Back in 2005, the General Assembly passed legislation capping medical malpractice awards. Before this, medical malpractice awards for “noneconomic damages,” such as “pain and suffering,” were capped at $579,000. The 2005 law lowered it to $350,000. The move was done to control the rising rates of medical malpractice insurance, which were driving up healthcare costs, and to reduce lawsuits, which were getting out-of-hand.

The legislation worked. Medical malpractice insurance rates leveled out and have remained stable. The number of lawsuits dropped, victims continued to receive compensation for their personal injury and doctors stayed in Missouri. For the most part, the whole topic became a settled issue. Until last year. 

Last July, in the case of Watts v. Cox Medical Centers, the state Supreme Court ruled in a 4-3 decision that the state’s cap on jury awards for noneconomic damages in medical malpractice cases was unconstitutional, effectively removing the limit. We’ve now returned to the pre-cap days, with all the same problems just waiting to pop back up.

On Tuesday, the Senate spent more than eight hours debating House Bill 112, which would re-establish the caps on medical malpractice jury awards for non-economic damages. This is, without a doubt, one of the more difficult issues facing the Legislature. It’s also one of the most important. At stake is the quality and cost of medical care for Missouri citizens.

Sound policy balances the interests of both sides of an issue. Lawmakers are often in the position of playing Goldilocks, seeking policy that’s not too hot, not too cold, but just right. If the law is skewed in favor of either side, the consequences can be devastating for the state.

No one denies that victims of medical malpractice are entitled to equitable remuneration. If a surgeon leaves a scalpel inside you, you deserve compensation. However, if juries are given carte blanche to hand out huge awards, often out of some mistaken attempt at “justice” instead of what’s actually fair, the health care industry will be hard-hit. Malpractice insurance premiums will skyrocket, and with them, health care costs. Doctors will move to states that favor sensible malpractice caps. These outcomes benefit no one, least of all the people of Missouri.

The duty before lawmakers now is to tip the scale back to the middle, to find the balance. As we saw Tuesday night, this is not an easy task. The legislation ultimately stalled and was laid aside for future debate. We will continue working towards a compromise on this issue.

The Senate gave final approval on Monday to legislation that would modify how prevailing wage amounts are calculated. As I’ve spoken about prevailing wage before, the system has been in need of reform for quite some time. The way the wage is figured is seriously flawed, resulting in wage amounts that are anything but representative of an area, especially in rural counties. These inflated rates, often based on collective bargaining agreements from metro areas, hamper many communities from starting county projects.

House Bill 34 makes a number of changes to the prevailing wage system to make it more reflective of what contractors actually earn in an area. Under the measure, the wage in third and fourth class counties would be figured using the most common wage, not the average, which often resulted in inflated rates. If there are no reports available for a particular year, the formula will take into account reports from the previous six years. If those are unavailable, the most recent reported wage in an adjoining county will be used. Only if all those options fail will the rate be based on collective bargaining agreements.

There are still issues to address. The current definition of “construction” under the prevailing wage is so vague and broad, just about any occupation could fall into the category. Also, we need to find a way to encourage employers to submit more wage surveys. This is probably the single biggest factor in the current system’s failings. However, House Bill 34 is a solid first step in fixing our prevailing wage. The bill now goes back to the House for consideration. 

Contact Me

I always appreciate hearing your comments, opinions, and concerns. Please feel free to contact me in Jefferson City at (573) 751-2459. You may write me at Wayne Wallingford, Missouri Senate, State Capitol, Jefferson City, MO 65101, or email at wayne.wallingford@senate.mo.gov or www.senate.mo.gov/wallingford.