With all the finger-pointing going on between doctors, insurers and trial lawyers in the debate over medical malpractice insurance, we think it’s instructive to back up and take a look at the larger picture.

The prices for medical malpractice insurance policies are skyrocketing. Rather than open up their wallets and expose themselves to a lawsuit, some Iowa doctors are deciding they’re better off avoiding practicing riskier medicine, including neurosurgery, obstetrics and colonoscopies. It’s no longer possible, for example, to undergo brain surgery in Cedar Rapids. Residents of that city must be flown to Des Moines for care. Pray you don’t need it the next time you’re visiting Rockwell Collins or Quaker Oats Co.

Iowa’s medical professionals argue – we think rightly – that caps should be placed on the so-called non-economic portion of damages awarded in medical malpractice cases. These “pain and suffering” awards have become a true problem in states such as Mississippi, where in the last nine years, jurors have determined that seven cases, among others, were so egregious that only $100 million or more would make things right. Not surprisingly, doctors have fled.

Medical malpractice is a tragedy, no doubt, and measures need to be in place to hold doctors accountable. We think the economic damages portion of current laws accomplish much of that.   The real issue is one of measurement. Economic damages are quantifiable, and thus insurance actuaries do a pretty good job setting prices for policies that cover problems when they happen without gouging doctors when they don’t.

What is not quantifiable is the level of a person’s emotional distress, and the amount of money that a sympathetic jury might award a victim.

Trial lawyers argue that Iowa’s judges and juries are more reasonable than their counterparts in other states. However flattering that may be, it’s hard to place a bet on it, and it is doubtful insurers will be convinced.

They also argue that non-breadwinners, such as children and stay-at-home parents, end up losing under a tort system that relies on how much money a person makes to determine payouts. It strikes us as good sense to come up with standards and values for various injuries, regardless of a person’s income, and incorporate them into current laws.

No one is suggesting that Iowa is another Mississippi. But one truism of life here is that all trends – even Starbucks and sushi bars – reach the state eventually. Iowa’s legislators have a chance now to act pre-emptively against the medical malpractice wave that’s sure to strike.

As it stands, the only people losing out are Iowans. With fewer physicians providing care, Iowans who need these services are experiencing longer wait times, or are unable to see specialists at all. That’s a tragedy, too.