Court Opinion

ID: 9503274
Source: CourtListenerOpinion
Date Created: 2023-08-06 19:39:47.747714+00
Date Added: 2024-06-11T09:03:21.607789
License: Public Domain

KISTLER, J.,
dissenting.
The majority holds that plaintiff may recover, as economic damages, medical costs that Medicare prevented plaintiffs medical providers from charging for their services. The majority’s decision is at odds with both federal and state law. As a matter of federal law, the statutes governing Medicare capped the costs of plaintiffs medical care; neither plaintiff nor Medicare incurred more medical costs than the Medicare statutes permitted. As a matter of state law, the only economic damages arising from plaintiffs injury were the medical costs for which plaintiff was liable and for which Medicare reimbursed his providers. Because I would hold that plaintiff cannot recover economic damages for medical costs for which no one was ever liable, I respectfully dissent.
Plaintiff was injured on defendant’s premises. As a result of that injury, plaintiff had reconstructive surgery on his shoulder and knee. Plaintiff was over 65 at the time of the accident, and Medicare both provided coverage for plaintiffs medical costs and capped the amount that plaintiffs medical providers could charge for their services. In this case, Medicare capped plaintiffs medical costs at approximately $13,400; that was the amount that Medicare paid plaintiffs medical providers and neither plaintiff nor Medicare ever was liable for more than that amount. Without that cap, plaintiffs medical providers would have charged approximately $39,000 for their services.
The question that this case presents is whether plaintiff can recover economic damages for the difference *245between the Medicare capped rate and the medical providers’ customary rate. Put differently, the question is whether plaintiff can recover economic damages from defendant for approximately $25,600 in medical “costs” for which no one was ever liable.
The answer to that question is, or should be, simple. Economic damages compensate a plaintiff for the costs incurred as a result of a defendant’s tort. A defendant should be responsible for all costs incurred, but no compensatory purpose is served by holding a defendant responsible for more than that. In this case, the Medicare statutes limited the costs incurred as a result of plaintiffs injury and imposed a corresponding limitation on the amount of economic damages that plaintiff could recover.
That limitation on the amount of damages is separate from the collateral source doctrine. The collateral source doctrine addresses whether a defendant may take advantage of a benefit that a plaintiff receives from a collateral source (someone other than the defendant) to reduce the amount of damages that a judge or jury has awarded. See ORS 31.580 (codifying doctrine); Fowler V. Harper, Fleming James, Jr., Oscar S. Gray, 4 Harper, James and Gray on Torts § 25.22, 801-04 (2007) (describing common-law doctrine). The collateral source doctrine does not address the amount of damages that a plaintiff can recover in the first instance. That much is clear from the terms of ORS 31.580, which provides that the collateral source doctrine comes into play only after “a party is awarded damages for bodily injury or death of a person.” By its terms, ORS 31.580 presumes an existing award of damages and is limited to the question of how much of that award a defendant owes.
In my view, the majority does not keep those two doctrines separate. Rather, it appears to rely on the collateral source doctrine to define the amount of economic damages that plaintiff can recover and in doing so errs. This dissent first explains that, as a matter of federal law, the Medicare capped rate limited the costs incurred as a result of plaintiffs injury; no one incurred more than that amount. This dissent then explains that, as a matter of state statute, plaintiffs economic damages are limited to the costs that were incurred. *246Finally, it explains why the collateral source statute does not provide a basis for awarding plaintiff more damages than the statute defining economic damages permits.
I. MEDICARE CAPS THE MEDICAL COSTS INCURRED
Plaintiff received medical services from eight providers. Seven provided physician services, which are covered under Medicare Part B. One provided inpatient hospital services, which are covered under Medicare Part A. Medicare Part A and Medicare Part B are subject to different statutory provisions, and this opinion begins by discussing the limitations that Medicare Part B places on the amount that physicians can charge Medicare beneficiaries.
Medicare Part B sets a reasonable charge (or Medicare approved charge) for medical services that a physician provides. As initially enacted, Medicare Part B did not limit the amount that a physician could charge a Medicare beneficiary unless the physician accepted assignment of the beneficiary’s Medicare claim. See 1 Medicare and Medicaid Guide (CCH) ¶ 3186,1184 (Nov 20,2007) (explaining the history of Part B). Rather, Medicare paid 80 percent of the Medicare approved charge, leaving the beneficiary responsible for the remainder of the physician’s customary charge. Id. Beginning in 1987, however, Medicare Part B capped the amount that physicians can charge Medicare beneficiaries. Id. Since 1991, that cap has taken the form of a “limiting charge,” which is a percentage of the Medicare approved charge. 42 USC § 1395w-4(g)(2)(C). Under Part B, “[n]o person is liable for payment of any amounts billed for the service in excess of [the] limiting charge.” 42 USC § 1395w-4(g)(l)(A)(ii).
The “limiting charge” establishes both the maximum that a physician can charge a Medicare beneficiary and the maximum for which a Medicare beneficiary will be liable. Physicians who do not accept assignment of Medicare claims can charge Medicare beneficiaries an amount up to the limiting charge. 42 USC § 1395w-4(g)(2)(C). Those physicians, however, may not “bill or collect an actual charge in excess of the limiting charge.” 42 USC § 1395w-4(g)(l)(A)(i). And, as noted, “[n]o person is liable for payment of any amounts billed for the service in excess of [the] limiting charge.” *24742 USC § 1395w-4(g)(l)(A)(ii). If a physician has not accepted assignment, a Medicare beneficiary is responsible for paying the physician’s bill up to the amount of the limiting charge, and Medicare will reimburse the beneficiary for 80 percent of the limiting charge. Under Medicare Part B, a patient is not liable for the physician’s customary charge to the extent it exceeds the Medicare “limiting charge.”1
Medicare Part A covers inpatient services in hospitals and similar facilities. Under Part A, a Medicare beneficiary is liable for a lesser amount of the cost than under Part B. Specifically, 42 USC § 1395cc(a)(l)(A)(i) provides that a hospital cannot receive payments under Medicare Part A unless it agrees “not to charge, except as provided in paragraph (2), any individual or any other person for items or services for which such individual is entitled.” Paragraph 2 of subsection 1395cc(a) lists the exceptions to that limitation on liability, which include: (1) payment of a deductible for each stay in the hospital ($1,068 in 2009); (2) daily coinsurance payments if the stay exceeds 60 days (either the hospital’s customary rate or a percentage of the deductible, whichever is lower); and (3) the additional cost of noncovered services, such as a private room, that the patient expressly requests. 42 USC § 1395cc(a)(2); see 3 Medicare and Medicaid Guide (CCH) ¶ 13,010, 5307-08 (Dec 2, 2008) (describing costs for which beneficiaries will be liable under Medicare Part A).
Medicare Part A differs from Medicare Part B in that Part A permits a hospital to charge a Medicare beneficiary only for the cost of the deductible and other charges. A beneficiary is not liable, under Part A, for the cost of inpatient hospital services up to the amount of Medicare cap — the amount that Medicare reimburses the hospital.2 However, both Part *248A and Part B are identical in that neither part permits a hospital or a physician to charge more than the Medicare capped amount. Under both Part A and Part B, no one incurs or is liable for a hospital or a physician’s customary charges to the extent that those charges exceed the Medicare cap.
Plaintiff argues, however, that he agreed to pay and was liable for the full amount of his providers’ customary charge.3 The record does not support that assertion. As noted, plaintiff received medical services from eight providers. The agreements with two of those providers are in the record. One agreement, with Open Advanced MRI & CT, reminds patients that “whether you have health insurance coverage or not, professional services are rendered to and charged to the patient.” It then adds, “You (or the responsible party in the case of a minor) are responsible for payment of your bill even if not covered in full or in part by your insurance.”4 The part of the agreement on which plaintiff relies states only that plaintiff remains responsible for payment of his bill, even if he has insurance. The agreement says nothing about the rate that plaintiff agreed to pay or whether plaintiff is responsible for any amounts over and above what Medicare permits. The agreement is silent on that point.
*249Medicare Part B prevents entities providing physician services, such as Open Advanced MRI, from billing a patient more than the limiting charge. 5 As noted, nonparticipating physicians may not bill a Medicare beneficiary for more than the limiting charge, and “[n]o [beneficiary] is liable for payment of any amounts billed for the service in excess of [the] limiting charge.” 42 USC § 1395w-4(g)(l)(A)(ii). It is hardly surprising that Open Advanced MRI’s agreement does not impose an obligation on its patients that would be contrary to federal law. Its agreement does not support plaintiffs position.
Plaintiffs agreement with Southwest Washington Medical Center presents a closer question but still does not support plaintiffs position. Paragraph 10 of that agreement states:
“I, the undersigned, agree * * * that in consideration of the services to be provided that the undersigned hereby obligates himself/herself * * * to pay the account of SWMC in accordance with its regular rates and terms. I further agree to pay for services denied or not covered by my insurance regardless of the reason for denial or non-coverage. I agree to pay for services not covered by my Medicaid program even if I did not disclose my Medicaid eligibility at registration or obtain eligibility on a retroactive basis.”
Plaintiff presumably interprets the agreement obligating him “to pay the account of SWMC in accordance with its regular rates and terms” as an agreement to accept liability for the hospital’s customary charges. While textually permissible, that interpretation conflicts with Medicare Part A, which requires hospitals to agree not to charge Medicare beneficiaries for their services except as expressly authorized.6
It is also equally permissible to read the agreement consistently with federal law; that is, the agreement “to pay * * * SWMC in accordance with its regular rates and terms” *250refers to those “rates and terms” that Medicare Part A permits. One should hesitate to assume that the nonspecific phrase “regular rates and terms” refers to rates and terms that are contrary to federal law. The third sentence in paragraph 10 supports that reading. It provides that the patient “agree[s] to pay for services not covered by my Medicaid program.” If the first sentence were as broad as plaintiff perceives, the third sentence in paragraph 10 would be unnecessary. That is, if the first sentence in paragraph 10 required a Medicaid beneficiary to assume responsibility for all the hospital’s customary charges, there would be no need to specify in the third sentence that a Medicaid beneficiary agrees to pay for those services that Medicaid does not cover. In any event, if the agreement with Southwest Washington Medical Center purported to impose liability on plaintiff for all the hospital’s customary charges, it would be inconsistent with Medicare Part A, and federal law would negate any contrary obligation that that agreement sought to impose.
Plaintiff did not introduce any other agreements that he may have had with his other six medical providers, all of whom were physicians. The burden of production was on plaintiff to prove the extent of his damages, and the absence of those agreements cuts against him. Beyond that, as explained above, Medicare Part B prevents a physician from charging more than the limiting charge. There is no reason to assume that plaintiffs doctors entered into agreements contrary to federal law, and, even if they did, federal law would supersede those agreements. As a matter of federal law, neither plaintiff nor Medicare incurred liability for any medical charges in excess of the Medicare cap.
II. ECONOMIC DAMAGES ARE LIMITED TO COSTS INCURRED
“For more than a century, the general rule in Oregon in assessing damages has been that a plaintiff should recover only such sums as will compensate a plaintiff for the injury suffered as a result of a defendant’s wrong.” Yamaha Store of Bend, Inc. v. Yamaha Motor Corp., 310 Or 333, 344, 798 P2d 656 (1990). ORS 31.710(2)(a) embodies that principle. It defines “economic damages” as “objectively verifiable monetary losses including but not limited to reasonable charges *251necessarily incurred for medical, hospital, nursing and rehabilitative services and other health care services * * That statute assumes that, at a minimum, charges for medical services must be “incurred” to be recovered as economic damages. As the majority notes, incurred means “become liable or subject to.” See Webster’s Third New Int’l Dictionary 1146 (unabridged ed 2002) (defining incur). And federal law makes clear that no one (neither plaintiff nor Medicare) became liable for any medical costs over the Medicare cap. The Medicare cap limits the amount of medical costs incurred as a result of plaintiffs injury, and ORS 31.710(2)(a) only permits recovery of those costs incurred as a result of defendant’s tort.7
That limitation also follows from this court’s precedent. This court’s cases have long recognized that the reasonable value of a doctor’s services limits the amount of economic damages that a plaintiff can recover; that is, if the amount that a doctor charges for medical services exceeds the reasonable value of those services, a plaintiff can recover only the reasonable value. Touhy v. Columbia Steel Co., 61 Or 527, 532-33, 122 P 36 (1912).8 The converse is not true, however. This court has never held nor suggested that, when the agreed charge for medical services is less than its reasonable value, a plaintiff may recover the reasonable value of those services. Such a rule would be antithetical to the principle that “a plaintiff should recover only such sums as will compensate a plaintiff for the injury suffered as a result of a defendant’s wrong.” Yamaha Store of Bend, Inc., 310 Or at *252344 (emphasis added). It also would be contrary to the use of the word “incurred” in the definition of economic damages in ORS 31.710(2)(a).
The majority questions whether the definition of economic damages found in ORS 31.710(2)(a) is limited to determining whether a statutory cap on economic damages applies. This court, however, has not limited the definition to that context. For instance, in Zehr v. Haugen, 318 Or 647, 656-67, 871 P2d 1006 (1994), the court relied on the definition of economic damages in ORS 31.710(2)(a) to determine whether the economic damages that the plaintiffs sought as part of their medical malpractice claim were recoverable.9 If the statutory definition of economic damages were limited to determining whether the statutory cap on economic damages applies, as the majority suggests, the court would not have considered that definition in Zehr to determine whether the damages sought in that case were recoverable. See also Clarke v. OHSU, 343 Or 581, 608 n 17, 175 P3d 418 (2007) (“Special damages now are described [in ORS 31.710(2)(a)] as economic damages and refer to the verifiable out-of-pocket losses, including medical expenses * * *.”).
The definition of economic damages in ORS 31.710(2)(a) limits defendants’ damages to the costs incurred, and federal law makes clear that no costs were incurred in this case over the Medicare cap. ORS 31.710(2)(a) and the Medicare cap combine to limit the amount of economic damages that the jury could award plaintiff.
III. THE COLLATERAL SOURCE STATUTE
The majority bases its opinion primarily on the collateral source statute. In the first part of its opinion, the majority asks whether the collateral source statute applies, but in doing so it assumes that plaintiff was liable for his medical providers’ customary charges. The first part of the court’s opinion thus assumes away what is, in my view, the *253dispositive question. In the second part of its opinion, the majority asks “whether the amount that defendant must pay as damages for that loss is limited to the amounts that plaintiff paid or remains legally obligated to pay for the medical care that he obtained to treat that loss.” 347 Or at 233. And it undertakes to answer that question in four related but separate ways.
The majority looks initially to the collateral source statute to answer the question it poses. It notes that, under the collateral source statute, a plaintiff may recover his or her medical costs from a defendant even though an insurer has paid those costs and the plaintiff does not remain legally obligated to pay them. Id. The majority reasons that the same answer should apply in this case. Id. at 233-34. The majority concludes that, if we were to reach a different answer, we could not give effect to ORS 31.580. Id. at 234.
In my view, the majority asks and answers the wrong question. The question is not whether plaintiff has paid or remains liable to pay its medical charges. Rather, the question is whether plaintiff ever incurred liability for those charges. That follows from ORS 31.710(2)(a), which provides that costs must be “incurred” to constitute economic damages. The collateral benefits statute does not point in a different direction. As noted, ORS 31.580 has nothing to do with the amount of damages a plaintiff incurs. That statute applies only after “a party is awarded damages for bodily injury or death.” It assumes that a judge or jury has determined the amount of damages and provides a rule to determine how much of those damages a defendant owes.
The majority reasons next that “[a] plaintiff who is injured and who obtains necessary medical treatment becomes liable or subject to’ reasonable charges for that treatment and thereby ‘incurs’ them.” Id. at 234. The majority’s reasoning sweeps too broadly. Ordinarily, the charge incurred for medical services turns on the terms of the agreement between the patient and the medical provider; that is, a patient ordinarily will be liable for and will incur whatever charges he or she agrees to pay a medical provider. That is true without regard to whether the patient agrees to pay *254more or less than the reasonable charge. The rule the majority posits applies only when no agreement exists and the law implies a reasonable charge. See Cronn v. Fisher, 245 Or 407, 416, 422 P2d 276 (1966) (discussing quantum meruit). In this case, the Medicare statutes imposed an a priori limit on the charges incurred for medical services. No one incurred any charges over and above that cap, and plaintiff may not recover damages for medical costs that no one incurred.
Although the majority relies on Cary v. Burris, 169 Or 24, 127 P2d 126 (1942), as support for its reasoning, that decision addresses a related but different issue. In Cary, an employee of the federal government was injured in an automobile accident. Id. at 25. The defendant alleged, as a partial defense, that the United States had paid the employee’s medical costs. Id. The employee admitted in his reply that “the United States Employees’ Compensation Commission had advanced all said sums but that he would be required to reimburse the commission for said advances out of the proceeds of the judgment [against defendant] when collected.” Id. at 25-26. The trial court ruled that the employee could recover damages for the money that the United States had advanced for his medical treatment, and this court affirmed. Id. at 29.10 In reaching that conclusion, this court recognized that a federal statute required the employee to reimburse the United States for any funds that it had advanced to pay for his medical costs. Id. at 27; see Dahn v. Davis, 258 US 421, 430, 42 S Ct 320, 66 L Ed 696 (1922) (discussing federal statute).
The decision in Cary addressed a typical situation in which a third party, such as an insurer, has paid medical expenses for which the plaintiff would otherwise be liable, and the question was whether the defendant could avoid responsibility for those expenses. Cary did not address a situation in which federal law limited the amount that a medical provider could charge a plaintiff in the first instance. In *255my view, Cary neither advances nor detracts from the majority’s reasoning.
The majority also relies on cases from other jurisdictions. As the majority notes, courts from other jurisdictions have split on this matter both in the result that they have reached and also in their analysis. Some have held, as I would, that a plaintiff cannot recover damages for costs that no one incurred. See Moorhead v. Crozer Chester Medical Center, 765 A2d 786, 789-91 (Pa 2001) (holding that the reasonable value of medical services that a Medicare beneficiary received cannot exceed “the amount that the plaintiff has actually paid or for which he or she has incurred liability”); Hanif v. Housing Authority, 246 Cal Rptr 192, 194-96 (Cal App 3 Dist 1988) (holding that a state Medicaid beneficiary cannot “recover from the tortfeasor more than the actual amount he paid or for which he incurred liability for past medical care and services”). Other courts have held that the amount Medicare pays is, while not dispositive, admissible evidence on the reasonable value of medical services. Robinson v. Bates, 857 NE2d 1195, 1200 (Ohio 2006). Still other courts have held, as the majority does, that a plaintiff can recover the reasonable value of the services received without regard to the limitations that Medicare or Medicaid places on the costs that a medical provider charges. See, e.g., Bynum v. Mango, 106 Hawai’i 81, 88, 101 P3d 1149, 1556-57 (Haw 2004); Brandon HMA, Inc. v. Bradshaw, 809 So 2d 611, 619-20 (Miss 2001).
Those various decisions establish that, at a minimum, the issue is one about which reasonable people can and have disagreed.11 Beyond that, the decisions do not have much bearing on the inquiry before us. The Oregon legislature has chosen to codify both the collateral benefit rule and the definition of economic damages. While other states’ common-law decisions may be informative and even persuasive in the abstract, ORS 31.710(2)(a) and ORS 31.580 define *256the scope of our inquiry in determining the extent of the damages that plaintiff may recover. As I read ORS 31.710(2)(a), it requires that costs be incurred before they may be recovered as economic damages. Conversely, ORS 31.580 has nothing to do with determining the extent of the damages that a plaintiff may recover. Rather, it defines a defendant’s responsibility for those damages that a judge or jury has awarded. Given those two statutes, I would hold that a plaintiff cannot recover economic damages for medical costs that no one ever incurred.
The majority notes one final point. It cites 42 USC § 1395y(a)(2) for the proposition that Medicare would not have made payments to plaintiffs medical providers if plaintiff had not agreed to assume liability for their customary charges. 347 Or at 241-42. That paragraph provides:
“Notwithstanding any other provision of this subchap-ter, no payment may be made under part A or part B of this subchapter for any expenses incurred for items or services—
“(2) for which the individual furnished such items or services has no legal obligation to pay, and which no other person * * * has a legal obligation to provide or pay for * * *
In my view, the majority reads paragraph 1395y(a)(2) for more than it is worth. That paragraph is one of 21 exclusions from Medicare coverage, which range from eyewear to pedicures. See 42 USC § 1395y(a)(7) (excluding coverage for eyewear); 42 USC § 1395y(a)(13)(C) (excluding coverage for pedicures). The exclusion that the majority cites applies to services “for which the individual furnished such * * * services has no legal obligation to pay, and [for] which no other person * * * has a legal obligation to provide or pay.” 42 USC § 1395y(a)(2) (emphasis added).
By its terms, paragraph 1395y(a)(2) excludes from Medicare coverage only those services provided for free, without expectation of payment from anyone. As the agency charged with administering Medicare has explained, the exclusion “applies where items and services are furnished *257gratuitously without regard to the beneficiary’s ability to pay and without expectation of payment from any source, such as free x-rays or immunizations provided by health organizations.” Center for Medicare Services, Medicare Benefits Policy Manual, Pub 100-02, ch 16, § 40.
This is not a case in which plaintiffs medical providers furnished services gratuitously without expectation of payment from anyone. Rather, plaintiff had an obligation to pay, at a minimum, the deductible for the inpatient hospital services he received under Part A and 20 percent of his physicians’ charges under Part B. And Medicare had an obligation to pay the remainder of the charges up to the Medicare approved amount. In my view, the majority errs in converting an exclusion from Medicare coverage for completely gratuitous services into an implicit requirement that Medicare beneficiaries assume liability for all of their medical providers’ customary charges.
As I read the governing Oregon statutes, medical charges must be incurred to be recovered as economic damages. In this case, neither plaintiff nor Medicare ever incurred liability for more than the Medicare cap. It follows that plaintiff may not collect damages for costs that no one incurred. I respectfully dissent.
Balmer, J., joins this dissenting opinion.

 Physicians who accept assignment of a Medicare beneficiary’s claim are limited to a lesser amount. They may not charge the beneficiary more than the Medicare approved amount, which is slightly less than the “limiting charge.” 42 USC § 1395u(b)(3)(B)(ii) (physicians who accept assignment agree that the “reasonable charge [set by Medicare] is the full charge for the service”); see 1 Medicare and Medicaid Guide (CCH) ¶ 3186, 1184 (same). Because the reasonable charge is less than the limiting charge, the limiting charge establishes the maximum amount that any physician can charge a Medicare beneficiary for medical services and the maximum amount for which the beneficiary will be liable.

 Since 1983, Medicare has capped the payments to hospitals and similar facilities by providing a set amount, adjusted for certain costs, for each condition *248diagnosed. See 1 Medicare and Medicaid Guide (CCH) ¶ 4202 (June 16, 2009) (describing history and methodology of setting payments to hospitals under Medicare Part A); 42 CFR § 412.60 (specifying procedures for determining Medicare payments under Part A).

 In resolving defendant’s motion to reduce the verdict, the trial court recited that “it is undisputed that * * * the plaintiff contractually agreed to pay” his medical providers’ customary charges. Defendant, however, argued in its motion that plaintiff had not “incurred” his providers’ customary charges to the extent that they exceed the amount that Medicare paid, and it quoted the federal district court opinion in Wildermuth v. Staton, No CIV.A. 01-2418-CM, 2002 WL 922137 at *5 (D Kan, Apr 29, 2002), for the proposition that “ ‘Medicare providers are prohibited under Medicare law and regulations from seeking reimbursement of the written-off amounts from any source.’ ”

 Paragraph 2 of the agreement states:
“Payment is preferred at the time of service as a courtesy and if you supply all information needed today, we will bill your primary insurance carrier and give you an insurance form for other billing. This does not waive your responsibility for payment. Remember whether you have health insurance coverage or not, professional services are rendered to and charged to the patient. This office cannot accept responsibility for collecting any insurance claim or negotiating a settlement on a disputed claim. You (or the responsible party in the case of a minor) are responsible for payment of your bill even if not covered in full or in part by your insurance.”

 Physician services include diagnostic tests, such as an MRI. See 42 CFR § 414.2 (defining physician services).

 Southwest Washington Medical Center’s bill makes clear that it provided hospital inpatient services subject to Part A rather than physician services subject to Part B.

 ORS 31.710(2)(a) does not, by its terms, limit the amount of economic damages to the costs incurred by the plaintiff. In this case, both plaintiff and Medicare incurred costs for medical services as a result of defendant’s acts, and defendant has not argued that it is not liable for the costs that plaintiff and Medicare incurred. Rather, it has argued only that it is not liable for costs that no one incurred.

 In Touhy, the plaintiff introduced into evidence the bills for medical treatment that he received as a result of the defendant’s negligence but submitted no evidence that those charges were reasonable. 61 Or at 530. This court held that, without evidence that the charges were reasonable, the plaintiff could not recover the cost of his medical treatment and directed that the amount of those bills be deducted from the judgment for plaintiff. Id. at 532-33. The court explained that “[t]he rule is that a plaintiff in a case involving personal injuries can recover, as a part of his damages, his reasonable expenses for medicines and medicinal treatment, but there must be some evidence that the charges were reasonable.” Id. at 532.

 Additionally, ORS 31.705 requires that jury verdicts in civil actions seeking damages arising out of bodily injury “shall set forth separately economic damages and noneconomic damages, if any, as defined in ORS 31.710.” That requirement is not limited to cases in which a plaintiffs prayer exceeds the statutory cap on economic damages, confirming that the legislature’s definition of economic damages is not as narrow as the majority suggests.

 Initially, the trial court ruled that the jury could not consider those sums as an element of the plaintiffs damages. The court then allowed the plaintiffs motion for a new trial on the ground that its damages ruling was erroneous, the defendant appealed to this court from that ruling, and this court affirmed. Id. at 26.

 Part of the difficulty arises, I suspect, from the fact that Medicare was not written with tort law in mind. When Congress decided to provide a system of medical coverage for persons over 65 years of age, it did not necessarily consider how the limitations it imposed on medical costs would affect a plaintiffs ability to recover damages for medical services resulting from a defendant’s tortious acts. We are, however, obliged to make that determination.