285, or $1,141 for a family of four.

4. The additional $11.4 billion in health care costs resulting from a higher cap would be borne by three groups of Californians: consumers, workers, and taxpayers.

5. A higher cap on non-economic damages would reduce

Californians’ access to quality health care. It would do so primarily in three ways: a. By making health care and health insurance more expensive and less affordable for California residents; b. By reducing the number of health care providers – doctors and hospitals – in California, particularly in rural, minority, and low-income areas; and c. By discouraging doctors from delivering babies and performing high-risk, but potentially lifesaving surgeries, where the risk of a lawsuit is disproportionately high.

6. The MICRA cap has not reduced access to the courts for individuals with meritorious claims.

7. Notwithstanding the MICRA cap, the rate of increase in medical liability damages awards in California far exceeds the rate of inflation. Even with the $250,000 cap on non-economic damages, the average size of paid claims has increased since 1976 at a rate that is more than 2.7 times the rate of inflation.

Other States Have Followed California’s Lead

California was the first state to reform its medical liability tort system, and in the intervening years many other states have followed its lead. Currently, 31 states limit the size of noneconomic damages awards.

The Fairness for Injured Patients Act (FIPA) Effectively Eliminates Caps on Non-Economic Damages

The initiative creates a new category of injuries which are indistinguishable from other injuries and not currently recognized under California law. This new “catastrophic injury” category does not include caps on non-economic damages set forth by the Medical Injury Compensation Reform Act (MICRA) and eliminates caps on attorneys’ fees. This measure would essentially eliminate the attorneys’ fee cap on both non-economic and economic damages.

This measure would obliterate existing safeguards for out-ofcontrol medical lawsuits, resulting in skyrocketing healthcare costs and huge windfalls for attorneys who would get paid ahead of the patients, with uncapped fees in this new category.

This initiative was written and promoted by out of state trial attorney, who is also funding the majority of the campaign.

What can we do???

• Educate self and colleagues about MICRA and its benefits. • Financially support and assist in fundraising campaign • Reach out to hospitals where you work • Talk to family, friends, and patients to vote no FIPA proposition • Talking points, flyers, education materials will be forthcoming from SJMS and CMA

Please reach out with questions, ideas, suggestions or to help to SJMS Subcommittee on “Vote No on FIPA” campaign members Drs. Neelesh Bangalore, Sanjeev Goswami, Sujeeth Punnam, Raghunath Reddy.

The CMA is doing an excellent job in fighting to defend MICRA and have already engaged the same team from 2014 that successfully defended MICRA in defeating prop 46. Please also visit the campaign website www.protectmicra.org for MICRA related information.

In closing, I would like to appeal that this is one battle that none of us can take lightly as the consequences if FIPA succeeds are devastating to say the least and will have both immediate and long-term impact on the viability of the practice of medicine, tremendous cost escalation, risk of losing many specialty practices, providers shying away from performing high risk procedures and so on.

Together we can win this!!!

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