Don't bet any serious money on it yet, but there may be some hope for

movement on the perennial issue of medical malpractice tort reform this

session.

The bill that would at least nudge Hawaii closer to reform is House Bill

1784, which has moved out of the Judiciary Committee — a barrier in the past

— and is poised for the great leap to the Senate.

In what is a welcome and potentially useful compromise, the revised bill

would cap the amount of "noneconomic" damages, such as emotional distress

and loss of companionship, that a plaintiff could receive in a tort claim

for medical malpractice.

The cap would only affect doctors in emergency medicine, neurological

surgery, obstetrics and gynecology, orthopedic surgery and general surgery,

areas the Hawaii Medical Association identified as more vulnerable to

lawsuits. The law, and the cap with it, would expire in five years, unless

data compiled by then shows it's effective — meaning it succeeded at

lowering insurance premiums and removing a deterrent for doctors to

practice.

But just where to set that cap would be the job of a task force that would

report back next session with the recommended dollar amount.

Task forces can be the bane of those who hope for gains in a legislative

agenda ‹ they often seem like stalling tactics and appeasements. But this

issue is complex, so the required assembly representing the insurance, legal

and medical professions could weigh all the competing data and arrive at a

reasonable limit.

In any case, HB 1784 already has some protection for victims built in: The

cap on noneconomic damages wouldn¹t apply if the victim is awarded economic

damages, such as lost wages and benefits, that are less than $1.5 million.

That provision may help allay the fears of some in the Senate concerned that

capped awards won't compensate victims adequately.

Doctors lobbying for such a measure point to a shortage of medical

professionals in key specialties willing to practice in rural areas, and in

a state composed of remote islands, that is a critical situation.

They are opposed by attorneys and advocates for victim's rights who maintain

that medical tort reform has not been proven to aid in its stated goal: to

improve the climate for medical practice enough that doctors would be more

willing to work in these areas.

It¹s certainly true that tort reform is only a start, that improving

reimbursement rates for physicians must be part of the solution. And further

incentives are needed to draw doctors to rural communities.

Encouragingly, there's a renewed effort this session to establish the

Hawaii Health Corps Program. Senate Bill 169 just passed the key Ways and

Means Committee; if passed, it would launch a recruitment plan for

healthcare professionals including a loan repayment program to help young

professionals willing to practice in shortage areas.

Tort reform is not by itself sufficient to solve the problem of healthcare

access in the state, but it is a necessary component. Passage of HB 1784 at

least would ensure that able minds would be brought to bear on a question

that has lingered, unanswered, in the Capitol for years.