Court Opinion

ID: 9631991
Source: CourtListenerOpinion
Date Created: 2023-08-22 10:58:17.565558+00
Date Added: 2024-06-11T12:30:51.573094
License: Public Domain

dissenting: I respectfully dissent from the principal and concurring opinions and the resultant decision holding K.S.A. 1986 Supp. 60-3403 (hereinafter simply 60-3403) unconstitutional as violating the Kansas Bill of Rights.
At the outset, in fairness to the litigants, counsel, and the bar of Kansas, I feel it is incumbent upon this court to comment upon the procedural morass which caused these cases to languish in the bowels of the court for over seven months. These cases were initially argued to the court on December 4, 1986, and in the normal course of events an opinion would have been forthcoming in approximately six weeks. The original appeals in these cases sought a determination of whether 60-3403 was unconstitutional as violating the equal protection and due process clauses of the United States and Kansas Constitutions. On February 20, *6821987, a majority of this court determined, sua sponte, that the cases should be reargued and that counsel should submit supplemental briefs on the issue of whether 60-3403 is unconstitutionally vague and indefinite. Thereafter, the case was reargued on March 27, 1987, and the decision is now finally forthcoming. It is interesting that the issue of whether the statute is unconstitutionally vague and indefinite, which was of such momentous importance less than five months ago, is not even mentioned in the principal opinion and receives only cursory consideration in the concurring opinion.
Although the principal opinion purports to be based upon “Sections 1 and 18 of the Kansas Bill of Rights,” it also asserts that “we do not reach the issue of whether 60-3403 violates Section 18 of the Kansas Bill of Rights.” As there is no further mention of the due process clause in Section 18, I can only assume that the opinion relies solely upon the equal protection clause found in Section 1 of the Kansas Bill of Rights. I cannot agree that 60-3403 is a violation of the equal protection clauses of either the Kansas Bill of Rights or the United States Constitution.
The principal opinion, in arriving at the decision that 60-3403 is unconstitutional, has not only abandoned the federal constitutional attacks upon the statute, evidently conceding that they lack merit, but has also, in my opinion, abandoned prior Kansas law. Without being too repetitive, these appeals question the power of the legislature to modify the effect of the collateral source rule of evidence in medical malpractice cases. The legislature, in its continuing attempts to alleviate the medical malpractice insurance crisis, determined that 60-3403 was warranted and necessary in its attempt to maintain the desired legislative objective of continued quality health care in Kansas.
K.S.A. 1986 Supp. 60-3403 is one of several statutes enacted in 1985 and 1986 to deal with the so-called medical malpractice insurance crisis. See K.S.A. 1986 Supp. 60-3401 through 60-3414. The legislative purpose in enacting the statutes is set forth in K.S.A. 1986 Supp. 60-3405, which states:
“Substantial increases in costs of professional liability insurance for health care providers have created a crisis of availability and affordability. This situation poses a serious threat to the continued availability and quality of health care in Kansas. In the interest of the public health and welfare, new measures are *683required to assure that affordable professional liability insurance will be available to Kansas health care providers, to assure that injured parties receive adequate compensation for their injuries, and to maintain the quality of health care in Kansas.”
While 60-3405 through 60-3414 were enacted in 1986, it is clear from the legislative history of the 1985 statutes that the same concerns, considerations, and purposes were considered by the legislature in adopting 60-3401 through 60-3404 as are reflected in 60-3405. The claimed unavailability and excessive cost of medical malpractice insurance and its asserted detrimental effect upon the quality and availability of medical care in Kansas is not a recent development. As early as 1971, the problems of obtaining and maintaining affordable medical malpractice insurance came before the legislature and in 1975 and 1976 the first legislation addressing the problem was enacted. See State ex rel. Schneider v. Liggett, 223 Kan. 610, 611, 576 P.2d 221 (1978). The earlier legislation obviously has not been effective in controlling the costs of medical malpractice insurance as premiums have continued to skyrocket. The health care providers and their malpractice insurance companies have waged a continuous fight before each session of the legislature to secure additional legislation directed at their specific problems. The statute now before the court is one of those enacted to address those problems.
The theory behind the adoption of 60-3403, which modifies the common-law collateral source rule in medical malpractice cases, is that if the jury is advised that a malpractice plaintiff has already been paid his medical costs, lost wages, or other items of traditional tort damages those payments will probably not be duplicated by the jury in its verdict, resulting in lower verdicts in medical malpractice cases. The lowered verdicts will result in lower payments by medical malpractice insurance carriers who in turn will then lower the premiums which have become prohibitive in many cases. It is claimed that if the lower verdicts do not result in premium reductions, they will at least stop or slow down the ever-increasing premiums charged by the insurance carriers.
Even though I, along with some other members of this court, may have serious doubts that these statutes, and in particular 60-3403, will accomplish the results sought by the legislature, it *684is not for this court to determine the validity of the statute based upon our personal opinions of its propriety. In Moody v. Board of Shawnee County Comm’rs, 237 Kan. 67, 697 P. 2d 1310 (1985), the court stated:
“The propriety, wisdom, necessity and expediency of legislation are exclusively matters for legislative determination. Courts will not invalidate laws, otherwise constitutional, because the members of the court do not consider the statute to be in the public interest; what the views of the members of the court may be upon the subject [are] wholly immaterial. It is not the province nor the right of courts to determine the wisdom of legislation touching the public interest, as that is a legislative function with which courts cannot interfere.” 237 Kan. at 74.
Our function as a court is limited to interpretation and enforcement of the laws enacted by the legislature, and only if a statute is clearly unconstitutional may we strike down an act of the legislature. Our personal views ánd beliefs must not be allowed to control our consideration of legislative acts. Suffice it to say, the legislative history of 60-3403 included in the record before this court in Farley v. Engelken consists of some 422 pages. The appropriate legislative committees had voluminous evidence, oral and written, presenting the arguments and positions of the health care providers and their insurance carriers favoring the legislation and those of the various groups opposing the legislation. Regardless of the personal opinions of members of this court, the legislature had before it considerable evidence supporting the conclusion that 60-3403 may be an effective way of accomplishing the desired legislative objectives. The justices supporting the principal opinion have taken it upon themselves to determine the wisdom and propriety of the statute and to conclude the statute is “counterproductive,” contrary to the dictates of Moody and many earlier cases. In doing so, the decision ignores the record before the court.
Our decisions in State ex rel. Schneider v. Liggett, 223 Kan. 610, and Stephens v. Snyder Clinic Ass’n, 230 Kan. 115, 631 P.2d 222 (1981), make it clear the court has accepted the legitimacy of the state’s interest in assuring the continued availability of health care to the citizenry and the legislature’s determination that a medical malpractice insurance crisis exists. Beyond this recognition of a legitimate state interest in assuring adequate health care for the public, the court has also recognized that *685legislation limited in its application to medical malpractice actions is constitutional and shall be subject to the rational basis test. The court is in no position to now substitute its judgment for that of the legislature as to the propriety of the statute. That is not the function of an appellate court.
In Liggett, the court examined the constitutionality of the Kansas Health Care Provider Insurance Act in light of a physician’s complaint that combining high-risk physicians (surgeons, anesthesiologists, etc.) with low-risk practitioners (family doctors, general practitioners, etc.) violated his equal protection rights. Liggett also claimed an equal protection violation resulted from the failure of the statute to include other professionals, i.e., dentists, lawyers, and nurses. The court upheld the statute, stating:
“We are of the opinion that equal protection is not offended by including high risk and low risk practitioners together. The legislature found the medical health care crisis was affecting all health care providers in this state although the primary impact fell on specialists in high risk areas. Even new doctors practicing in low risk fields were beginning to find it difficult, if not impossible, to obtain coverage. In addition, evidence showed that low risk practitioners needed high risk specialists in order to provide comprehensive care for their patients. Were insurance coverage unavailable for the specialists in high risk fields, the evidence indicates these professionals would either leave the state or would soon quit the practice, causing a general decline in the overall quality of health care available in this state.
“The insurance commissioner testified before legislative committees that the insurance pool had to include low risk providers as well as high risk practitioners or the entire program would be actuarially unsound. We therefore find the purposes of the act and the classifications of physicians within the act were related as a means to accomplish those purposes.” 223 Kan. at 620.
In Stephens, the court was called upon to decide the constitutionality of K.S.A. 60-513(c) in the face of an equal protection challenge. The statute imposed a shorter period of limitations for actions in medical malpractice cases than other tort actions and was adopted as a result of the “medical malpractice insurance crisis.” The plaintiff maintained the statute created a classification which was arbitrary, discriminatory, and without a rational basis. The court applied the “reasonable basis” test and found the differentiation between “health care providers” and other tortfeasors acceptable. Justice (now Chief Justice) Prager, writing for the court, said:
*686“We have concluded from a study of the legislative history of the medical malpractice legislation enacted in the 1976 session that the amendments to K.S.A. 60-513 satisfy the requirements of the ‘reasonable basis’ test and that the classification distinguishing health care providers from other persons in respect to the statute of limitations bears a rational relation to the purpose of the health care legislation enacted in 1976. Stated in another way, we find there is a reasonable relation existing between the legislative objective of assuring continued quality health care in this state and the amendment of K.S.A. 60-513 to shorten the statute of limitations to four years for tort actions brought against health care providers. K.S.A. 60-513, as amended in 1976, does not violate equal protection guarantees.
“The 1976 amendment to K.S.A. 60-513 was the legislature’s attempt to assure continued quality health care for Kansans by combating the rapidly rising cost of medical malpractice insurance and the increasing reluctance of insurance underwriters to underwrite medical professionals. One of the principal causes of the increased costs and unavailability of medical malpractice insurance was attributed to the ‘long tail,’ or the length of time after the negligent conduct, allowed for the discovery of the injury and the filing of suit thereon. Medical malpractice insurance policies insure against liability arising from conduct while the policy is in effect. Because of the ‘long tail,’ or ten-year discovery period, under the prior statute, premiums were being calculated to include the possibility of claims on policies in effect up to ten years earlier. With the increased number of medical malpractice claims being filed, underwriting malpractice policies became unprofitable, with underwriters leaving the medical malpractice market. As a result, it was feared that doctors would be unable to procure insurance, or would be unwilling to pay exorbitant premiums, and would leave to practice outside of this state. Reduction of the discovery period was considered to be the obvious compromise to assure continued availability of malpractice insurance while protecting the injured parties’ causes of action. The public interest in solving the medical malpractice problem is discussed in depth in State ex rel. Schneider v. Liggett, 223 Kan. 610. That discussion shows clearly that there is a reasonable basis for dealing with malpractice actions against health care providers in a different manner than in cases involving other tortfeasors.” 230 Kan. at 130-31. (Emphasis added.)
It would seem obvious that if a statute, based upon the same classifications now before the court, which totally eliminates a person’s cause of action and remedy is constitutional, then 60-3403 is also constitutional.
It is interesting to note that the principal opinion attempts to distinguish Stephens upon the basis that, being a statute of limitations case, it did not limit the recovery and then relies upon Kenyon v. Hammer, 142 Ariz. 69, 84, 688 P.2d 961 (1984), a shortened statute of limitations case, for the proposition that 60-3403 is unconstitutional. The attempts to discredit the legis*687lative objectives of the statute, in view of our prior cases, are not persuasive, in my opinion.
It has long been recognized that the test of equal protection and due process of law under the Kansas Constitution is the same as that under the United States Constitution. Henry v. Bauder, 213 Kan. 751, 752-53, 518 P.2d 362 (1974); Tri-State Hotel Co. v. Londerholm, 195 Kan. 748, 759, 408 P.2d 877 (1965). The principal opinion, however, without any citation of authority, baldly states, “[T]he Kansas Constitution affords separate, adequate, and greater rights than the federal Constitution,” and then goes on to apply “a higher level of scrutiny” than the rational basis test. It appears to be the position of the principal opinion that some “higher standard of review” is required because medical malpractice claimants are comparable to the traditional “suspect” classifications of minorities, women, illegitimates, and aliens as recognized in various decisions of the United States Supreme Court. Thus, the opinion advocates that this “ ‘court must be sensitive to its institutional role as a counter-majoritarian monitor of legislative legitimacy,’ ” whatever that may mean. I must confess I do not know. The instant case does not involve a “suspect” classification of individuals nor does it involve such an impairment of rights that the equal protection afforded by Section 1 of the Kansas Bill of Rights is violated. What 60-3403 does do is nothing more than change a procedural rule of evidence. In Allman v. Holleman, 233 Kan. 781, 789, 667 P.2d 296 (1983), a case in which the court recognized the validity of the collateral source rule, Justice Herd, the author of the principal opinion herein, stated: “As the definition illustrates, the collateral source rule is merely a species of the relevancy doctrine.” That is, it is nothing more than a procedural rule of evidence, does not bar a person’s remedy by due course of law, and does not violate equal protection of the law.
A similar challenge to that presented in the case at bar appeared in Eastin v. Broomfield, 116 Ariz. 576, 570 P.2d 744 (1977), where the court had before it a statute similar to 60-3403. Art. II, § 31 of the Arizona Constitution prohibited enactment of laws “limiting the amount of damages to be recovered for causing the death or injury of any person,” and Art. XVIII, § 6 provided that “[t]he right of action to recover damages for inju*688ries shall never be abrogated, and the amount recovered shall not be subject to any statutory limitation.” Obviously, the Arizona constitutional provisions are far more restrictive than those of the Kansas Bill of Rights. The petitioners in Eastin claimed abrogation of the collateral source rule in medical malpractice actions violated these constitutional prohibitions. The Arizona Supreme Court, in a unanimous decision, rejected these arguments, stating:
“The purpose of this rule is to inform the factfinder of the true extent of the plaintiff s economic loss in order to avoid the inequity of windfall recoveries. The resulting judgments will no doubt reflect a setoff for the benefits the plaintiff has already received and these lower judgments would be reflected in lower malpractice insurance premiums, one of the objectives of the legislation. It should be noted that admission into evidence of plaintiffs’ collateral benefits in no way guarantees any reduction in the damages awarded by the trier of fact. The jury may still choose to ignore the collateral benefits in making its decision as to the damages sustained by the plaintiffs.” 116 Ariz. at 585.
It was also asserted that the statute violated the constitutional rights to equal protection and due process of law. The court found no merit to these contentions, stating:
“Abolition of the collateral source rule does not deprive the medical malpractice claimant of any property interest accorded protection by the due process clause of the United States Constitution. Nor is the application of the rule only to malpractice actions so arbitrary and unreasonable as to deny to medical malpractice claimants equal protection of the laws. The rule was intended by the legislature to give the jury the true extent of damages sustained by the plaintiff thereby. By scaling down the size of jury verdicts by the amount of collateral benefits the plaintiff may have received, the legislature could reasonably assume that a reduction in premiums would follow. This was one of the reasons for the Act. The legislature is entitled to proceed ‘one step at a time, addressing itself to the phase of the problem which seems most acute to the legislative mind.’ Williamson v. Lee Optical Co., 348 U.S. 483, 489, 75 S. Ct. 461, 465, 99 L. Ed. 563, 573 (1955).” 116 Ariz. at 585.
In Manzanares v. Bell, 214 Kan. 589, 599, 522 P.2d 1291 (1974), the court, in discussing a Section 18 challenge to the No-Fault Insurance Act, stated:
“The No-Fault Act before this court does not totally abolish the common-law right to damages for personal injury; nor does it abolish the right to recovery for actual economic loss. It does provide a limitation on the right to recover non-pecuniary losses for pain, suffering, mental anguish and inconvenience. The Act prospectively modifies the common-law tort liability concept, and in no manner retroactively affects accrued common-law rights of redress. There is a *689plethora of authority that ‘[N]o person has a vested interest in any rule of law, entitling him to insist that it shall remain unchanged for his benefit.’ [Citation omitted.] Accordingly, a ‘citizen may find that events occurring after passage of such a statute place him in a different position' legally from that which he would have occupied had they occurred before passage of the statute.’ ” 214 Kan. at 599.
The rationale in Manzanares is equally applicable to equal protection attacks upon legislative enactments. No class of individuals has a common-law or vested constitutional right in any particular rule of court procedure. K.S.A. 1986 Supp. 60-3403 merely alters a procedural rule of evidence as recognized by this court in Allman v. Holleman, 233 Kan. 781. The statute does not create a suspect class which is entitled to some vague heightened scrutiny test when considering whether it violates the equal protection guarantees of the Kansas Bill of Rights.
If it can be said that a procedural rule of evidence affects a constitutional right, which subjects the rule to heightened or strict scrutiny, then every rule of procedure and evidence must be subject to the same test. Obviously that cannot be the law. Even the concurring opinion of Justice Lockett correctly recognizes that heightened scrutiny is not the proper test.
As pointed out in the principal opinion, 60-3403 has been considered by at least four different federal district court judges in Kansas. They have split two and two in their attempts to determine the proper test to be applied to the statute and whether the statute is constitutional. After reviewing the Kansas federal district court cases which had considered 60-3403 and its predecessor, K.S.A. 60-471, Chief Judge O’Connor, in Ferguson v. Garmon, 643 F. Supp. 335 (D. Kan. 1986), recognized the obvious split of opinion among the judges of his court and stated:
“To this dissonance, we must add our voice. Unfortunately, our conclusion will not resolve the disharmony. With all due respect to Judges Theis and Saffels, we believe that, under the law, we must employ the rational basis test.
“Our conclusion is based in large part on the unanimity with which the courts of appeals have applied the rational basis test to uphold all sorts of statutes that treat medical malpractice plaintiffs differently than other tort plaintiffs. The Second, Fourth, Fifth, Eighth, Ninth, and, significantly, the Tenth Circuits have all agreed that the rational basis test applies to statutes that draw such a classification. See Gronne v. Abrams, 793 F.2d 74 (2d Cir. 1986) (applying the rational basis test to uphold a New York statute that requires pre-trial screening of medical malpractice claims); Montagino v. Canale, 792 F.2d 554 (5th Cir. 1986) (applying the rational basis test to uphold a Louisiana statute that sets a *690lower statute of limitations for medical malpractice claims); Hoffman v. United States, 767 F.2d 1431 (9th Cir. 1985) (applying the rational basis test to uphold a California statute that limits noneconomic losses in medical malpractice actions to $250,000.00); Brubaker v. Cavanaugh, 741 F.2d 318 (10th Cir. 1984) (applying the rational basis test to uphold a Kansas statute that sets a lower statute of limitations for medical malpractice claims); Jewson v. Mayo Clinic, 691 F.2d 405 (8th Cir. 1982) (applying the rational basis test to uphold a Minnesota statute that sets a lower statute of limitations for medical malpractice claims); DiAntonio v. Northampton-Accomack Memorial Hospital, 628 F.2d 287 (4th Cir. 1980) (applying the rational basis test to uphold a Virginia statute that provides for pre-trial screening of medical malpractice claims).
“We are, of course, particularly guided by the Tenth Circuit’s decision in Brubaker. As we just noted, the court there applied the rational basis test, without hesitation, to a Kansas statute that provides a shorter statute of limitations for actions against health care providers than against other tortfeasors. 741 F.2d 318. Surely, if a statute that shortens the time within which a plaintiff must sue to avoid losing his entire claim need only meet minimal scrutiny, a statute that merely allows evidence of collateral source payments to be considered by a jury faces no more exacting standard.
“Judge Theis, in Coburn, recognized that the courts of appeals have made their views clear. Nonetheless, he dismissed those cases as being ‘unhelpful’ and of ‘scant assistance’ because ‘they applied the mere rational basis test without any consideration of whether heightened scrutiny was required.’ 627 F. Supp. at 992. Although we perhaps agree with Judge Theis that the Supreme Court has, on recent occasions, applied the rational basis test more stringently than it has done so traditionally, (see, e.g., City of Cleburne v. Cleburne Living Center, 473 U.S. 432, 105 S. Ct. 3249, 87 L. Ed. 2d 313 (1985), the Court has expressly denied that it was blurring the tripartite level of review under equal protection law. [Citations omitted.] Moreover, we deem it significant that the courts of appeals have refused to discuss, much less recognize, the heightened form of rational basis test enunciated in Coburn.
“Finally, we note that in 1985 the Supreme Court summarily dismissed a relevant decision by the California Supreme Court in Fein v. Permanente Medical Group, 38 Cal. 3d 137, 695 P.2d 665, 211 Cal. Rptr. 368, appeal dismissed 474 U.S. 892, 106 S. Ct. 214, 88 L. Ed. 2d 215 (1985). In Fein, the state supreme court used the national basis test in determining that the California statute, which limits recovery of noneconomic damages and allows health care providers to introduce evidence of collateral source payments, is constitutional. The United States Supreme Court dismissed the appeal for want of a substantial federal question. 106 S. Ct. 214.
“Admittedly, the Supreme Court’s summary dismissal did not explicitly address which level of review is appropriate. Nonetheless, the Court’s decision was a ruling, on the merits, (see Hicks v. Miranda, 422 U.S. 332, 344, 95 S. Ct. 2281, 2289, 45 L. Ed. 2d 223 (1975)), that the plaintiff s equal protection argument did not pose a substantial federal question. The Court has warned that ‘inferior *691federal courts had best adhere to the view that if the Court has branded a question as unsubstantial, it remains so except when doctrinal developments indicate otherwise.’ Hicks, 422 U.S. at 344, 95 S.Ct. at 2289 (quoting Port Authority Bond Holders Protective Committee v. Port of New York Authority, 387 F.2d 259, 263 n.3 (1967)). Because there have been no doctrinal developments in the interim, and because we are unpersuaded by Judge Theis’ attempt to distinguish Fein, we conclude that medical malpractice classifications warrant minimal scrutiny and thus that the court need only assure itself that such classifications are rationally related to a legitimate state purpose.” 643 F. Supp. at 339-40.
I also note that, in the cases now oh appeal, and in the various cases from the Kansas federal district courts, none of the numerous judges who have considered the constitutionality of 60-3403 have applied the traditional strict scrutiny or heightened scrutiny tests. The principal opinion is incorrect in doing so now. Section 1 of the Kansas Bill of Rights does not require that 60-3403 be subjected to strict scrutiny or even to some new form of heightened scrutiny not recognized by any appellate court.
Turning briefly to the concurring opinion of Justice Lockett, I agree with him that the rational basis test is proper and that the principal opinion is incorrect in asserting the so-called “heightened scrutiny” test. I also agree that the legislature could abolish the collateral source rule, being merely a rule of evidence, in all tort cases and that 60-3403 might be difficult to apply. I do not agree that departure from our earlier decisions in which we have recognized the legitimate objective of the legislature is proper in this case. That bridge was crossed long ago and nothing has occurred to change our prior determinations.
It is my opinion that the rational basis test is the proper test to apply in determining whether 60-3403 is unconstitutional as a violation of both due process and equal protection of the laws under both the Kansas and federal Constitutions. I am also of the opinion that the statute bears a reasonable relation to the appropriate legislative objectives sought and therefore is not unconstitutional as a violation of the guarantees of either the Kansas Bill of Rights or the United States Constitution.
Miller and McFarland, JJ., join the foregoing dissenting opinion.