State legislators have taken a first step toward restoring limits on pain and suffering awards in medical malpractice cases, a major Republican goal of this legislative session.

The state Supreme Court declared the previous caps unconstitutional, saying that limits should provide equal protection for all, with life expectancy considered, and said that a better rationale for capping awards was needed.

The Republican-dominated Assembly voted 64-30 to approve a GOP plan to address the first issue by setting a limit of $550,000 for minors and $450,000 for adults.

But Democrats sharply criticized other aspects of the plan, noting that the adult limit was only $5,000 more than the previous cap and no longer took cost-of-living increases into account. Instead, the board of the state's Patients Compensation Fund would be required to recommend any increase to the Legislature every two years.

"If we say this amount is frozen, it will take only one committee chair in one house to block an increase in the amount," said Rep. Marlin Schneider, D-Wisconsin Rapids, after Republicans tabled an amendment that would have restored inflationary increases.

"These benefits will decline in terms of real dollars. You just doomed this bill to failure," Schneider declared.

Rep. David Cullen, D-Milwaukee, who proposed the amendment, said that a board including doctors and insurance executives would be unlikely to recommend an increase.

"You will pass a bill that is likely to have a veto and then we won't have a cap," Cullen said.

Gov. Jim Doyle, a Democrat, has previously indicated that he is likely to veto the bill because it is so similar to the previous law that it would probably be declared unconstitutional as well.

Majority Leader Rep. Mike Huebsch, R-West Salem, who served on a task force that helped develop the proposal, argued passionately that increased insurance costs are passed on to patients, and that the new limits were based on actuarial tables, caps in other states and the amounts of malpractice awards.

Rep. Terese Berceau, D-Madison, charged that the actuarial study used by Republicans in developing the caps was funded by the Wisconsin Medical Society and the Wisconsin Hospital Association. "Those are not exactly objective parties," she said.

Rep. Gary Sherman, D-Port Wing, argued that the caps had done nothing to hold down health care costs. Though malpractice insurance premiums in Wisconsin are among the lowest in the nation, health care costs are among the highest, he pointed out.

"We are talking about limiting what severely injured people get when doctors make a mistake," said Jon Richards, D-Milwaukee, the Assembly's assistant minority leader. "Doctors are not gods."

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