To the editor: With all due respect to columnist George Skelton, who calls for increasing California’s medical malpractice cap, there simply is no reliable way to calculate the monetary value of “pain and suffering” that victims of malpractice experience.

Non-economic damages were rightfully limited in 1975 legislation signed by then-Gov. Jerry Brown during a time when California was suffering a shortage of physicians, particularly those in such “high-risk” specialties as anesthesiology, neurosurgery, obstetrics and thoracic and cardiovascular surgery.

If the trial lawyers succeed in raising the malpractice cap through their second initiative in six years, I predict that health insurance premiums for all not only will rise greatly, but “defensive medicine” and the retirement of older physicians will accelerate while shortages of younger physicians in certain key specialties will reappear.

California no longer is a haven for younger doctors, who are faced with the same constraints as other Californians when it comes to housing costs. As an added burden, most are also paying off huge medical school loans. Voters next year will need to carefully consider whether they are willing to tolerate a physician exodus to Nevada (which has a $350,000 limit) or Texas ($250,000).


Dr. Harold N. Bass, Porter Ranch

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To the editor: While discussing caps on medical malpractice awards, state government should contemplate the numerous insurers and managed care platforms making medical determinations without any liability at all.

Many health insurers employ physicians working outside California to review and direct care. Most of those physicians are not licensed in California. Why would a bariatric surgeon on the East Coast be allowed to deny a medically necessary MRI for a child with congenital heart disease in California?


Accountability must be compelled at all levels of care with a clear and equitable policy for meeting credentialing criteria through the Medical Board of California. Otherwise there can be no credible proposal for raising caps.

Kim Griffin, San Mateo

The writer is a registered nurse.