The Volokh Conspiracy

Punitive Damages and American Exceptionalism:

The United States has a rather unique approach to punitive damages -- one that courts in other countries find alien, if not unconscionable. As the New York Times reports, foreign systems tend to disfavor punitives, and foreign courts can be reluctant to enforce American court judgments that include large punitive awards.

Most of the rest of the world views the idea of punitive damages with alarm. As the Italian court explained, private lawsuits brought by injured people should have only one goal — compensation for a loss. Allowing separate awards meant to punish the defendant, foreign courts say, is a terrible idea.

Punishments, they say, should be meted out only by the criminal justice system, with its elaborate due process protections and disinterested prosecutors. It is not fair, they add, to give plaintiffs a windfall beyond what they have lost. And the ad hoc opinions of a jury, they say, are a poor substitute for the considered judgments of government safety regulators.

Some common-law countries do allow punitive damages, though in limited circumstances and modest amounts. In the United States, by contrast, enormous punitive awards are relatively common, although they are often reduced or eliminated on appeal. Last month, for instance, the United States Supreme Court heard arguments in the Exxon Valdez case, where a jury’s initial award of $5 billion was later reduced to $2.5 billion.

Still, such awards terrify foreign courts.

“The U.S. practice of permitting a lay jury to exercise largely discretionary judgment with limited constraints in awarding punitive damages is regarded almost universally outside the U.S. with a high degree of disfavor,” said Gary Born, an American lawyer who works in London.

That the U.S. approach is "exceptional," of course, does not mean it is wrong. While the U.S. legal system has its problems, taken as a whole I find it preferable to existing alternatives (though that may well reflect a bias for the familiar).

Dan Schmutter:

Punishments, they say, should be meted out only by the criminal justice system, with its elaborate due process protections and disinterested prosecutors


Umm . . . disinterested prosecutors? Aren't prosecutors advocates for the State? How are they disinterested?

Dan Schmutter
3.26.2008 10:29am
Just Saying:
Punishments, they say, should be meted out only by the criminal justice system, with its elaborate due process protections and disinterested prosecutors

Meaning, of course, any company that can stay in good favor with the right civil servants can do virtually anything with immunity; pay off a few settlements and judgments here and there, and keep on doing whatever it is you shouldn't be doing.

I'm not sure I like the American system either, but it seems like it does motivate corporations to be careful. I rather like the notion of a corporation having to ask itself, "If this is ever an issue at a trial, is my lawyer really going to be able to sell this to 12 jurors?". Given the massive legal advantage corporations have-- from being repeat players to more resources-- I think the fears of companies being 'ruined' by punitive damages are overstated. That being said, I'd love to see some empirical information on how corporate decision-making is impacted by punitive damages.
3.26.2008 10:37am
martinned (mail) (www):
L.S.,

@Dan Schmutter: That depends on the extent to which the system is adversarial. At the very least, the prosecutor wouldn't normally prosecute someone unless they were themselves convinced of the defendant's guilt.

As for Jonathan's question, I'm thinking bias for the familiar in the same way that I'm very happy to live in a country with no juries. While I have arguments for disliking juries, I'm willing to accept I'm biased here.
3.26.2008 10:37am
A.C.:
Most people I've met from outside the US distrust juries, period. The expression "lay jury" is telling. The notion is that decisions should be left to trained professionals, wherever they may be located in the system.

Kind of belies the notion, often expressed by the same people who detest juries, that Americans are pro-business elitists and that Europeans have more respect for the common people.
3.26.2008 10:38am
ejo:
but, as the consensus in foreign countries seems to be they are disfavored, doesn't that mean we are wrong? after all, we are wrong on the death penalty based on the international consensus. why shouldn't we take this foreign law into account with our punitives jurisprudence?
3.26.2008 10:38am
Tracy Johnson (www):
I find it funny that two blogs earlier we find it praiseworthy the Medellin judgment disallows the International Court ruling. But in this blog entry, be almost begs to use foreign court practices. (The argument of the earlier entry notwithstanding, I'm just using juxtaposition here.)
3.26.2008 10:40am
martinned (mail) (www):
L.S.,

While I would not advocate the kind of position riduled in previous comments, taking a cue from other Common Law jurisdictions seems reasonable. As stated in the post, none of them have "exemplary damages" (as they're called in the UK) anywhere near as high as in the US. As for juries, in the UK at least civil juries are limited to defamation suits and a few small categories. (I know, in the US there's a constitutional guarantee on this point, so it's a non-starter. But still.)
3.26.2008 10:48am
Terrivus:
Usually when one hears about foreign legal practices, it is a more "liberal" practice, leading those who agree with such practices to support reliance on foreign legal authorities and practices.

So I think it would be interesting to keep a list of practices in foreign jurisdictions that are more "conservative" than American legal practices. Then, whenever Justice Breyer or the like rallies for placing greater authority on foreign authorities and practices, one could reasonably ask whether such proponents also advocate for incorporating those more "conservative" practices (with which they likely disagree) as well.

Off the top of my head, a list of "conservative" practices would include:

1. Absence or distrust of punitive damages
2. Lack of an exclusionary rule

Any others?

(Note that when I say "conservative" and "liberal," I mean as a matter of policy, not constitutionally; cf. Scalia and Thomas on punitive damages.)
3.26.2008 11:04am
Terrivus:
"in this blog entry, [h]e almost begs to use foreign court practices."

Are you reading a different entry than I am? Nothing in the post comes close to suggesting that Prof. Adler "begs" to look to foreign court practices. He describes the Times article and then blockquotes it. And his last two sentences, if anything, offer support for the American legal system's approach, finding it "preferable to existing alternatives."

Seriously, what the hell are you talking about?
3.26.2008 11:08am
Bart (mail):
Foreigners are hardly the only ones horrified about the US system awarding high capped to unlimited punis.

Punis enrich lawyers and their lotto winning clients at the expense of consumers how pay higher costs for or the absence of products, services and insurance.

On a related note, out here in Colorado, our Dem governor and legislature are getting set to reward their lawyer contributors by substantially raising the caps on medical malpractice non-economic damages despite pleas from the doctors that they will have to leave the state when their already insane insurance becomes unaffordable or unavailable.
3.26.2008 11:12am
Just Saying:
Terrivus-- My understanding is that many countries have more restrictions on abortion than Roe v. Wade and its progeny would allow.
3.26.2008 11:12am
x (mail):
"In the United States, by contrast, enormous punitive awards are relatively common, although they are often reduced or eliminated on appeal."

I don't think enormous punitive awards are "relatively common," I think they're relatively rare. And they seem to be VERY OFTEN reduced or eliminated on appeal.

Punitive damages 1) provide access to justice for harmed individuals, 2) motivate corporations to do the right thing and not just sharpen the pencil and figure the "cost of doing business."
3.26.2008 11:12am
martinned (mail) (www):
L.S.,

@Terrivus: Since no one is saying the US should consider the practices of countries that aren't "civilised" in the sense that they are democratic, respect civil liberties and uphold the rule of law, are there countries that are civilised in this sense that are more conservative than the US?

In Ireland, Portugal and Poland abortion is still illegal. In Ireland (I used to live there, so I know a few things about their laws), you have to be separated for 2 years before you can get a divorce, and prenups are null and void on the grounds that they go against public policy (order, morality, etc.).

Some of my favourite passages from the Bunreacht na hEireann, i.e. the constitution of Ireland:

Preamble:
"In the Name of the Most Holy Trinity, from Whom is all authority and to Whom, as our final end, all actions both of men and States must be referred,

We, the people of Éire,

Humbly acknowledging all our obligations to our Divine Lord, Jesus Christ, Who sustained our fathers through centuries of trial,

Gratefully remembering their heroic and unremitting struggle to regain the rightful independence of our Nation,

And seeking to promote the common good, with due observance of Prudence, Justice and Charity, so that the dignity and freedom of the individual may be assured, true social order attained, the unity of our country restored, and concord established with other nations,

Do hereby adopt, enact, and give to ourselves this Constitution."

"Article 6
1. All powers of government, legislative, executive and judicial, derive, under God, from the people, whose right it is to designate the rulers of the State and, in final appeal, to decide all questions of national policy, according to the requirements of the common good."

"The Family
Article 41
1. 1° The State recognises the Family as the natural primary and fundamental unit group of Society, and as a moral institution possessing inalienable and imprescriptible rights, antecedent and superior to all positive law.
CONSTITUTION OF IRELAND – BUNREACHT NA hÉIREANN
2° The State, therefore, guarantees to protect the Family in its constitution and authority, as the necessary basis of social order and as indispensable to the welfare of the Nation and the State.
2. 1° In particular, the State recognises that by her life within the home, woman gives to the State a support without which the common good cannot be achieved.
2° The State shall, therefore, endeavour to ensure that mothers shall not be obliged by economic necessity to engage in labour to the neglect of their duties in the home.
3. 1° The State pledges itself to guard with special care the institution of Marriage, on which the Family is founded, and to protect it against attack."

"Article 44
1. The State acknowledges that the homage of public worship is due to Almighty God. It shall hold His Name in reverence, and shall respect and honour religion."

Conservative enough? Still, in most other questions, Irish laws would, in US eyes, probably look as "liberal" as those of any other Western country.
3.26.2008 11:13am
DiverDan (mail):
I have to agree with the foreign authorities on this point -allowing juries (who are typically made up of the 12 people out of the panel LEAST likely to know anything, and LEAST likely to be competent to make a rational decision free from bias and emotion) to fix a "punishment" (often for nothing more than pissing off the jury by taking a perfectly lawful course of conduct that some feel was "unfair") is a recipe for economic chaos. Even in states where the Legislature has sought to limit exemplary damages, like Texas where the Statute allows exemplary damages only for fraud, malice, or gross negligence, requires proof by "clear and convincing evidence", and prohibits any exemplary damages unless the Plaintiff proves "more than nominal damages", juries will regularly be encouraged by Plaintiffs' lawyers to give only a wink and a nod to these limits. As a result, Defendants are required to pay multiple Plaintiffs exemplary damages for the same conduct, something that would be barred in the criminal arena by the double jeopardy clause. Frankly, if we are going to allow civil juries to award exemplary damages, we ought to require that any damages awarded go not to the Plaintiff (or his/her attorney) as an undeserved windfall, but rather to a common fund to benefit everyone who was damaged by the conducty complained of.
3.26.2008 11:17am
T. Gracchus (mail):
Neither the article nor commentators here note the connection to contingency representation, not usually available outside the US. Contingency makes representation available in a range of cases which would otherwise be impractical.
3.26.2008 11:17am
tyree (mail):
"That the U.S. approach is "exceptional," of course, does not mean it is wrong."

Spoken like a true lawyer. My father, the doctor, who quit practicing medicine when he could no longer afford malpractice insurance, would disagree.
3.26.2008 11:25am
Cornellian (mail):
I believe that Canada has civil juries that can impose punitive damages. However, those punitive damage awards have to be confined to the wrongdoing at issue in the action, they can't go and base it on some percentage of the revenue from all sales of the defective product, or anything like that. That restriction, plus pretty close judicial scrutiny of the awards keeps them from turning into the lottery system that we have here.
3.26.2008 11:31am
Loren (mail):
I mostly agree with DiverDan's comment, the punitive award should not be given to the plaintiff, as a "reward", but to either a fund for similarly damaged persons, or to the State, which is the only entity whom we, as a society, empower to punish lawbreakers.
3.26.2008 11:32am
JB:
I would hesitate--nay, run the other way--from a policy of giving punitive damages to the State. That's a recipe for bringing the traffic-ticket mentality into the civil court system. Need to balance the budget? Sue some companies!

I'm frankly shocked anyone suggested this on a blog like this.
3.26.2008 11:47am
Vivictius (mail):
The American system of punitive damages is broken and the only people supporting it are the lawyers making money off of it. I agree with Loren that if nothing else the punitive damages should not go to the plantiff an any case.

People complain about the high cost of medical care in this country, well, this is the main reason it costs so damn much. At my local hospital they have to pay $100,000 a month for each doctor in malpractice insurance.

Dont see that changing much, for lawyers, making money trumps everything else.
3.26.2008 11:47am
John M. Perkins (mail):
Loren,

Howzabout some qui tam like bonus for the plaintiff?
3.26.2008 11:48am
Anderson (mail):
Anyone who reads the actual article, rather than Prof. Adler's excerpt, will see that the article goes on to discuss how some foreign jurisdictions are becoming more accepting of punitive-damage awards.
3.26.2008 11:52am
pireader (mail):
Bart wrote--"substantially raising the caps on medical malpractice non-economic damages despite pleas from the doctors that they will have to leave the state when their already insane insurance becomes unaffordable or unavailable."

Let's bookmark this and come back in a year or so.

If the caps get raised but medical care remains available in Colorado, then we'll understand why this sort of doom-crying only arouses amused contempt amongst legislators and politicians. Conversely, if civilization does collapse in Colorado, then we can enjoy watching the Legislature wrestle through the wreckage.

Anybody wanna do a side bet on which way matters will go?
3.26.2008 11:55am
roystgnr:
While there's certainly problems with the current practice of punitive damages (and I also like DiverDan's idea for improving it), it should be clear that restricting awards to "compensation for a loss" is insufficient to deter the acts that cause such losses. In such a system, the expected value of (essentially) stealing $X from someone is $X times the probability p of getting away with it. Since p is always positive, the system needs some additional costs such as punitive damages to make the expected value of this antisocial behavior negative. Litigation itself is one such cost, but not always enough of a cost. I'd prefer it if companies' financial incentives to harm me were not based on the marginal cost of their lawyers' time.
3.26.2008 11:56am
Z9Z99:
The American justice system is very good, and the jury system has much to recommend it, particularly when juries adhere to the role of "trier of fact." I wouldn't trade the U.S. system for anyone else's. However, punitive damages are one area that could use some gussying up. In my opinion, and off the top of my head, some concerns are:

1.) Punitive damages are allowed from state juries in areas where the federal law preempts state legislatures from acting, such as in airline regulation.

2.) A defendant who is sued in multiple jurisdictions for the same act, is subject to repeated punitive sanctions.

3.) One of the whole points to having a written law is that it provides a measure of predictability. Everyone knows what is expected of them, and the consequences when they don't measure up. Even a few outlying punitive damages awards erodes this predictability.

4.) Using the collective force of the state to punish an individual for conduct that the state itself does not proscribe is an aberration of the state's responsibility to administer justice.

5.) Punitive damages may be available, for the same conduct, against one class of defendants and not another, e.g. the government.

6.) Punitive damages should not be regarded as a remedy for the state's failure to exercise its oversight or regulatory authority.
3.26.2008 11:57am
Tracy Johnson (www):
I took my cue from the last paragraph saying it is "exceptional" and the almost apologetic "it is not wrong". It makes it seem the author is sorry it is not so, but the "preferable" in the last sentence mellows it out a bit.
3.26.2008 11:58am
Curt Fischer:

And the ad hoc opinions of a jury, they say, are a poor substitute for the considered judgments of government safety regulators.


I'm surprised no one else has held this line in particular to ridicule. Certainly government safety regulators may offer judgements superior to juries some of the time. But why would government regulators be immune to making "ad hoc" judgements in all cases?

What about the recent California lawsuit against the EPA? Which government regulators in that case gave "considered judgements"? How about the FDA's decision to approve Vioxx? Was that a "considered jugement"? Would we expect the same FDA that approved Vioxx to then turn around and arbitrate disputes between Vioxx victims and Merck? Would we need a new government agency to handle these product liability disputes?

Color me skeptical....
3.26.2008 11:59am
Jack S. (mail) (www):
Notwithstanding the merits of punitive damages, or lack thereof, this judgment from Italy flies in the face of comity accorded by most legal systems.

Not enforcing a judgment for public policy reasons is generally an extremely high bar to overcome. Apparently Italy (and Germany to a certain extent) have chosen to set the bar quite a bit lower.

Moreover, companies wishing to do business in the US are well aware of the risks. Should they chose not to accept the risk, they should not do business rather than being able to hide behind the courts in their country. (no comment on medmal/PI problems..I agree there is a HUGE problem there).
3.26.2008 12:00pm
bearing (mail) (www):
My question is, why are punitive damages paid to the victim/plaintiff? Why don't they go to the government and get used for the common good?

If a man commits a crime against me and is convicted, I don't get to have him serve his punishment by being my personal slave for the duration of the sentence.
3.26.2008 12:01pm
Loren (mail):
John,

IANAL, and my one year of Jr. High Latin, some 35 years ago did not cause qui tam to stick in my head, but hopefully Wikipedia is correct on this. I suppose some qui tam might be appropriate.

But then you get into the issue of the underlying civil action was supposed to make the injured party whole, not richer then before they were injured.

JB,

Again, IANAL but wouldn't the State actually have to have suffered a personal injury to bring a case in civil court? And how could a "corporate" entity like the State suffer a personal injury?
3.26.2008 12:02pm
CJColucci:
I'm not sure what the kerfuffle is about. If other systems don't think punitive damages are a good idea, fine. If they think punitives so violate their public policy that they will refuse to recognize a punitive damages award, also fine. If, in the fullness of time, mature consideration of foreign systems of law contributes to a change in our view of the matter, that would be fine, too.
3.26.2008 12:02pm
Heinz:
The skepticism of punitive damages is not limited to courts. I guess most ordinary people here - i.e. central Europe - (who of course are only aware of the most spectacular or curious cases that make it into the news) would consider the American system to be rather strange (or worse).
3.26.2008 12:06pm
Orielbean (mail):
Dealing in pensions, I would say that damages and compliance are the two largest things I deal with every single day. Any system, resource, budget, or sale consideration takes a back seat to the first two. And it works quite well I might add - all the participants do not need to worry that their retirements are handled by risky administrators.
3.26.2008 12:07pm
lostmycookies (mail):

My question is, why are punitive damages paid to the victim/plaintiff? Why don't they go to the government and get used for the common good?


Because this is the United States of America, not the Association of Socialist Squishes.

One of the most difficult parts of the transition from blind believer in the garbage stuffed in der brain from childhood to libertarianism is the shocking recognition that government does nothing, absolutely nothing, good for the commoners. It merely squelches real good by transferring resources from one group to another, e.g., my money to section 8 vouchers for lowlife losers or 100 Billion Dollar bank bailouts for highlife losers.
3.26.2008 12:17pm
stanneus :
While we’re on the topic of jackpot justice, how about the two other features of American tort law that contribute to it: class actions and money damages for pain &suffering? Neither of these features are commonplace in Europe. True, class actions, if very strictly limited, can provide certain valuable economies of scale in litigation, but just as often they are used as an in terrorem device to extort undeserved settlements. And lay juries award damages for pain &suffering just as whimsically as they do punitive damages. Punitives, class actions, and pain &suffering constitute the unholy trinity of tort law. Good riddance to then all. They’ll never disappear, of course, because John Q. Public sees himself as a possible future winner of the lottery tort law has become.
3.26.2008 12:28pm
J. F. Thomas (mail):
the shocking recognition that government does nothing, absolutely nothing, good for the commoners.

How about clean drinking water, flood control, and sewage treatment?
3.26.2008 12:32pm
iNonymous:
As far as I know, Louisiana (as a quasi-civil law jurisdiction) is the most hostile state in terms of punitive damages. If I recall, they are only allowed in cases of (1) drunken vehicular manslaughter and (2) child sexual abuse. Punitive d's are pretty much unheard of.

Yet most large corporations still look at the LA justice system with, shall we say, a healthy mistrust.
3.26.2008 12:48pm
Hoya:
3.26.2008 12:54pm
...Max... (mail):
How about clean drinking water, flood control, and sewage treatment?

I pay a water/sewage bill every month. Don't you? Or are you saying it is a tax rather than a fee for service?
3.26.2008 1:04pm
Dave D. (mail):
....That Mr. J.F. Thomas , from New Orleans, should refer to gooberment provided Clean water, Flood control and sewage treatment is....is....mindbogling ! I'd have thought he had gotten enough of local government control of these three to last him a lifetime.
3.26.2008 1:13pm
Bored Lawyer:

A defendant who is sued in multiple jurisdictions for the same act, is subject to repeated punitive sanctions.


Does no jurisdiction deal with this problem in any way? This feature strikes me as having the most potential for injustice.

How about a rule that any punitive damages must be reduced by the amount of punitive damages already paid by the same defendant for the same wrong? Otherwise you get over-deterrence.

Say Jury A awarded $100 million in punitives for selling defective products. Jury B awards $150 Million. That means jury B thinks that the defendant needs to be deterred and made an example of to the tune of $150 Million. But defendant has ALREADY been made an example of to the tune of $100 Million in case A. So really you only need an extra $50 Million in deterrence.

(And if Jury B's award is lower, then the defendant has already been deterred to the same extent and more!)

Or maybe Jury B should be told of any prior punitive award by Jury A.

Any thoughts?
3.26.2008 1:17pm
hattio1:
These other countries have a high degree of skepticism for punitive damages and would prefer regulation be done by regulators and the criminal justice system. Anybody want to bet that most of those countries have greater regulations and more effective (and more punishing) criminal justice system when it comes to corporations? In the US, we have relatively little regulation of most industries (there are definitely exceptions), and when a company does have a criminal case against it, the punishment is almost exclusively fines (and often a small percentage of the money they saved by breaking the law). I would bet that in other countries there is a real chance of CEO's going to jail.

As to the whole issue of medical malpractice ruining doctors, just look at what insurance rates have done in states that have put in malpractice caps. They haven't gone down, they've gone up. The problem isn't the medical malpractice specialties.

Finally, Martinned says;

At the very least, the prosecutor wouldn't normally prosecute someone unless they were themselves convinced of the defendant's guilt.


First off, I'm not sure this is true, especially if the criminal fines increase their own budget. But, even assuming it were true, is this a feature or a bug? If the prosecutor never believes a company has done something wrong, doesn't that leave consumers unprotected by both the civil justice and the criminal justice systems?

Last thought, what about problems of jurisdiction? If company headquarters in NY makes a decision about a product that only endangers consumers in hot dry climates (just as an example) how are Nevada and Arizona to defend their claims. Company execs won't travel there, and I can guarantee NY won't extradite the CEO of a big company who has tons of business in NY.
3.26.2008 1:30pm
Positroll (mail):
Punitive damages cannot be discussed without looking at the legal system as a whole. The following comment gets this, but misses another point:
"Neither the article nor commentators here note the connection to contingency representation, not usually available outside the US. Contingency makes representation available in a range of cases which would otherwise be impractical."
What the comment misses is that in many of these cases, "looser pays" could be a viable alternative - but that would mess with other parts of the American system.

Another factor is the availability of payments by the "welfare state" in many European countries:
If you take the typical mass tort, one problem is that is very difficult to figure out the degree of damages caused that will only show themselves in the future. Punitive damages can be used to cover such cases. The European solution is to provide for social security payments and more or less free health care.

A further reason punitive damages are disliked in the rest of the world is the impression (correct or not) that American juries are more ready to impose big punitive damages on foreign corporations. This combines with class actions (more or less unique to the U.S., too), extremely broad bases for general jurisdiction (doing business) covering actions abroad and a discrimatory application of the "forum non conveniens doctrin" to fend of foreign plaintiffs, as well as general disrespect for the sometimes applicable foreign law shown by juries.

P.S. Damages for pain and suffering are known to most continental systems.
3.26.2008 1:36pm
Bart (mail):
pireader (mail):

Bart wrote--"substantially raising the caps on medical malpractice non-economic damages despite pleas from the doctors that they will have to leave the state when their already insane insurance becomes unaffordable or unavailable."

Let's bookmark this and come back in a year or so.

If the caps get raised but medical care remains available in Colorado, then we'll understand why this sort of doom-crying only arouses amused contempt amongst legislators and politicians. Conversely, if civilization does collapse in Colorado, then we can enjoy watching the Legislature wrestle through the wreckage.

Anybody wanna do a side bet on which way matters will go?

If the Dems manage to raised the cap on non-economic medical malpractice damages in my formerly Red state of Colorado, I will wager that both medical malpractice insurance rates will rise and doctors will leave the state out of economic necessity.

There is no real doubt about these two results. This is happening all across the country right now.

I just hope my sister and her husband are not among the physicians forced to move or discontinue practice after I convinced them they were moving to paradise after they finished up med school.
3.26.2008 1:40pm
Positroll (mail):
"Umm . . . disinterested prosecutors? Aren't prosecutors advocates for the State? How are they disinterested?"
Depending on the country, the neutrality to the prosecutors can be a very important part of their job description (the French juge d'instruction being an extreme case). In most countries I am familiar with, they are less likely to prosecute innocent people than those in the U.S.
One reason: in most European countries, they (and their superiors) are career officials with a lot of job security. Usually the get promoted not on the basis of how many people they send to prison (I'd guess that European prisons tend to be more expensive than their US counterparts), but on how well (/fast) they handle their dockets.
3.26.2008 1:54pm
K Parker (mail):
roystgnr:

Your calculation glosses over something that's crucial: stealing is an actual crime. If someone breaks into my house and makes off with my goods, and there's plausible evidence of who did it, the criminal justice system normally asserts itself, and the possible penalty there is way more than just $X.
3.26.2008 2:03pm
z9z99:
Bart,

I'm not sure that doctors leaving the state is the threshold. If malpractice rates rise physcians may not leave the state en masse, but may limit their medicaid participation, or stop doing obstetrics in rural areas, avoid high risk procedures like bariatric surgery, etc. In other words, even if doctors stay, they may try to manage their risk by limiting the services that they provide.

And as I understand the Colorado bill, malpractice rates for a given level of coverage will be capped (potentially limiting the pool of insureds) for a given level of coverage, but removing the caps on impairment and disfigurement will force doctors to increase their limits, making their malpractice overhead increase regardless.
3.26.2008 2:05pm
hattio1:
Bart,
The problem is that malpractice insurance rates rise regardless of the caps. So if we've got a "solution" that puts some cost on people (those who are injured and can't recover an appropriate amount) and doesn't solve the problem it purports to, should we do away with the solution?
3.26.2008 2:13pm
karrde (mail) (www):
Bart and pi_reader:

It is much more accurate to say that the increased cost in malpractice insurance will increase costs across the board for doctors, which will cause a decrease in the number of doctors practicing and an increase in the cost of medical services provided...Causing an increase in insurance rates for everyone who purchases insurance inside the state.

Health care will be available, the question is At What Cost?
3.26.2008 2:17pm
hattio1:
Karrde,
Once again, look at what happened to the cost of medical malpractice insurance when malpractice caps were in place. Cost of medical malpractice insurance still increased. I understand your link between increased malpractice insurance costs and increased cost and decreased availability of medical care. It's the first link in that chain that you haven't established. Find me a state in which malpractice caps were established and the malpractice rates decreased (or even remained flat) and your argument will get somewhere. Until then, its assume the effect and all the rest of the effects logically follow. I'm sure you're right about all the rest of the effects, I'm just not going to assume that your first effect is correct...especially when the evidence points to it not being correct.
3.26.2008 2:37pm
eric (mail):
Medical malpractice damage caps are an arbitrary and silly way of handling the problem of lack of doctors.

Here is some salary data I found on the net (probably inaccurate or old, oh well):
1. Anesthesiologists $184,340
2. Surgeons $184,150
3. Obstetricians &Gynecologists $178,040
4. Orthodontists $176,900
5. Oral &Maxillofacial Surgeons $164,760
6. Internists - General $160,860
7. Prosthodontists $158,940
8. Psychiatrists $149,990
9. Family &General Practitioners $149,850
10. Chief Executives $144,600

So nine of the top ten highest paying jobs in America are physicians and somehow these physicians are not going to be able to pay their malpractice insurance and will quit practicing medicine? Or is the argument that they will leave the state if we don't cap damages?

The truth of the matter seems to be that we don't have enough doctors to begin with (this is reflected by their high pay). We should import every foreign doctor we can (they seem happy to come). Perhaps encouraging more people to go to medical school would also pay off.

Medical malpractice insurers could simply refuse to insure the small amount of doctors that are responsible for most malpractice, then malpractice claims would go down in number.

Frivilous lawsuits deserve santions.

Of course, if trial lawyers gave as much to Republicans as say, Realtors, tort reform probably would not have happened at all.
3.26.2008 3:00pm
A.C.:
Can we really say that jury verdicts of any kind, much less punitive damages, drive medical malpractice insurance rates? The overwhelming majority of cases settle before they ever reach that stage. It would seem to me that the steady drip of settlements -- and even ordinary verdicts -- would be more expensive over the long haul than the odd showstopper.

And do the giant punitive damages cases even turn up in medical malpractice? I thought they were more common in product liability cases where the defendants are large corporations. The amount of money it takes to send a message to a physician, even a rich one, is very different from the amount it takes to get Big Pharma to notice you're there.

And how are the regulators supposed to handle the drug cases, anyway? They can do all the clinical trials they want, but you won't find the rarer side effects until the drug is being used in the population at large. It's a matter of numbers.
3.26.2008 3:16pm
visitor from Texas (mail) (www):

Here is some salary data I found on the net (probably inaccurate or old, oh well):
1. Anesthesiologists $184,340
2. Surgeons $184,150
3. Obstetricians &Gynecologists $178,040
4. Orthodontists $176,900
5. Oral &Maxillofacial Surgeons $164,760
6. Internists - General $160,860
7. Prosthodontists $158,940
8. Psychiatrists $149,990
9. Family &General Practitioners $149,850
10. Chief Executives $144,600



Those numbers are bogus. Go to gasworks (the correct one, the wrong one will get you some stupid porn site, the right one is an employment service for anesthesiologists).

$360,000.00 or more starting, right out of school, with six weeks vacation is much more typical. Five to six million a year only gets you to the top 40%.

Trauma ortho surgeons? Just out of residency they are making two to three million a year. I depose them regularly. Under oath, that is where the numbers work out.

Same surgeon in England? Working lots of overtime. Just had a recruiter tell me they could get such a surgeon 100,000 euros a year. They would take as many as I could find.

GPs? Probably that chart is a bit high. I've hired some for a clinic at much less, and there wasn't that much of a problem getting them.
3.26.2008 4:42pm
lostmycookies (mail):
Eric is correct, we should have a new visa system that allows any doctor from any moderately civilized country to come here and set up shop after passing a bare-bones test.

I'll never know why people think the laws of supply and demand doesn't apply when it comes to doctors. Ditto for insurance. If the barriers to entry in the insurance field dropped, there'd be cheaper malpractice insurance out there.

But that was all part of Ted Kennedy and ilk's plan. Give insurance co's lots of protection so they can gouge the consumers for fat profit margins; give the doctors beloved AMA the abililty to thwart opening of new medschools and artificially restrict residency programs so doctors make more money; give hospitals generous subsidies if only they submit to the dictate of the State. Then, add a few non-optional insurance programs...and enslave the docs to the system...and force hospitals to give free care to any smelly lowlife who shows up.

Ah, those stupid capitalist pigs. They will indeed sell you the rope you use to hang them. Give it to them good, Teddy, they deserve it.
3.26.2008 4:50pm
Dilan Esper (mail) (www):
So I think it would be interesting to keep a list of practices in foreign jurisdictions that are more "conservative" than American legal practices. Then, whenever Justice Breyer or the like rallies for placing greater authority on foreign authorities and practices, one could reasonably ask whether such proponents also advocate for incorporating those more "conservative" practices (with which they likely disagree) as well.

Off the top of my head, a list of "conservative" practices would include:

1. Absence or distrust of punitive damages

When I see comments like this, I am reminded of how little most conservatives who bash on the judiciary really know about it (just as they don't know that much about the media that they bash on).

You might want to look at just who on the Supreme Court has been pushing for due process limits on punitive damages for the last 10 years or so. Hint: it's not Scalia or Thomas.
3.26.2008 5:32pm
David M. Nieporent (www):
Hint: that's based on their view of the constitution, not their view of punitive damages.
3.27.2008 1:14am
Dilan Esper (mail) (www):
David:

That's a nonresponse. My post was directed at someone up the thread who assumed he had really "gotten" Breyer and the liberals for their support of "internationalizing" some issues but not others. In fact, the liberals support limits on punitive damages and some of the conservatives don't, and had the poster known that, he wouldn't have popped off in that way.

In any event, what the split on punitive damages on the Court really shows is that social issues like abortion and gay rights, rather than economic issues, are the motivating factors behind both liberal and conservative positions on substantive due process.
3.27.2008 2:11pm
TokyoTom (mail):
Punitives, class actions, and pain &suffering constitute the unholy trinity of tort law. Good riddance to then all. They’ll never disappear, of course, because John Q. Public sees himself as a possible future winner of the lottery tort law has become.

I have to say I share stanneus' concern, but see these developments as stemming from popularly desires to counterbalance some of the risk-shifting that statist corporations (back by wealthy investors) have successfully engaged in.

After all the health and environmental regulatory systems developed because of the havoc wrought when corporations were able to persuade judges to move from stricter views of tort toward a "balancing" that favored industry, and the regulatory schemes themselves in part have been supported by industry as barriers of entry to competitors.

Of course the trial bar itself can be seen as a group that extracts rents both from industry and from plaintiffs, but they I believe they are largely accepted as a balance to induistry (which has a similar group of rent-seekers in the relatively insulated management class inside public companies).
3.27.2008 11:06pm
bearing (mail) (www):
lostmycookies: That ad-hominem was inappropriate -- and incorrect. I *am* libertarian, and my question was serious, not an attempt to inject big-governmentism into the discussion. What *is* the rationale for paying punitive damages to the plaintiff? Presumably, the plaintiff has already received compensatory damages. It strikes me that the addition of punitive damages paid to the client feeds the get-rich-quick lawsuit culture.

Since I concede the value of punitive damages as, you know, *punishment,* I don't really care whether the punitive damages get paid to the government (in which case you might call it a "fine," something for which there is a bit of a precedent) or to a deserving private charity. It seemed rhetorically useful to compare it to criminal punishments, which generally aren't applied to enrich the victim.

Now how did it get started anyway? Paying punitive damages to plaintiffs, that is.
3.29.2008 11:54am

Post as: [Register] [Log In]

Account:
Password:
Remember info?

[Important Note to Helpful Readers: If we have confusing typos and especially ugly formatting errors, such as an unclosed underline or bold tag, we'd love to hear from you about them -- but please e-mail the author about this, rather than leaving a comment. We often won't read the comments for a while after the post, and if there's a glaring formatting error, we'd see it quickly when we revisit the post, even without the comment; and in any event the comment likely isn't going to be that helpful to your fellow comment readers. So please e-mail us directly about glitches like this. Thanks!]

Comment Policy: We'd like the posts to be civil, of course (no profanity, personal insults, and the like), but we're also hoping that people try to be as calm, reasoned, and substantive as possible. So please, also avoid rants, invective, substantial and repeated exaggeration, and radical departures from the topic of the thread. Sticking with substance -- and staying on-topic -- will make the comments more helpful to other readers, and more pleasant.

As editors, we reserve the right to delete posts, and even to kick out posters, though we hope that both of these will be exceptional events. (We also reserve the right to be busy with other things, and therefore (1) not remove all the posts that might merit removal, and (2) ignore demands such as "You should remove A's posts, because they're just as bad as B's!")

Here's a tip: Reread your post, and think of what people would think if you said this over dinner. If you think people would view you as a crank, a blowhard, or as someone who vastly overdoes it on the hyperbole, rewrite your post before hitting enter.

And if you think this is the other people's fault -- you're one of the few who sees the world clearly, but fools wrongly view you as a crank, a blowhard, or as someone who overdoes it on the hyperbole -- then you should still rewrite your post before hitting enter. After all, if you're one of the few who sees the world clearly, then surely it's especially important that you frame your arguments in a way that is persuasive and as unalienating as possible, even to fools.

Our goal is to provide an interesting and pleasant environment that can help inform readers. To do that, we'll occasionally have to exercise our editorial discretion. Think of this as an in-person discussion group, where having different voices is critical to a great conversation -- but where sometimes the leader has to deal with cranks who sour the conversation more than they enliven it.

Naturally, there's always a risk that this discretion will be used erroneously, no matter how well-intentioned the editor. But discussion groups (especially on the Internet, but also off it) generally need an editor who'll occasionally make such judgments.

And, remember, it's a big Internet. If you think we were mistaken in removing your post (or, in extreme cases, in removing you) -- or if you prefer a more free-for-all approach -- there are surely plenty of ways you can still get your views out.