In large part due to rapidly rising malpractice premiums, an exploding number of frivolous lawsuits, and the lack of medical malpractice reform, neurosurgeons have been leaving the state of Pennsylvania in droves. In the Greater Pittsburgh Area alone, the number of practicing neurosurgeons has fallen over the past few years by over 30%. The Neurosurgery Group is finding it increasingly difficult to recruit or retain younger neurosurgeons.

State Legislation
After a three-year battle between doctors and lawyers over a possible $250,000 cap on pain and suffering awards in medical malpractice lawsuits in Pennsylvania, the measure was defeated in the state legislature in August of 2004, just before the summer recess. Doctors lost the battle for a cap but won legal reforms intended to make it harder to file unreasonable suits against them. The number of medical malpractice cases filed in Pennsylvania dropped by 29 percent in the first full year after the change in the law in 2002, though this doesn't take into consideration that a staggering increase in cases was filed prior to the provisions of the new laws taking effect.

Federal Legislation
The Bush administration supported the HEALTH Act, which is virtually identical to California's successful MICRA law. The provisions of the HEALTH Act are as follows:

1. National adoption of proven minimum standards to make the medical liability system more fair, predictable, and timely.
   
2. Secure the ability of injured patients to get quicker, unlimited compensation for their "economic losses," including the loss of ability to provide unpaid services like care for children or parents.
   
3. Ensure that recoveries for non-economic damages do not exceed a reasonable amount ($250,000).
   
4. Reserve punitive damages for cases where they are justified, and limit punitive damages to reasonable amounts (i.e., up to the greater of two times economic damages or $250,000).
   
5. Provide for payments of judgments over time rather than in a single lump sum, to ensure that appropriate payments are there when patients need them.
   
6. Ensure that old cases cannot be brought years after an event.
   
7. Ensure that juries are informed if a plaintiff has other sources of reimbursement for an injury
   
8. Provide that defendants pay judgments in proportion to their fault.

The House of Representatives passed the HEALTH Act in the summer of 2003. From there, it went to the Senate.

Senate Democrats won their fight to bottle up the legislation limiting damage awards in medical malpractice cases, all but dooming a measure that President Bush made a priority. The vote was 49-48, 11 short of the 60 needed to overcome the Democratic-led filibuster.