Patient suffering.

The article by Stephanie Mencimer, "Malpractice Makes Perfect" (October) is exceptionally well written and insightful. Thank you for having the courage to print the truth. Patients' lives depend upon efforts by reporters like you.

Many states, including my home state of Florida, were inundated this year with identical bogus propaganda about a crisis in health-care access, courtesy of organized medical interest groups such as the AMA, FMA, and AHA. Interestingly enough, the 2003 Florida Senate Judiciary Committee actually put these Florida doctors and hospitals and insurance representatives under oath in order to ferret out truth from fiction. The results of this sworn testimony revealed that Florida (like West Virginia) indeed has had no increase in jury payouts, no problem with doctors leaving the state, and no problem with doctors closing their practices as purported by organized medicine. Unfortunately, the Florida legislature in concert with pressure from Gov. Jeb Bush, nonetheless passed a bill to cap patients' pain and suffering jury awards to ostensibly bring down doctors' medical malpractice premiums and remove access to care problems.

Patti O'Regan, LMHC, ARNP, NP-C

Board Certified Nurse Practitioner

Port Richey, Fla.

This was an excellent article by Stephanie Mencimer! Having worked for two hospitals over the past 20 years, I have seen too many physicians' unfortunate mistakes.

I have never thought that we should limit the amount of money a victim of medical malpractice could sue for. After reading the article, I believe that the physicians responsible for such mistakes should in fact be singled out for higher premiums. We should have the same policy for medical screw-ups that they have in California for drug busts: the "one, two, three strikes, and you're out!" law. And by "out," I mean no license ever again.

Cheryl O'Leary

Via email

Stephanie Mencimer's article is based solely on the bogus claims of trial lawyers. The truth is, America's medical liability crisis is growing--patients are losing access to care, and we need reasonable liability reforms like those working in California for more than 25 years.

Held up to the light of day, it's easy to see through Mencimer's arguments. One of her more egregious claims is that stock market losses are the cause of rising liability insurance premiums. The GAO debunked this trial-lawyer smokescreen earlier this year--making it clear that bonds make up 80 percent of insurers' investments and that "no medical malpractice insurers experienced a net loss on their investment portfolios" in recent years. The same GAO report identified increasing lawsuit awards as the main driver of medical liability premiums. The root of this crisis has been identified time and again I escalating jury awards, settlements, and the high cost of defending against lawsuits, which drive liability premium increases, with devastating results for patients.

To address this crisis, the AMA supports proven medical liability reforms, including a cap on non-economic damages to stabilize premiums and maintain patient access to care. These reforms have been a proven success in California with striking data to show it. An obstetrician in Los Angeles pays about $69,000 a year for insurance. That same obstetrician would pay $249,000 for liability insurance in Miami, Fla.

We must stem the tide of this crisis by enacting meaningful reforms. Our hearts go out to patients harmed by negligence, and the AMA has always held that these patients should be compensated fairly. Unfortunately, the current liability system has failed patients. Our system has evolved into a "lawsuit lottery," where select patients and their lawyers. get astronomical awards, and many patients suffer access-to-care problems because of it.

Donald J. Palmisano, M.D., J.D.

AMA President