I-300, I-336 are too broad-based

Outside the tight-knit troops arrayed along the front lines of Initiatives 330 and 336, few knowledgeable observers believe that this is the right fight or that the collateral damage is worth it.

If we are to solve the problem posed by medical errors and the inefficient and sometimes excessive system for compensating victims, we will first need a cease-fire from doctors and lawyers. Passage of one or both of these initiatives will only cause the two sides to dig in for another battle.

Initiative 330 purports to solve the problem of rising medical malpractice premiums for certain services, such as baby delivery, neurosurgery and trauma care. Even opponents agree that the spike in premiums in those areas poses a problem.

But I-330 offers a broad-based fix for a narrow problem. Its provisions cover nearly all medical entities, including blood banks, sperm banks and health maintenance organizations. Its definition of health care providers includes nutritionists, dietitians and social workers. Are they all suffering from insurance premium crises?

As with so many citizen initiatives, I-330 wields a machete when a scalpel is called for. And, more importantly, it does nothing to solve the larger crisis of patient safety. That’s the chief reason the Washington State Nurses Association recommends a no vote.

That’s not to say the current system of compensation through litigation is the answer either. It clearly isn’t. Studies show that only a tiny fraction of patients harmed by avoidable medical errors seek legal recourse. The landmark Institutes of Medicine study revealed that as many as 98,000 people die each year from medical errors. An estimated 770,000 people are killed or injured because of mistakes in prescribing and administering drugs. Malpractice lawsuits have not improved those numbers.

I-336 seeks to limit medical errors and thus the instances of malpractice, but it is also a blunt tool. Some of its provisions are as likely to drive away good doctors as bad ones. Any regimen for improving patient safety requires buy-in from the medical community. I-336 will only increase the resistance. The state nurses association opposes the initiative because it isn’t sufficiently focused on establishing safer systems.

Safer systems should be the ultimate goal. I-330 focuses attention on the back end of the problem, after the damage is done. To some extent, so does I-336.

The Legislature is the proper body for hashing out the complexities of this issue. Lawmakers need to pave the way for the collection of comprehensive data to bring an end to the battle of competing incomplete studies. They need to encourage the free flow of information by making sure medical error reports don’t become litigation fodder. And they need to ensure that regulators have the tools they need to crack down on incompetent and negligent medical professionals.

The problems spotlighted by the two initiatives require solutions at the front end. Those are more likely to be achieved if both measures are defeated.