Malpractice cap in bill too low

New York is closer than ever to limiting the amount of money patients can be awarded for pain and suffering in medical malpractice lawsuits.

Capping non-economic damages will help hold the line on malpractice insurance premiums, slow the flight of doctors from high-risk specialties such as obstetrics, and should speed the resolution of lawsuits by promoting settlements. It's an important step in the right direction. But it's no silver bullet.

The $250,000 cap that Gov. Andrew M. Cuomo and Senate Republicans favor is too low. It would shortchange people with grievous injuries -- disfiguring facial wounds for instance -- that cause a great deal of emotional pain and suffering but, in some cases, modest economic losses.

And a cap also won't do much to hold down the soaring cost of medical care. Defensive medicine accounts for about 1 percent of the nation's health care bill. And even with a cap, doctors will continue to defensively order tests and procedures just in case they're sued.

If Albany does impose a cap, it shouldn't be the end of reform. What's needed are workable alternatives to long, costly litigation as a way to resolve medical malpractice claims.

Approaches to explore include voluntary arbitration, a no-fault system for birth injuries, or special malpractice courts, possibly without juries, to mute the emotional element in tragic cases.

Officials should also look for ways to reduce the incidence of negligence, for instance tougher discipline for impaired or incompetent doctors. Those who are repeatedly negligent shouldn't be allowed to practice.

About half the states have imposed some limit on malpractice awards, but the debate has been long and agonizing in New York. Cuomo's provider-heavy Medicaid redesign team gave the issue a key boost this year when a cap was among its package of recommendations to cut the cost of Medicaid. The state Senate's Republican majority subsequently included the cap in its budget bill.

But there is no cap in the Assembly's bill. Speaker Sheldon Silver (D-Manhattan), a personal injury lawyer, has long resisted limiting medical malpractice awards. So the imposition of a cap isn't a done deal. To get it completed, officials should negotiate a higher ceiling on the awards.

What's needed is a balance that works well for doctors, hospitals and aggrieved patients.