Court Opinion

ID: 9541673
Source: CourtListenerOpinion
Date Created: 2023-08-07 16:27:40.801757+00
Date Added: 2024-06-11T15:04:21.822761
License: Public Domain

Opinion
KAUS, J.
In May 1975, the Governor—citing serious problems that had arisen throughout the state as a result of a rapid increase in medical malpractice insurance premiums—convened the Legislature in extraordinary session to consider measures aimed at remedying the situation.1 In response, the Legislature enacted the Medical Injury Compensation Reform Act of 1975 (MICRA) (Stats. 1975, Second Ex. Sess. 1975-1976, chs. 1, 2, pp. 3949-4007), a lengthy statute which attacked the problem on several fronts. In broad outline, the act (1) attempted to reduce the incidence and severity of medical malpractice injuries by strengthening governmental oversight of the education, licensing and discipline of physicians and health care providers, (2) sought to curtail unwarranted insurance premium increases by authorizing alternative insurance coverage programs and by establishing new procedures to review substantial rate increases, and (3) at*364tempted to reduce the cost and increase the efficiency of medical malpractice litigation by revising a number of legal rules applicable to such litigation.
This case involves a wide-ranging constitutional challenge to one of the provisions of MICRA affecting medical malpractice lawsuits—a provision codified as section 667.7 of the Code of Civil Procedure.2 Section 667.7 provides that when a plaintiff in a medical malpractice case has sustained “future damages” of $50,000 or more, compensation for those future damages is to be paid periodically over the course of time the plaintiff incurs the losses, rather than in a lump sum payment at the time of judgment. Plaintiff attacks this “periodic payment of damages” provision on a variety of grounds, contending, inter alia, that it violates the state and federal constitutional guarantees of due process, equal protection, and the right to jury trial.
As explained hereafter, we have concluded that section 667.7 does not deny due process or equal protection. In order to avoid a potential conflict with the right to trial by jury, however, we conclude that the provision should be interpreted to require the jury to designate the portion of its award attributable to future damages. As so interpreted, we conclude that the provision is constitutional.
I
For purposes of this appeal, the facts may be briefly summarized. Late in 1976, after a brain scan had disclosed a lesion or tumor, plaintiff Mary English3 was admitted to defendant Community Hospital of Los Gatos-Saratoga for surgery. On the eve of her scheduled operation, she fainted or fell in a shower stall and suffered severe burns to her thigh, hip, and groin, as a result of overheated water. After the burns had been treated and dressed by her neurosurgeon, the brain surgery proceeded as scheduled. The tumor, though then in remission, was found to be malignant and of a type which reportedly results in death within one year in 95 percent of all cases. Following release from the hospital, plaintiff received radiation and chemotherapy treatments.
Plaintiff was treated for her burn injuries by a plastic surgeon under whose care a gradual but steady healing took place. Because of the burns, however, *365she was totally disabled for four months and partially disabled for two more months. Intermittent breakdown and blistering of the healed tissues continued to occur.
Alleging that defendant’s negligence had led to her fall in the shower and to her severe burns, plaintiff brought the present action to recover for the resulting damages. At the time of trial, some 14 months after the accident, plaintiff still suffered residual disability caused by recurring blisters, and scarring in three of the four burn areas had resulted in a permanent cosmetic deformity. Plaintiff’s doctor testified that it was reasonably probable that future surgery would be required, and that such surgery would be followed by periods of total and partial disability to permit proper healing. Plaintiff testified that she had not been able to work in 1977, the year following the accident, that she did not anticipate returning to work in 1978 because the condition of her left knee and leg prevented her from driving a car, and that if future surgery were recommended she “would certainly do it.”
At the conclusion of the trial, the jury rendered a general verdict for $198,069.88 in favor of plaintiff. After the verdict was returned, defendant raised the periodic payment issue for the first time, moving for an order of periodic payment of future damages pursuant to section 667.7. The trial court, while concluding that the section was by its terms applicable, denied defendant’s motion on the ground that the provision was unconstitutional. The court relied on two theories: (1) it concluded that the provision denies equal protection by granting a privilege to health care defendants that is not afforded to other defendants, and (2) it held that the provision denies due process to the spouse of an injured plaintiff by limiting the damages that a defendant is obligated to pay in the event of the plaintiff’s death. In light of its constitutional ruling, the trial court entered a lump sum judgment in favor of plaintiff in the amount of the verdict.
Defendant now appeals from the judgment,4 contending primarily that the trial court’s constitutional rulings with respect to section 667.7 are in error.5 *366In response, plaintiff claims that the provision is unconstitutional both on the grounds relied on by the trial court and on additional grounds as well. Numerous amicus briefs have been filed on both sides of the case.
II
At common law, a plaintiff who suffers bodily injury at the hands of a tortfeasor has traditionally been compensated for both past and future damages through a lump sum judgment, payable at the conclusion of the trial. (2 Harper & James, The Law of Torts (1956) § 25.2, p. 1303.) Over the past 30 years, however, several tort scholars—noting that lump sum awards are often dissipated by improvident expenditures or investments before the injured person actually incurs the future medical expenses or earning losses—have advocated the legislative adoption of a “periodic payment” procedure as a reform measure which would, in these commentators’ view, benefit both plaintiffs and defendants. (See id., at pp. 1303-1304; Keeton & O’Connell, Basic Protection for the Traffic Victim—A Blueprint for Reforming Automobile Insurance (1965) pp. 351-358; Henderson, Periodic Payments of Bodily Injury Awards (1980) 66 A.B.A.J. 734.) In the last decade, many states have enacted provisions authorizing the periodic payment of damages in a variety of tort fields,6 and, in 1980, the National Conference of Commissioners on Uniform State Laws approved a “Model Periodic Payment of Judgments Act” embodying this revised approach to compensation for future tort damages.
Section 667.7—the provision at issue here—represents the Legislature’s initial adoption of the periodic-payment-of-damages concept into California tort law. The section—set forth in full below7—provides generally that when *367a plaintiff in a medical malpractice action obtains an award of $50,000 or more for “future damages,” the trial court, on motion of either party, shall enter a judgment providing for the periodic payment of those damages. *368Explaining that the legislative intent is that “courts will utilize such judgments to provide compensation sufficient to meet the needs of an injured plaintiff and those persons who are dependent on the plaintiff for whatever period is necessary while eliminating the potential windfall from a lump-sum recovery which was intended to provide for the care of an injured plaintiff over an extended period who then dies shortly after the judgment is paid” (§ 667.7, subd. (f)), the section provides (1) that the judgment shall specify, inter alia, the dollar amount of the individual payments, the interval between payments and the period of time over which the payments shall be made (id., subd. (b)(1)), (2) that the payment schedule shall be modifiable only if the plaintiff dies before all payments are due (ibid.),8 and (3) that even if the plaintiff does die, the portion of future damages awarded for the plaintiff’s loss of future earnings shall not be reduced or terminated but shall be paid to persons to whom the plaintiff owed a duty of support at the time of his or her death. (Id., subd. (c).)
As noted above, plaintiff—and amici appearing on plaintiff’s behalf—contend that this periodic payment provision violates a number of constitutional guarantees. We turn first to the most fundamental challenge, the contention that the change from a lump sum judgment to a periodic payment procedure violates due process.
Ill
Plaintiff’s due process claim rests initially on the contention that the change from a lump sum judgment to a periodic payment procedure violates the due process rights of medical malpractice victims by diminishing the value of their malpractice actions without providing them an adequate “quid pro quo.” Although defendant—and supporting amici—strenuously contest plaintiff’s factual assertion and maintain that the periodic payment provision itself, and MICRA in general, do in fact afford malpractice victims a substantial quid pro quo, settled constitutional principles teach that it is both unnecessary and inappropriate for us to attempt to balance the relative benefits and detriments of the legislation—i.e., the “adequacy” of the quid pro quo—in determining its validity under the due process clause.  It is well established that a plaintiff has no vested property right in a particular measure of damages, and that the Legislature possesses broad authority to modify the scope and nature of such damages. (See, e.g., Werner v. Southern Cal. etc. Newspapers (1950) 35 Cal.2d 121, 129 [216 P.2d *369825, 13 A.L.R.2d 252]; Feckenscher v. Gamble (1938) 12 Cal.2d 482, 499-500 [85 P.2d 885]; Tulley v. Tranor (1878) 53 Cal. 274, 280.) Since the demise of the substantive due process analysis of Lochner v. New York (1905) 198 U.S. 45 [49 L.Ed. 937, 25 S.Ct. 539], it has been clear that the constitutionality of measures affecting such economic rights under the due process clause does not depend on a judicial assessment of the justifications for the legislation or of the wisdom or fairness of the enactment. So long as the measure is rationally related to a legitimate state interest, policy determinations as to the need for, and desirability of, the enactment are for the Legislature.
Here, there can be no serious question but that the provision is rationally related to a legitimate state interest. Clearly, the Legislature could conclude that a procedure that provides for the periodic payment of future damages will further the fundamental goal of matching losses with compensation by helping to ensure that money paid to an injured plaintiff will in fact be available when the plaintiff incurs the anticipated expenses or losses in the future. In addition, the Legislature could legitimately determine that the public interest would be served by limiting a defendant’s obligation to those future damages that a plaintiff actually incurs, eliminating the so-called “windfall” obtained by a plaintiff’s heirs when they inherit a portion of a lump sum judgment that was intended to compensate the injured person for losses he in fact never sustained. Although reasonable persons may disagree as to the wisdom of a periodic payment approach in general, or with the merits of the particular procedure which the Legislature chose to adopt, the provision is obviously not irrational.9
Plaintiff alternatively argues that section 667.7 violates the due process rights of a malpractice victim’s spouse by authorizing the termination of a portion of the future damage award on the death of the plaintiff. As noted above, the trial court accepted this argument, apparently concluding that a spouse has a vested community property right in the full amount of the damages found by the jury. Any rights which a surviving spouse may have in a personal injury judgment under the community property statutes, however, are obviously contingent on the nature of the judgment and on the measure of damages which the state has authorized for such a cause of action. Just as the injured victim has no vested right in a particular measure *370of damages, the spouse similarly has no such vested right. In short, the spouse clearly has no greater constitutional right than the victim to a damage award that continues beyond the victim’s life.
IV
Plaintiff next contends that even if the adoption of a periodic payment procedure is consistent with due process, section 667.7 is nonetheless unconstitutional as a denial of equal protection. As we have seen, the trial court upheld this claim, concluding that the statute is invalid because it provides a “special benefit” to one class of negligent tortfeasors—medical care providers—which is not afforded to other negligent tortfeasors. In a variant on this theme, plaintiff additionally maintains that the provision denies equal protection to persons injured by medical malpractice, withholding from this class the benefits of lump sum damage awards that are available to those who suffer negligently inflicted injury outside of the medical malpractice context. The gist of both arguments, of course, is that the Legislature acted unconstitutionally in limiting the operation of section 667.7 to medical malpractice cases.
The claim is by no means a novel one. In the mid-1970’s, in reaction to medical malpractice crises throughout the country, virtually every state passed one or more statutory provisions to deal with the medical malpractice insurance problem. Although legislative solutions varied from state to state, in many jurisdictions the resulting enactments have been challenged, inter alia, as a violation of the federal equal protection clause or a related state constitutional provision, on the ground that they improperly single out medical malpractice litigants for differential treatment. The overwhelming majority of courts—both state and federal—which have spoken to the issue have emphatically rejected the contention.10
*371With respect to section 667.7, we too conclude that the equal protection claim is unfounded. It is true, of course, that a periodic payment of damages procedure could reasonably be applied across the entire tort spectrum; as already noted, there have been a variety of proposals advocating just such a general reform. Countless constitutional precedents establish, however, that the equal protection clause does not prohibit a Legislature from implementing a reform measure “one step at a time” (Williamson v. Lee Optical Co. (1955) 348 U.S. 483, 489 [99 L.Ed. 563, 573, 75 S.Ct. 461]), or prevent it “from striking the evil where it is felt most.” (Werner v. Southern Cal. etc. Newspapers (1950) 35 Cal.2d 121, 132 [216 P.2d 825, 13 A.L.R.2d 252].)
The reason the Legislature limited the application of section 667.7—and, indeed, MICRA in general—to the medical malpractice field was, of course, because it was responding to an insurance “crisis” that had arisen in a particular area. The problem which was the immediate impetus to the enactment of MICRA arose when the insurance companies which issued virtually all of the medical malpractice insurance policies in California determined that the costs of affording such coverage were so high that they would no longer continue to provide such coverage as they had in the past. Some of the insurers withdrew from the medical malpractice field entirely, while others raised the premiums which they charged to doctors and hospitals to what were frequently referred to as “skyrocketing” rates. As a consequence, many doctors decided either to stop providing medical care with respect to certain high risk procedures or treatment, to terminate their practice in this state altogether, or to “go bare,” i.e., to practice without malpractice insurance. The result was that in parts of the state medical care was not fully available, and patients who were treated by uninsured doctors faced the prospect of obtaining only unenforceable judgments if they should suffer serious injury as a result of malpractice.
Many factors have been tendered to explain why these problems arose in the medical malpractice field—the changing doctor-patient relationship, a *372rapid “liberalization” of tort doctrine in medical malpractice cases, a uniquely small number of insureds over which to spread premiums, imprudent investments on the part of medical malpractice insurers, and others. (See generally Keene, California’s Medical Malpractice Crisis in A Legislator’s Guide to the Medical Malpractice Issue (1976) 27, 27-28.) Plaintiff— and supporting amici—challenge the factual accuracy of some of these explanations and invite us to determine the “true” cause of the medical malpractice insurance problems that preceded MICRA and even to second-guess the Legislature as to whether a “crisis” actually existed.11
                   It is not the judiciary’s function, however, to reweigh the “legislative facts” underlying a legislative enactment. (See, e.g., Minnesota v. Cloverleaf Creamery Co. (1981) 449 U.S. 456, 464 [66 L.Ed.2d 659, 668-669, 101 S.Ct. 715] [“states are not required to convince the courts of the correctness of their legislative judgments . . .”].) Whatever the reasons for the medical malpractice insurance problems, it is clear that the Legislature—which thoroughly investigated this matter through numerous hearings, audits and the like—could rationally conclude from the information before it that the high insurance costs in this particular area posed special problems with respect to the continued availability of adequate insurance coverage and adequate medical care and could fashion remedies—directed to the medical malpractice context—to meet these problems.
Section 667.7 is one of a number of provisions of MICRA which was intended, in part, to reduce the cost of medical malpractice insurance. By reducing such costs, the Legislature hoped (1) to restore insurance premiums to a level doctors and hospitals could afford, thereby inducing them to resume providing medical care to all segments of the community, and (2) to insure that insurance would in fact be available as a protection for patients injured through medical malpractice.
Plaintiff does not—and could not—claim that section 667.7’s periodic payment provisions are not rationally related to the objective of reducing insurance costs. As the legislative history of MICRA indicates, one of the factors which contributed to the high cost of malpractice insurance was the need for insurance companies to retain large reserves to pay out sizeable *373lump sum awards. The adoption of a periodic payment procedure permits insurers to retain fewer liquid reserves and to increase investments, thereby reducing the costs to insurers and, in turn, to insureds. In addition, the portion of section 667.7 which provides for the termination of a significant portion of the remaining future damage payments in the event of the plaintiff’s death is obviously related to the goal of reducing insurance costs.
Thus, since there was a rational and legitimate basis for the Legislature’s decision to attempt to reduce insurance costs in the medical malpractice area and since the provisions of section 667.7 are rationally related to that objective, the Legislature did not violate equal protection principles in limiting section 667.7’s application to medical malpractice actions.12
A number of amici, theorizing that the primary purpose of MICRA was to contain the overall costs of medical care, contend that section 667.7— and, by logical inference, all of MICRA—should be held unconstitutional on the basis of statistics which indicate that the overall costs of medical and hospital care rose considerably in the years since MICRA’s enactment. This contention is riddled with fundamental flaws. First, the legislative history of MICRA does not suggest that the Legislature intended to hold down the overall costs of medical care but instead demonstrates—as we have explained—that the Legislature hoped to reduce the cost of medical malpractice insurance, so that doctors would obtain insurance for all medical procedures and would resume full practice; indeed, in this respect amici’s statistics suggest that MICRA was in fact successful. The statistical information before the Legislature indicated, however, that insurance costs amounted to only a small percentage of overall medical costs (see, e.g., Assem. Select Com. on Medical Malpractice Preliminary Rep. (June 1974) p. 49), and thus in an era of substantial inflation—as experienced in the late 1970’s—even the total elimination of malpractice insurance premiums could not reasonably have been expected to reduce the overall cost of medical care.
Second, the rise in medical and hospital costs cannot, in any event, properly be attributed to a failure of section 667.7, since the section has never fully been implemented. The trial court’s decision in this case was apparently the first judicial ruling on the question, and in view of its finding of *374unconstitutionality, the periodic payment procedure has not been widely enforced. Thus amici’s statistics do not shed any light on the effectiveness of the statutory reform.
Finally, and most fundamentally, the constitutionality of a measure under the equal protection clause does not depend on a court’s assessment of the empirical success or failure of the measure’s provisions. As Justice Brennan explained recently in Minnesota.v. Cloverleaf Creamery Co., supra, 449 U.S. 456, 466 [66 L.Ed.2d 659, 670]: “Whether in fact the Act will promote [the legislative objectives] is not the question: the Equal Protection Clause is satisfied by our conclusion that the [state] Legislature could rationally have decided that [it] . . . might [do so] . . . .” (Original italics.) As we have explained, there can be no question but that—from the information before it—the Legislature could rationally have decided that the enactment might serve its insurance cost reduction objective. Amici’s argument is misguided.
In addition to challenging the disparate treatment between medical malpractice victims and other victims of negligently inflicted injury, plaintiff also attacks the provisions of section 667.7 which limit the periodic payment procedure to those malpractice victims with future damages of $50,000 or more. The Legislature adopted the $50,000 threshold based on a determination that the administrative costs involved in the implementation of a periodic payment award would mean that such a procedure would not be cost efficient for smaller future damage claims. The Legislature has broad leeway in making these kinds of economic “line-drawing” determinations, and the “classification” resulting from the $50,000 threshold certainly has a rational basis.
Accordingly, we conclude that section 667.7 does not deny equal protection.
V
Plaintiff’s next contention relates to section 667.7’s impact on the constitutional right to jury trial. (Cal. Const., art. I, § 16.)
As enacted, section 667.7 is somewhat ambiguous on the precise roles which the Legislature contemplated that the jury and court would play in the formulation of a periodic payment judgment. On the one hand, it is apparent from the statute (1) that the jury remains the ultimate decision-maker of the plaintiff’s “total damages,” and (2) that the court is to fashion the specific details of the periodic payment award, designating the dollar *375amount of the payments, the interval between payments and the period of time over which the payments are to be made. (§ 667.7, subd. (b)(1).) On the other hand, however, the statute does not make clear whether it is the jury or the court which is to determine the amount of the “future damages” component of the overall award.13
Plaintiff contends that the jury trial guarantee requires that the jury not only fix the amount of future damages but also that it make special findings on any subsidiary issue that may affect the structuring of a periodic payment schedule. Defendant takes the position that the jury’s only role is to establish total damages, and that thereafter it is the court that both determines the amount attributable to future damages and establishes the periodic payment schedule. Defendant maintains that the court’s authority under its proposed interpretation does not infringe the right to jury trial.
Our prior decisions provide only limited guidance on the constitutional jury trial question. Although a number of cases have defined the constitutional jury trial right as essentially that existing at common law at the time the Constitution was adopted (see, e.g., People v. One 1941 Chevrolet Coupe (1951) 37 Cal.2d 283 [231 P.2d 832]; Southern Pac. Transportation Co. v. Superior Court (1976) 58 Cal.App.3d 433, 436 [129 Cal.Rptr. 912]), in Jehl v. Southern Pac. Co. (1967) 66 Cal.2d 821 [59 Cal.Rptr. 276, 427 P.2d 988], in a unanimous opinion authored by Chief Justice Traynor, we upheld the validity of the additur procedure—a device unknown at common law—explaining that the constitutional provision “ ‘does not require adherence to the letter of common law practice, and new procedures better suited to the efficient administration of justice may be substituted if there is no *376impairment of the substantial features of a jury trial. ’ . . . The guarantee of jury trial in the California Constitution operates at the time of trial to require submission of certain issues to the jury. Once a verdict has been returned, however, the effect of the constitutional provision is to prohibit improper interference with the jury’s decision.” (Id., at pp. 828-829.) (Italics added.)
Because tort judgments were not subject to periodic payment at common law, an historical perspective provides no direct guidance in determining the permissible roles of court and jury in implementing a periodic payment procedure. Thus, the constitutional question before us is basically whether defendant’s proposed interpretation of the statute—authorizing the trial court to fix the amount of future damages subject to periodic payment-amounts to an impermissible “impairment of the substantial features of a jury trial” or to an “improper interference with the jury’s decision.”  Neither party has cited any authority closely in point, but in light of the familiar principle that a statute should be construed to avoid all doubts as to its constitutionality (United States ex rel. Atty. Gen. v. Delaware & Hudson Co. (1909) 213 U.S. 366, 407-408 [53 L.Ed. 836, 848-849, 29 S.Ct. 527]), we conclude that section 667.7 should be interpreted to require the jury to designate the portion of its verdict that is intended to compensate the plaintiff for future damages. Under section 667.7’s procedure, this “future damage” figure plays a number of crucial roles: (1) it identifies the amount that the jury has determined as attributable to past and present damages, an amount which the plaintiff will be entitled to receive in an immediate lump sum payment at the time of judgment, and (2) it determines whether the periodic payment procedure will be applicable to the case or not—depending on whether future damages are found to equal or exceed $50,000. If the finding on the amount of future damages were left solely to the court, the court might seriously underestimate the award which the jury intended as compensation for losses which the plaintiff has already incurred, thereby significantly undermining the statutory purpose of affording a fair correlation between the sustaining of losses and the payment of damages.
Once the jury has designated the amount of future damages—and has thus identified the amount of damages subject to periodic payment—we believe that the court’s authority under section 667.7, subdivision (b)(1), to fashion the details of a periodic payment schedule does not infringe the constitutional right to jury trial. As defendant notes, the court’s function in this regard is similar to the authority long exercised by courts in the disbursement of the proceeds of a judgment under a number of well-established statutory schemes. (See, e.g., § 377 [court apportionment of wrongful death recovery among individual heirs]; Prob. Code, §§ 3600-3603 [court control *377over disbursement of proceeds of judgment in favor of minors and incompetent persons].) Plaintiff cites no decision to support the contention that the exercise of such limited judicial authority is incompatible with the jury trial guarantee, and the additur procedure—upheld in Jehl, supra, 66 Cal.2d 821—affords a court considerably greater latitude in fixing the plaintiff’s ultimate damage recovery.
Thus, we conclude that when section 667.7 is interpreted to require the jury to designate the amount of future damages which is subject to periodic payment, the section does not conflict with the constitutional right to jury trial.
VI
Finally, plaintiff contends that even if section 667.7 can be construed to eliminate any right-to-jury-trial problem, the provision should still be struck down as unconstitutionally “void for vagueness, ambiguity and unworkability,” because it leaves unanswered many questions as to how a trial court is to actually formulate a comprehensive payment schedule without the benefit of very detailed special jury verdicts. In structuring a periodic payment schedule in light of the statutory objective of “provid[ing] compensation sufficient to meet the needs of an injured plaintiff ... for whatever period is necessary” (§ 667.7, subd. (f)), a court will, of course, necessarily be guided by the evidence of future damages introduced at trial, and the difficulty of the court’s task will thus inevitably vary with the nature of the future damages involved in a given case.  There is nothing in section 667.7, however, which precludes resort to the special verdict procedure of section 625, and—particularly when the elements of future damage are in dispute—we think trial courts would be well advised to permit liberal use of the special verdict procedure so that the individual components of the jury’s future damage award can be ascertained and the periodic payment schedule can be knowledgeably established.14 As in the comparative negligence field (see Li v. Yellow Cab Co. (1975) 13 Cal.3d 804, 824 [119 Cal.Rptr. 858, 532 P.2d 1226, 78 A.L.R.3d 393]), we believe that reliance on the special verdict procedure “can be of invaluable assistance” (ibid.) to the court in this realm.
*378In any event, plaintiff provides no authority to support its claim that the remaining uncertainties which may inhere in the statute provide a proper basis for striking it down on its face. As with other innovative procedures and doctrines—for example, comparative negligence—in the first instance trial courts will deal with novel problems that arise in time-honored case-by-case fashion, and appellate courts will remain available to aid in the familiar common law task of filling in the gaps in the statutory scheme. (Cf. Li v. Yellow Cab Co., supra, 13 Cal.3d at pp. 826-827.)
VII
The question remains as to the proper disposition of this case. As noted at the outset, defendant did not raise the matter of periodic payments until after the jury had returned its verdict. As a consequence, the jury made no finding as to the amount of future damages and plaintiff was deprived of the opportunity to seek additional special verdicts to guide the structuring of a periodic payment schedule. Because plaintiff has died in the interim (see fn. 3, ante), granting a new trial at this point obviously would not restore the status quo ante. Although it is impossible to determine with certainty how the jury would have apportioned the damages or how the court would have scheduled payments, the evidence at trial did indicate that plaintiff had a short life expectancy. Thus, it seems reasonable to assume that at least the bulk of the damages would have been attributed either to past damages or to the period of time which plaintiff survived. Under these circumstances, we conclude that the interests of justice would be best served by upholding the trial court’s lump sum award.
The appeal from the order denying the motion for periodic payments is dismissed. (See fn. 4, ante.) On remand, the trial court shall reduce the judgment in accordance with the stipulation of the parties. (See fn. 5, ante.) In all other respects, the judgment is affirmed. Each party shall bear its own costs on appeal.
Broussard, J., Grodin, J., and Feinberg, J.,* concurred.

The Governor’s proclamation stated in part: “The cost of medical malpractice insurance has risen to levels which many physicians and surgeons find intolerable. The inability of doctors to obtain such insurance at reasonable rates is endangering the health of the people of this State, and threatens the closing of many hospitals. The longer term consequences of such closings could seriously limit the health care provided to hundreds of thousands of our citizens.” (Governor’s Proclamation to Leg. (May 16, 1975) Stats. 1975 (Second Ex. Sess. 1975-1976) p. 3947.)

Unless otherwise specified, all section references are to the Code of Civil Procedure.

Mary English died on November 24, 1978, while this appeal was pending. By stipulation, American Bank and Trust Company, special administrator of her estate, has been substituted as plaintiff in this action. For convenience, we shall use the term “plaintiff” to refer both to Mary English and to the present representative of her interest.

Defendant also purports to appeal from the trial court’s order, prior to judgment, denying the motion for periodic payments. Though reviewable on appeal from the judgment, that order itself is nonappealable. (§ 904.1; see generally 6 Witkin, Cal. Procedure (2d ed. 1971) Appeal, §§ 34, 62, 68, pp. 4048-4049, 4077, 4082-4083.) Accordingly, the purported appeal from that order must be dismissed.

Defendant raises two additional claims on appeal. First, defendant asserts that the trial court erred in failing to reduce the judgment by $2,023.04, pursuant to a stipulation of the parties with respect to Medi-Cal payments received by plaintiff. Plaintiff concedes that the parties entered into such a stipulation, but suggests that the stipulated reduction was for $2,500, rather than the lower figure cited by defendant. Because the record is ambiguous on the amount of the stipulation, we shall direct the trial court, on remand, to determine the *366stipulated figure and to reduce the judgment by that amount.
Second, defendant contends that the damage award was excessive and that the trial court erred in denying its motion for a remittitur or a new trial with respect to damages. The Court of Appeal addressed and rejected this claim when the case was before it, and, for the reasons stated by that court, we also conclude that the contention lacks merit. (See People v. Ford (1981) 30 Cal.3d 209, 215-216 [178 Cal.Rptr. 196, 635 P.2d 1176].)

See generally Elligett, The Periodic Payment of Judgments (1979) 46 Ins.Couns.J. 130.

Section 667.7 provides: “(a) In any action for injury or damages against a provider of health care services, a superior court shall, at the request of either party, enter a judgment ordering that money damages or its equivalent for future damages of the judgment creditor be paid in whole or in part by periodic payments rather than by a lump-sum payment if the award equals or exceeds fifty thousand dollars ($50,000) in future damages. In entering a judgment ordering the payment of future damages by periodic payments, the court shall make a specific finding as to the dollar amount of periodic payments which will compensate the judgment creditor for such future damages. As a condition to authorizing periodic payments of future damages, the court shall require the judgment debtor who is not adequately insured to post security adequate to assure full payment of such damages awarded by the judgment. Upon termination of periodic payments of future damages, the court shall order *367the return of this security, or so much as remains, to the judgment debtor.
“(b)(1) The judgment ordering the payment of fiiture damages by periodic payments shall specify the recipient or recipients of the payments, the dollar amount of the payments, the interval between payments, and the number of payments or the period of time over which payments shall be made. Such payments shall only be subject to modification in the event of the death of the judgment creditor.
“(2) In the event that the court finds that the judgment debtor has exhibited a continuing pattern of failing to make the payments as specified in paragraph (1), the court shall find the judgment debtor in contempt of court and, in addition to the required periodic payments, shall order the judgment debtor to pay the judgment creditor all damages caused by the failure to make such periodic payments, including court costs and attorney’s fees.
“(c) However, money damages awarded for loss of fiiture earnings shall not be reduced or payments terminated by reason of the death of the judgment creditor, but shall be paid to persons to whom the judgment creditor owed a duty of support, as provided by law, immediately prior to his death. In such cases the court which rendered the original judgment, may, upon petition of any party in interest, modify the judgment to award and apportion the unpaid future damages in accordance with this subdivision.
“(d) Following the occurrence or expiration of all obligations specified in the periodic payment judgment, any obligation of the judgment debtor to make further payments shall cease and any security given, pursuant to subdivision (a) shall revert to the judgment debtor.
“(e) As used in this section:
“(I) ‘Future damages’ includes damages for future medical treatment, care or custody, loss of future earnings, loss of bodily function, or fiiture pain and suffering of the judgment creditor.
“(2) ‘Periodic payments’ means the payment of money or delivery of other property to the judgment creditor at regular intervals.
“(3) ‘Health care provider’ means any person licensed or certified pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code, or licensed pursuant to the Osteopathic Initiative Act, or the Chiropractic Initiative Act, or licensed pursuant to Chapter 2.5 (commencing with Section 1440) of Division 2 of the Health and Safety Code; and any clinic, health dispensary, or health facility, licensed pursuant to Division 2 (commencing with Section 1200) of the Health and Safety Code. ‘Health care provider’ includes the legal representatives of a health care provider.
“(4) ‘Professional negligence’ means a negligent act or omission to act by a health care provider in the rendering of professional services, which act or omission is the proximate cause of a personal injury or wrongful death, provided that such services are within the scope of services for which the provider is licensed and which are not within any restriction imposed by the licensing agency or licensed hospital.
“(f) It is the intent of the Legislature in enacting this section to authorize the entry of judgments in malpractice actions against health care providers which provide for the payment of future damages through periodic payments rather than lump-sum payments. By authorizing periodic payment judgments, it is the further intent of the Legislature that the courts will utilize such judgments to provide compensation sufficient to meet the needs of an injured plaintiff and those persons who are dependent on the plaintiff for whatever period is necessary while eliminating the potential windfall from a lump-sum recovery which was intended to provide for the care of an injured plaintiff over an extended period who then dies shortly after the judgment is paid, leaving the balance of the judgment award to persons and purposes for which it was not intended. It is also the intent of the Legislature that all elements of the periodic payment program be specified with certainty in the judgment ordering such payments and that the judgment not be subject to modification at some future time which might alter the specifications of the original judgment.”

AIthough the statute does not expressly provide what modification should follow the plaintiff’s death, in context it is evident that the Legislature contemplated that a defendant’s continuing liability for future damages other than damages for loss of future earnings would be subject to termination on the plaintiff’s death. (See § 667.7, subds. (b)(1), (c), (f).)

Although the dissent suggests that any periodic payment procedure requires a special “prescience” in anticipating future damages (post, p. 379), the reality is that in fashioning lump sum awards, juries have always been required to predict future losses on the basis of many variables, including inflationary trends—and then to reduce anticipated losses to present value. (See, e.g., Rodriguez v. McDonnell Douglas Corp. (1978) 87 Cal.App.3d 626, 660-662 [151 Cal.Rptr. 399].)

The courts of 23 states and 3 federal circuits have rejected equal protection challenges in this setting. (See Reese v. Rankin Fite Memorial Hospital (Ala. 1981) 403 So.2d 158, 160-162; Eastin v. Broomfield (1977) 116 Ariz. 576 [570 P.2d 744, 750-751]; Gay v. Rabon (1983) 280 Ark. 5 [652 S.W.2d 836, 837-838]; Lacy v. Green (Del.Super. 1981) 428 A.2d 1171, 1177-1178; Pinillos v. Cedars of Lebanon Hospital Corp. (Fla. 1981) 403 So.2d 365, 367-368; LePelley v. Grefenson (1980) 101 Idaho 422 [614 P.2d 962, 967-968]; Anderson v. Wagner (1979) 79 Ill.2d 295 [402 N.E.2d 560, 570-571]; Johnson v. St. Vincent Hospital, Inc. (1980) 273 Ind. 374 404 N.E.2d 585, 600-601; Rudolph v. Iowa Methodist Medical Ctr. (Iowa 1980) 293 N.W.2d 550, 557-559; Stephens v. Snyder Clinic Ass’n (1981) 230 Kan. 115 [631 P.2d 222, 233-236]; Everett v. Goldman (La. 1978) 359 So.2d 1256, 1265-1267; Attorney General v. Johnson (1978) 282 Md. 274 [385 A.2d 57, 76-80], app. dis. 439 U.S. 805 [58 L.Ed.2d 97, 99 S.Ct. 60]; Paro v. Longwood Hospital (1977) 373 Mass. 645 [369 N.E.2d 985, 987-989]; Linder v. C.W. Smith, M.D. (Mont. 1981) 629 P.2d 1187, 1192-1193; Prendergast v. Nelson (1977) 199 Neb. 97 [256 N.W.2d 657, 667-669]; Perna v. Pirozzi (1983) 92 N.J. 446 [457 A.2d 431, 437]; Armijo v. Tandysh (Ct.App. 1981) 98 N.M. 181 [646 P.2d 1245, 1247]; Comiskey v. Arlen (1976) 55 App.Div.2d 304 [390 N.Y.S.2d 122, 129-130]; Roberts v. Durham County Hospital Corp. (1983) 56 N.C.App. *371533 [289 S.E.2d 875, 878-880], affd. (1983) 307 N.C. 465 [298 S.E.2d 384]; Beatty v. Akron City Hospital (1981) 67 Ohio St.2d 483 [424 N.E.2d 586, 591-595, 424 N.E.2d 586]; Allen v. Intermountain Health Care, Inc. (Utah 1981) 635 P.2d 30, 31-32; Duffy v. King Chiropractic Clinic (1977) 17 Wn.App. 693 [565 P.2d 435, 437]; State ex rel. Strykowski v. Wilkie (1978) 81 Wis.2d 491 [261 N.W.2d 434, 441-444]; Woods v. Holy Cross Hospital (5th Cir. 1979) 591 F.2d 1164, 1171-1175; DiAntonio v. Northampton-Accomack Memorial (4th Cir. 1980) 628 F.2d 287, 291-292; Fitz v. Dolyak (8th Cir. 1983) 712 F.2d 330, 332-333.)
Three state courts have reached a contrary conclusion. (See Carson v. Maurer (1980) 120 N.H. 925 [424 A.2d 825, 830-839, 12 A.L.R.4th]; Arneson v. Olson (N.D. 1978) 270 N.W.2d 125, 131-136; Boucher v. Sayeed (R.I. 1983) 459 A.2d 87, 91-94.)

The preamble to MICRA states: “The Legislature finds and declares that there is a major health care crisis in the State of California attributable to skyrocketing malpractice premium costs and resulting in a potential breakdown of the health delivery system, severe hardships for the medically indigent, a denial of access for the economically marginal, and depletion of physicians such as to substantially worsen the quality of health care available to citizens of this state. The Legislature, acting within the scope of its police powers, finds the statutory remedy herein provided is intended to provide an adequate and reasonable remedy within the limits of what the foregoing public health safety considerations permit now and into the foreseeable future.” (Stats. 1975, Second Ex. Sess. 1975-1976, ch. 2, § 12.5, p. 4007.)

Although several amici urge the court to apply a stricter standard of review, the governing authorities—both federal and state—establish that the traditional “rational relationship” standard is applicable here. (See, e.g., Duke Power Co. v. Carolina Env. Study Group (1978) 438 U.S. 59, 93-94 [57 L.Ed.2d 595, 624-625, 98 S.Ct. 2620]; Cory v. Shierloh (1981) 29 Cal.3d 430, 438-439 [174 Cal.Rptr. 500, 629 P.2d 8]; Brown v. Merlo (1973) 8 Cal.3d 855, 862, fn. 2 [506 P.2d 212, 66 A.L.R.2d 505].)

Defendant contends that the language and legislative history of section 667.7 demonstrate that the Legislature intended the court to make this determination. Defendant relies on the fact that an earlier version of the bill that was ultimately enacted as MICRA provided, in part, that “[i]n entering a judgment ordering the payment of future damages, the jury or the court, in the event the trial is without a jury, shall make a specific finding as to the dollar amount of periodic payments which will compensate the judgment creditor for such future damages” (Assem. Bill No. 1, as amended June 6, 1975, 13 Assem.J. (1975-1976 Second Ex. Sess.) p. 60) (italics added), but that, as enacted, this language was amended to delete any reference to the jury and to provide simply that the court shall make the specified finding. (§ 667.7, subd. (a).) As plaintiff points out, however, the initial sentence of section 667.7 provides simply that a periodic payment judgment is to be ordered “if the award equals or exceeds fifty thousand dollars ($50,000) in future damages,” suggesting that the amount attributable to future damages will be determined as part of the overall determination of “the award,” and the following sentence of section 667.7—the sentence on which defendant relies—is not necessarily inconsistent with such an interpretation for it defines the court’s role as making “a specific finding as to the dollar amount of periodic payments which will compensate ... for such future damages” (italics added), implying that the amount of “such” damages has been independently designated. Thus, we find the statute ambiguous on this point.

Although the scope of the special verdicts will necessarily vary with the evidence presented in a particular case, we believe that it would generally be wise to have the jury designate the portion of the future damage award which is intended to compensate the plaintiff for loss of future earnings. This figure will become of crucial importance in the event that the plaintiff dies before the judgment is fully paid, because section 667.7, subdivision (c) provides that damages for future earnings—unlike the other components of future damages—must continue to be paid to a plaintiff’s dependents after the plaintiff’s death.

Retired Associate Justice of the Court of Appeal sitting under assignment by the Chairperson of the Judicial Council.