'What is the value of life?'

By Stephen Gruber-Miller

February 6, 2023 via Des Moines Register

Iowa bills to cap lawsuits pit Republicans against Republicans

At the Iowa Capitol, Republicans rarely disagree with each other in public.

But in passionate committee speeches, newsletters and reply-all emails, a vocal group of GOP lawmakers have made it clear they don't like proposals supported by party leadership that would limit how much money Iowans could recover in lawsuits over medical malpractice and commercial vehicle accidents.

"Why would any pro-life legislator allow an insurance company to value a life?" Sen. Mark Lofgren, R-Muscatine, wrote in a Jan. 24 email sent to every Iowa lawmaker and legislative staffer.

"I know that sometimes we lean on leadership for direction on bills, but this is such an important issue that you, yourself, will have to hear from those that experience errors," Lofgren wrote. "There’s a lot more to medical malpractice than most people know. You don’t just snap your fingers and do a civil suit."

In speaking out, Republicans are placing themselves at odds with party leadership, including Gov. Kim Reynolds, who has made "tort reform" a major part of her agenda this year, specifically medical malpractice.

Reynolds and other supporters say limiting damages in lawsuits for pain and suffering to $1 million is necessary to protect Iowa's health care and trucking industries from rising insurance premiums.

“Supporting quality access to care is a pro-life issue," Reynolds said in a statement Friday. "Mothers and fathers should not have to worry about if an OB-GYN or physician is available in their community. Those who should be held accountable will be, but for those who are practicing safely and correctly, we have to provide them with security or else our entire medical system falls into jeopardy.”

The fight over "tort reform" is coming on the heels of Reynolds' first victory of the year — a law allowing all Iowa families to access state money to pay private school costs. That success came over the opposition of a dozen Republican members of the Iowa House and Senate.

The bills limiting damages in medical malpractice cases, House File 161, and commercial vehicle lawsuits, House Study Bill 114, are both eligible for debate by the full Iowa House. The Senate's version of medical malpractice legislation could also be debated soon.

The discomfort from some Republicans may not ultimately be enough to stop the bills from passing.

That would showcase the power of the party's expanded majorities to pass legislation over objections from within their ranks.

Radio ad aims to spur Republican opposition

Republican lawmakers driving to the Iowa Capitol and tuned in to WHO Radio have probably heard an ad summing up the opposition to the legislation.

"What is the value of life?" asks Sam Clovis, a Republican and former U.S. Senate candidate and Trump administration official.

"Corporate lobbyists in Des Moines are trying to take away your right to trial by jury. They want the Legislature to assign a government-mandated value to human life. Folks, that's immoral."

It's an argument some Republicans have found convincing.

Sen. Sandy Salmon, R-Janesville, wrote Jan. 28 in her weekly newsletter that "I have been opposed to this in the past and see no reason to change."

"This, for all practical purposes, denies Iowans that sustain egregious injuries or death due to a breach in the standard of care their 7th Amendment right to a jury trial," Salmon wrote. "This hard cap will cut off access to the courts for the worst cases, the cases that need justice the most."

Other Republicans see Clovis' point but ultimately take a different view of the legislation.

"My personal opinions are conflicted ... because Sam's right," Senate President Amy Sinclair, R-Allerton, said on "Iowa Press" on Jan. 27. "It's difficult to place a dollar figure on the value of life and pain and suffering. And that's a valid argument."

But Sinclair said failing to pass the legislation would be harmful to Iowans in rural areas who need health care.

"It's hard for me to set a hard cap on what the value of a human life is," she said. "But it's not hard for me to set a public policy that allows for us to recruit and retain the best and brightest so folks in rural areas can continue to access their necessary health care needs."

The radio ad featuring Clovis is paid for by Accountable Iowa, which is affiliated with the Iowa Association for Justice, an association of trial lawyers in Iowa.

Andrew Mertens, the group's deputy executive director, said it has spent more than $10,000 to air the ad since the second week of January, focusing primarily on the WHO and WMT radio stations in Des Moines and Cedar Rapids.

Clovis is currently suing UnityPoint Health and several providers in northwest Iowa after becoming paraplegic because of an undiagnosed spinal cord abscess. He said he can now walk with the use of a walker.

He sees Republican support for capping damages as being in alignment with special interests, not Iowans.

"The other side has been arguing this from an economic perspective, and not once — not once — have I heard an argument about patient safety and about improving patient safety and reducing medical error," he said. "That, to me, is very troubling."

'We already feel like a number,' says Iowan who opposes medical malpractice limits

As lawmakers wrestle with whether to support the legislation, they're hearing from Iowans like Janis Adamski.

Her husband, Nick Adamski, died of pneumonia in 2019, leaving behind their two daughters, Taylor and Abby. The family recently settled a medical malpractice lawsuit against a clinic they say failed to properly diagnose Nick.

"Losing him destroyed our world," Janis Adamski said. "It crushed confidence, just the security of life in general. It’s been a scary process. I’ve been scared of the future, of how am I going to raise my kids and what can I give to my kids now that their father’s gone?"

Nick was "all about his family," Janis Adamski said. He loved to participate in 4-H and other activities with his daughters.

"All my hobbies were his hobbies," Abby Adamski said of her father. The two of them would watch reruns of "MASH" and "The Big Bang Theory," and movies like "The Hunt for Red October."

"Him and I always went fishing, and now it’s very hard for me to go."

Janis and Abby Adamski made the hourlong drive from their home in Stratford to the Iowa Capitol in late January to urge lawmakers to oppose the legislation. Janis Adamski said she wanted to stand up for families who could end up in the same position as hers.

"Right now we already feel like a number where we go into urgent care and it’s in and out, nobody’s listening and nobody’s held to the consequence of not doing their job," Janis Adamski said. "And so I believe with the cap, when you don’t have those consequences it’s just going to allow for more chaos."

Limits on lawsuits pass House committees over some Republican opposition

When the medical malpractice legislation passed the House Health and Human Services Committee last month, it did so over opposition from two Republicans.

Rep. Brian Lohse, R-Bondurant, a lawyer who formerly worked in the insurance industry litigating claims, spoke passionately against the bill, saying lawmakers shouldn't limit juries' discretion over medical malpractice cases.

"It’s not our right, not knowing the facts, to set a limit on a person’s pain and suffering," Lohse said. "In fact, I find it incredibly arrogant for us to sit here and say we know better than the people who hear the facts."

Rep. Ann Meyer, R-Fort Dodge, the committee's chair, pushed back. The legislation wouldn't limit economic or punitive damages, she argued, only noneconomic damages for injuries that are more difficult to quantify, such as pain and suffering.

Meyer spoke about her son, who died of a medical error when he was 5. No amount of money can bring him back, she said.

"When my son passed away, I was angry," she said. "But I’m a legislator, I can’t just look at one case. None of us can look at one case. We have to look at the entire state of our health care."

In the end, the legislation passed the committee over the objections of Lohse and Rep. Eddie Andrews, R-Johnston, as well as every Democrat.

It was a similar situation when the House Judiciary Committee passed the bill limiting damages in commercial vehicle accidents. Three Republicans — Lohse; Rep. Megan Jones, R-Sioux Rapids; and Rep. Stan Gustafson, R-Norwalk — joined Democrats in voting no.

"I can’t support this legislation," Jones said. "I can’t in good conscience put economic development — alleged at that — alleged economic development over and above our lives."

Rep. Bill Gustoff, R-Des Moines, said the bill is about balancing interests, not valuing life. He acknowledged "it's not a perfect bill" but said no one has stepped forward to help him improve it.

"The number of responses I’ve gotten to help fix these problems that I keep hearing about is a big fat zero," Gustoff said. "So I’m willing to work on that and fix those things, but I need some language. I need somebody to tell me if they think there’s a problem, what’s the fix?"