The rapidly rising cost and decreasing availability of medical-malpractice liability insurance is a nationwide problem that is becoming acute in our state. Some people believe that there is not a "crisis." Others seek to shift the blame to the insurance industry or to stock markets. While we recognize the complexity of the problem, we believe that meaningful tort reform will be effective in addressing the problem.

Jefferson City Medical Group is one of the largest physician-owned multi-specialty groups in the state. We provide health care to over 60,000 people in the Capitol City area. Many of our physicians have trained at the most prestigious institutions, and we have a reputation for excellent medical care. Despite a favorable malpractice record, we are experiencing severe increases in the cost of medical-malpractice insurance. Our rates have risen 30 percent per year for the past three years and are expected to rise 50 percent in June - if we can even renew our coverage when it expires. Many other fine physicians across our state are in a similar situation.

Currently, physicians in high-risk specialties (such as surgery or delivering babies) are limiting their practices, retiring early or considering relocation to other states. Once physicians leave the area, it will be very difficult to get them back. As Missourians, we all need to work for reforms that will prevent doctors from leaving our state. Our patients need access to the knowledge and skill of these highly trained physicians. As health care becomes more costly and less available, expectant mothers, the poor, patients with Medicaid insurance and the most vulnerable members of society will be the first to suffer.

While we do not seek to prevent a legitimate injured plaintiff from receiving a reasonable settlement, we do believe that something must be done. We favor reforms that include limits on "non-economic damage awards," prohibition of "venue shopping," and reforms of "joint and several liability rules." These simple changes would still allow an injured person to receive fair restitution but would prevent outrageous awards for "pain and suffering." Cases would have to be tried in hometown courts, and attorneys would not be allowed to move cases to cities with reputations for excessive awards. Liability would be assigned according to who was to blame, rather than who had "deep pockets."

In summary, we believe that the medical-liability situation in our state is out of control and that abusive litigation by a few threatens the right of all citizens to access health care. I urge you to support the passage of laws to reform the medical-liability system in Missouri.

Richard B. Jennett, M.D., F.A.C.P., is president and CEO of the Jefferson City Medical Group.

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