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Judd v. Drezga11/5/2004
information presented by the parties and amici reveals that the cap meets the standard for constitutionality set by article I, section 24.
With regard to controlling health care costs, a report authored by Congress's Office of Technology Assessment evaluated six different empirical studies and concluded that "caps on damage awards were the only type of State tort reform that consistently showed significant results in reducing the malpractice cost indicators." Impact of Legal Reforms, supra, at 64. This reveals that such caps may be considered reasonably necessary to implement the legislature's policy of controlling malpractice insurance costs, and thus health care costs. However, the caps appear not only to be reasonably necessary, but to have an actual and substantial impact. This can be seen from a review of the actions and experiences of other states.
A study addressing California's experience with damage caps reported that "caps on non-economic damages tend to be particularly effective in reducing costs because of the extreme variability of damage award attributable to pain and suffering." LECG, Inc., California's MICRA Reforms: How Would a Higher Cap on Non-Economic Damages Affect the Cost of and Access to Health Care? 7 (1998) [hereinafter California's MICRA Reforms]. As the aforementioned Office of Technology Assessment report indicated, " ven though caps on damages directly affect only a small minority of cases, this minority often accounts for a disproportionate share of total malpractice payments. In addition, it is the large, unexpected claim that makes it difficult for insurers to plan reserves." Impact of Legal Reforms, supra, at 64. Thus, Judd's unreasonableness argument, premised on the fact that there are relatively few claims in Utah subject to the cap, is not sufficiently compelling. It appears that the enactment of a cap allows sufficient quantification of quality of life damages to have a substantial impact on insurance rates.
The Board of Trustees of the American Medical Association has reported to its House of Delegates that the presence of a cap on non-economic damages in California has stabilized local malpractice insurance rates at some of the lowest levels in the nation. American Medical Ass'n, Report 35 of The Board of Trustees 6 (2002). That same report compared the malpractice insurance rates paid by physicians in California to those paid by physicians in Nevada, where there was no cap on damages. Nevada physicians paid considerably more for comparable insurance than did California physicians--ranging from 42.8% higher premiums in the family and general practice field to 93% more in obstetrics and gynecology. Id. at 6-7. In short, there is sufficient evidence that caps on quality of life damages do have an actual impact on the cost of malpractice insurance.
The legislature also identified ensuring the continuing availability of health care resources as one of its purposes. Utah Code Ann. ยง 78-14-2 (2002). This concern appears to be equally as valid as, and related to, controlling costs. Nevada's recent experience illustrates the effect of high malpractice insurance rates on the availability of health care resources. In July 2002, Las Vegas's only Level 1 trauma center closed. William Booth, Las Vegas Trauma Center Closes as Doctors Quit, Wash. Post, July 4, 2002, at A2. The closure of the trauma unit was precipitated by the resignation of virtually all of the facility's surgeons, who left because of the soaring cost of insuring themselves against malpractice. Id. After the closure, the nearest trauma center was 188 miles away from Las Vegas. Id. Nevada's experience, while extreme, is not unique. Doctors in other states reportedly have
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