It's a little misleading to suggest that "Tort Reform Doesn't Solve The Doctor Shortage" by citing Georgia, since

1) The linked article doesn't say anything of the kind, and
2) Georgia hasn't had tort reform.

The linked article does say, "The ink has long since dried," but the author of that article was apparently unaware of the fact that a law isn't truly a law until the courts uphold it. Much of the tort reform legislation passed in Georgia has been put on hold or struck down by various courts. In other words, the ink is still wet.

And even to the extent tort reform has taken effect, the article compares post-reform Georgia to other states, not to pre-reform Georgia. Without knowing the trend in Georgia, it is absurd to claim that tort reform isn't having a salutory effect on any "doctor shortage" in Georgia.

So... do you have any statistics regarding physician availability in other states? I know the stats must exist, and I'd like to see them. Especially if we can also compare them with stats about educational and employment opportunities for doctors.

David is precisely correct; this is a point I've made for a long time. While most bills become law when the executive branch signs a bill passed by the legislature, parties cannot count on reforms being effective until the third branch, often dominated by trial attorneys, acts on it. As we see in Louisiana, in a decision trumpeted by the posters here, courts will frequently act as a superlegislature to overturn reforms on ludicrous grounds. In Texas, where reforms were passed by constitutional amendment, and in Mississippi, where the state Supreme Court has demonstrated that it is not in the litigation lobby's pocket, insurance rates have dropped by a great deal. In Georgia and South Carolina, where the effectiveness of reforms remains uncertain, the insurance companies do not dare reduce rates in anticipation of the savings.

Hi David,

Thanks for your comments on Tort Deform.

I am a little confused about your statement that

"that a law isn't truly a law until the courts uphold it"

and that

"Georgia hasn't had tort reform"

As to the first point, a law that goes unchallenged in the courts is definitely a law. I just don’t really get your point here.

As to the second point,

I think is considerably strains the truth to state that
"Georgia hasn't had tort reform"

I have written on Tort Deform about tort “reform” in Georgia

Launch: Tort Victim Tragedies
(http://www.tortdeform.com/archives/2006/09/launch_tort_victim_tragedies.html)

as has Allison Wall, The Executive Director of Georgia Watch.
(Tort "Reform" in Georgia: Dispelling the Myth)
(http://www.tortdeform.com/archives/2006/09/tort_reform_in_georgia_dispell.html)

Georgia Watch is a consumer protection organization in Georgia. One of its specific platforms is fighting tort reform nationally as well as specifically in Georgia (link here to see recent issues commentary on Georgia tort reform initiatives http://www.georgiawatch.org/issues/tort.php4)

In addition, according to the Tort Reform Association of America (a leading tort "reform" organization) there have been numerous tort reforms in Georgia. ATRA lists only one of these initiatives as having been overturned on constitutional grounds since 1983.

Maybe they are not up to date, but they give a rough picture of the amount of reforms.

NAMIC’s list also lists many tort “reform” pieces of legislation.

Both lists are below.

In light of these points can you please explain the basis for your assertions above.

ATRA Georgia List (http://www.atra.org/states/index.php?state=GA&display=bychallenged)

GEORGIA REFORMS

Civil Justice Reforms Upheld as Constitutional (after 1983)

Braden v. Bell, 473 S.E.2d 523 (Ga. App. 1996) The five-year statute of repose for medical malpractice claims did not violate the equal protection guarantees of the State or Federal Constitutions.
Love v. Whirlpool Corp., 449 S.E.2d 602 (Ga. 1994) The ten-year products liability statute of repose did not violate the equal protection or due process provisions of the State or Federal Constitutions.
Mack Trucks, Inc. v. Conkle, 436 S.E.2d 635 (Ga. 1993) The statute providing for only one award of punitive damages against a products liability defendant for any single act or omission did not violate the equal protection provisions of the State or Federal Constitutions. The provision of the statute requiring 75% of punitive damages awarded in product liability actions be paid to the State treasury did not violate the equal protection provision of State Constitution and did not violate the “takings” clause of the Federal Constitution.
Nelms v. Georgian Manor Condominium Association, Inc., 321 S.E.2d 330 (Ga. 1984) The eight-year statute of repose for improvements to real property did not violate the access to courts provision of the State Constitution.
State of Georgia v. Moseley, 436 S.E.2d 632 (Ga. 1993) cert. denied, 511 U.S. 1107 (1994). The statute requiring 75% of punitive damages awards in products liability actions to be paid to the State did not violate takings clauses of the State or Federal Constitutions or the right to jury trial or access to courts provisions of the State Constitution.

Civil Justice Reforms Struck Down as Unconstitutional (after 1983)
Denton v. Con-Way Southern Express, Inc., 402 S.E.2d 269 (Ga. 1991) The statute authorizing admission of collateral sources of recovery available to plaintiffs seeking special damages for tortious injury violated the State Constitutional requirement of impartial and complete protection to person and property.

Civil Justice Reforms Unchallenged on Constitutional Grounds

Appeal Bond Reform: SB 411 (2004). Expands the cap of $25 million on appeal bonds that applied to punitive damages and expands the cap to cover all forms of judgments in all civil cases.
Appeal Bond Reform: HB 1346 (2000). Limits the amount a defendant can be required to pay to secure the right to appeal to $25 million. The reform applies in out of state judgments during the stay period only.
Arbitration Reform: HB 792 (2003). Provides criteria to determine when an award in arbitration can be vacated.
Asbestos/Silica Litigation Reform: HB 416 (2005). Establishes minimum medical criteria (based on AMA guide to the evaluation of permanent impairment) for the filing of asbestos and silica claims and established criteria for dismissal of pending claims. Provides that, in general, asbestos and silica claims may only be brought or maintained by Georgia residents
Class Action Reform: SB 19 (2005).Specifies detailed procedures for the filing and certification of class action lawsuits. Provides for the interlocutory appeal of class action certifications.

Class Action Reform: HB 792 (2003). Updates Georgia class action laws by providing for detailed procedures for class action cases. Specifies factors under which a court may decline to exercise jurisdiction in a cause of action of a nonresident occurring outside the state.
Comparative Negligence: SB 3 (2005). Provides for comparative negligence amongst all parties for all cases.
Early Offer of Settlement: S.B. 239 (2006). Provides that a party declining a settlement offer is potentially liable for attorneys’ fees and court costs. S.B. 239 establishes that a plaintiff who rejects an offer of settlement would be liable for attorneys’ fess and litigation costs if the defendant is found not liable or the final judgment in favor of the plaintiff is 75 percent of the settlement offer. A defendant who rejects a plaintiff’s offer of settlement would be liable for attorneys’ fees and litigation costs if the plaintiff recovers a final judgment which is 125 percent greater than the offer of settlement.
Expert Witness Standards: SB 3 (2005). Strengthens expert witness rules and adopted the Daubert standard in civil cases.
Forum Non Conveniens: SB 3 (2005). Allows courts to dismiss cases with little or no connection to the venue under the doctrine of forum non conveniens.
Interest Rate Reform: HB 792 (2003). Provides that the interest rate on judgments equals the Federal Reserve’s prime rate plus 3 percent.

Joint and Several Liability: SB 3 (2005). Eliminates joint and several liability.
Joint and Several Liability Reform: Ga. Code Ann. § 51-12-33. Bars application of the rule of joint and several liability in certain cases where the plaintiff is partially at fault.
Medical Liability Reform/ Expressions of Sympathy: SB 3 (2005). Provides that expressions of sympathy, regret, apology, etc. by healthcare providers are inadmissible as evidence and shall not constitute an admission of liability.

Medical Liability Reform/Emergency Medical Situations: SB 3 (2005). Provides that in claims arising out of the provision of emergency medical care against a hospital emergency department, no physician or health care provider shall be liable unless it is proven by clear and convincing evidence that the physician or health care provider’s actions showed gross negligence.
Medical Liability Reform/Noneconomic Damages Reform: SB 3 (2005). Limits noneconomic damages to $350,000 per healthcare provider, with an overall aggregate limit of $1.05 million.
Obesity Litigation Reform: HB 196 (2005). Exempts from civil liability manufacturers, producers, packers, distributors, carriers, holders, sellers, marketers, and advertisers of food (as defined in 21 U.S.C. 321 (f)) or an association of one or more such entities for claims arising out of weight gain, obesity, a health condition associated with weight gain or obesity, or other generally known conditions allegedly caused or likely to result from the long-term consumption of food. The liability exemption does not apply if the claim is based on a material violation of a state or federal adulteration or misbranding requirement. The liability exemption also does not apply for any other material violation of federal or state law applicable to the manufacturing, marketing, distribution, advertising, labeling or sale of food and the violation was committed knowingly and willfully. Provides that discovery and all other proceedings shall be stayed during a motion to dismiss.
Obesity Litigation Reform: HB 1519 (2004). Exempts from civil liability manufacturers, packers, distributors, carriers, holders, sellers, marketers, or advertisers of food (as defined in Title 21 U.S.C. Section 301, et seq., 52 Stat. Section 1040, et seq.) or an association of one or more such entities when the claim is for weight gain, obesity, or a health condition associated with weight gain or obesity resulting from the long-term consumption of food. The liability exemption does not apply if the claim is based on a material violation of a state or federal adulteration or misbranding requirements. The liability exemption also does not apply for any other material violation of federal or state law applicable to the manufacturing, marketing, distribution, advertising, labeling, or sale of food and the violation was committed knowingly and willfully. Finally, H.B. 1519 provides that discovery and all other proceedings shall be stayed during a motion to dismiss.
Offer of Judgment: SB 3 (2005). Provides for offer of judgment for all cases. An offering party may obtain litigation costs, including attorney's fees, if the final judgment is not at least 25 percent more favorable than the offer.
Punitive Damages Reform: Clear and Convincing Evidence: Ga. Code Ann. § 51-12-5.1. Requires a plaintiff to prove punitive damages by “clear and convincing” evidence.
Punitive Damages Reform: Limits on Damages: Ga. Code Ann. § 51-12-5.1 (f)(g). Limits punitive damages to $250,000 unless the plaintiff demonstrates that the defendant acted with a specific intent to harm.
Venue Reform: SB 3 (2005). In cases involving multiple defendants, if defendants who reside in the county where the action is pending are discharged from liability, the non-resident defendant may require that the case be transferred to a county or court in which venue would otherwise be proper.
Venue Reform: HB 792 (2003). Provides that Georgia courts may decline jurisdiction of any civil causes of a nonresident by considering the following factors: (1) the place of accrual of the cause of action; (2) the location of witnesses; (3) the residence or residences of the parties; (4) whether a litigant is attempting to circumvent the applicable statute of limitations of another state; and (5) the public factor of the convenience to and burden upon the court.

NAMIC (http://www.namic.org/reports/tortReform/stateGA.asp)

Georgia Tort Reform Legislation
ISSUE CURRENT LAW STATUTORY CITATION and LINK OTHER PROVISIONS 2004 NEW LAWS and NET EFFECT of LAW CHANGE
Appeal Bond Reform Limits the amount of appeal bond for civil actions to $25 million. Georgia Code 5-6-46
If it is proven that the party posting bond is purposefully dissipating assets in an effort to avoid ultimate payment of the judgment the limits described herein shall not apply. N/A
Class Action Reform Establishes procedures to govern class actions including initiation, dismissal, transfer of structured settlements, notice and judgments. Georgia Code 9-11-23
N/A N/A
Joint and Several Liability Reform Establishes a limit of several liability in personal injury and property damage cases. Georgia Unannotated Code 51-12-33
Applicable only when plaintiff is assessed some measure of fault. N/A
Prejudgment Interest Reform Establishes that the rate of interest on all judgments in the state shall be limited to the prime rate plus 3%. Georgia Code 7-4-12
N/A N/A
Product Liability Reform Establishes that a product seller is not a manufacturer and therefore not liable for product liability claims. Georgia Code 51-1-11.1
N/A N/A
Punitive Damage Reform Punitive damages limited to $250,000. Georgia Unannotated Code 51-12-5.1
Not applicable to product liability cases. N/A
NAMIC does not present the information contained in this report as an exact and absolute portrayal of all tort reform-related laws that have been enacted in every state to date. Rather, it represents a comprehensive listing and summary analysis of the existing laws and recently enacted legislation specifically identified by NAMIC State and Regulatory Affairs staff as generated through its own internal intelligence and legislative and regulatory tracking tools as those which bear direct relevance to the key facets of tort reform NAMIC supports.
This report is for use as a convenient tool for our members, and is not intended, and should not be considered to be, legal advice. Please consult your legal representatives.

Nice redirection, Ted, but this post had nothing to do with malpractice rates, but physician availability. Do you have evidence that shows malpractice "reforms" have any effect on physician availability? If so, I'd love to see it.

Yes. See the AEI panel I was on where I presented Jonathan Klick's paper on the subject.

Ted writes:

"Yes. See the AEI panel I was on where I presented Jonathan Klick's paper on the subject."

That methodology was flawed, as has been explained many litigation group meetings.

"That methodology was flawed, as has been explained many litigation group meetings."

Lee, you're putting your credibility at issue here. Support this assertion, because you don't in your comment, and I don't believe you. Randy Bovbjerg at the Urban Institute was on the same panel, and didn't once mention flaws in the methodology. Klick's paper can be found on this page; click on "Klick Medmal Reform" for the paper and "Klick Presentation" for his Powerpoint. The results are consistent with Mello et al. and Helland: reform increases physician supply.

Hi Ted,

Thanks for your comment on Tort Deform,

I think that you should ease up on Lee until you support your comment back on the Workers Compensation Denial post

(http://www.tortdeform.com/archives/2006/09/workers_compensation_denials_s.html#comments)

where you informed us that are immune from being asked to support your assertions when asked pointed questions.

Cyrus: are you taking the position that it's okay for your co-blogger to deliberately lie about a medical malpractice study because I didn't answer an irrelevant question about workers' compensation in a completely different thread?

Ted, I was using your own argument to ridicule your position.

You wrote: "Yes. See the AEI panel I was on where I presented Jonathan Klick's paper on the subject."

No link, no citation that would allow anyone to find your evidence.

You now seem to think you can make a vague reference in lieu of evidence, even though you previously cited an article that contradicted your conclusion.

be well

Hi Ted,

Thanks for your comments on Tort Deform.

Do you really feel that Lee was "lying?"

Could it not be that you simply have two different views of an issue?

Is that possible?

CD: Do you really feel that Lee was "lying?"

Yes, I do. He made a factual claim that wasn't true, and that he knew wasn't true. His 1:21 am comment shows that he made up the claim, and is now trying to pass it off as a "joke." My reference was hardly vague: the first Google result would've found the study I referred to and that Tilson lied about.

In fact, I have been to numerous meetings where such information was discussed. In all likelihood, This study was discussed at one of the many meetings I have attended.

I am glad you have such thick skin and such a wonderful sense of humor.

I do not come here for suggestions for fishing expeditions. I visited the website in on the link, and there is only a title of a paper there.

Support your positions any way you want. But even Plato has refuted your argument.

Geez.

Hey Ted, the Klick paper I was finally able to locate, though it took a while, contradicts the proposition for which you cited it.

It says that abolishing joint and several liability, mandating future payments, and adopting a no fault approach will decrease the supply of specialty physicians.

While some tort reforms may increase supply, the net effect on public health is not clear. He expresses some concern about the prospect of reducing incentives for physicians to provide optimal care.

Ted, that is twice you have cited Klick's papers to me. Each time, close reading of the papers offers evidence that contradicts the propositions for which they are cited.

You say you presented this one.

"I visited the website in on the link, and there is only a title of a paper there."

Is it a medical problem that Tilson's physically incapable of honesty? Because this is a lie, too. The PDF of the 20-page paper is plainly labeled precisely where I said it was.

The Klick paper says:

"Abolilshing joint and several liability, mandating periodic payment of future losses, and the establishment of no-fault victims' funds all lead to stastically significant decreases in the number of doctors in high risk specialties."

Does the paper say that, on page 13/14?

Doesn't that sentence contradict the proposition for which you cited it?

Lee

I did go to the web page. I had to search for the paper using the title. Eventually, if one wants to continue on Ted's fishing expeditions, one can sometimes find it. But this is beside the point.

The issue is whether tort reform increases physician availability.

Klick's paper includes the sentence above, along with other sentences. That sentence contradicts the proposition for which Ted cited it.

Simple as that.

"Doesn't that sentence contradict the proposition for which you cited it?"

No. I was talking about noneconomic damages caps.

Ted writes:

"Doesn't that sentence contradict the proposition for which you cited it?"

No. I was talking about noneconomic damages caps.

Posted by: Ted | October 4, 2006 03:05 PM

But you were asked:

" Do you have evidence that shows malpractice "reforms" have any effect on physician availability? If so, I'd love to see it.

Posted by: Justinian Lane | October 1, 2006 03:49 PM "

to which you (Ted) replied:

"Yes. See the AEI panel I was on where I presented Jonathan Klick's paper on the subject.

Posted by: Ted | October 1, 2006 04:09 PM "

But let's ignore this.

Here is what matters: preventing injuries.

Ted, are you willing to help prevent injuries? Prevent medical malpractice? Prevent the epidemic of medical errors that kill hundreds of thousands of Americans a year?

Perhaps you could also put that question to some of your other friends.

If we prevent errors, then we have solved a problem on which we agree.

What do you say?

Lee

The legal system in US has been criticized for being too costly, inefficient and ineffective in administering fair awards. The economic costs associated with these are considerable.

These costs are:
1. The individuals suffer directly by having less disposable income than they would otherwise have.
2. Individuals suffer indirectly when the businesses raise their price on goods and services, as a result of paying higher premiums on product liability.
3. When businesses charge higher prices, they do less business as it slows down the job expansion and economic growth. Individuals bear the brunt of this economic slowdown in the form of lower wages and fewer jobs
4. Increasing awareness of litigations, discourage the businesses and individuals from taking any kind of risks which means fewer new products and new technologies are brought to the market.

Individuals living in the urban areas are the ones who are greatly affected by these tort laws as they experienced an even greater increase in tort costs. In the current environment of fiscal responsibility and taxpayer flight from cities, urban governments and residents can ill-afford to allocate large portions of their budgets to litigation costs.

The economic effects of such a huge tort burden on the American economy are hard to be measured directly, but are nonetheless significant. Individuals suffer from the high price of insurance and the increased cost of goods and services. Businesses are hurt by the higher prices they must charge to pay their insurance costs. The overall economy also suffers when productivity and growth are slowed by excessive litigation, which discourages risk-taking and slows the introduction of new products and technologies.
In such circumstances, Tax reforms become very important for the growth of the economy. Texans for Lawsuit Reforms is one such organization, started by Mr. Dick Weekley to fight tort laws and its adverse effects on the economy. It’s a statewide organization aimed at bringing fairness and balance back to the Texan Judicial System.

For more info on Tort Reforms, login to
www.pacificresearch.org/press/clip/2006/clip-05-24-06tlr.html

There is no doctor shortage. If there were, doctors income would increase. They wouldn't be treated like dirt.

The profession is the most regulated, with minute by minute supervision by the lawyer and doctor traitors working for insurance companies. The content of their notes, every tiniest decision and prescription for aspirin is second guessed, with the slightest miscoding resulting in Federal charges, and FBI SWAT goons (lawyers) surrounding the office with assault vehicles, roughing up the staff in front of patients.

If doctors were illegal aliens picking lettuce, they might be left better alone, as long as the lettuce kept coming.

I support the taking of names, and the deterrence of the enemies of clinical care. Once this decision is made by the doctor, it will be unfortunate.