RENO - Doctors and lawyers in Nevada are trading insults and accusations in a showdown over medical malpractice initiatives that has voters wondering who to believe.
Both sides have accused the other of deception in their claims for or against Questions 3, 4 and 5 on the Nov. 2 ballot - portraying themselves as the protector of public trust and their opponents as the face of greed.
The issue of limiting malpractice awards also will appear on ballots in three other states - Florida, Oregon and Wyoming.
With the stakes high, will voters be able to sift through the rhetoric and understand the ramifications of what they're voting for?
"No," said Eric Herzik, a political science professor and interim dean of the College of Liberal Arts at the University of Nevada, Reno.
"I think the lawyers are not only hoping that's the case, they are aiding and abetting the confusion," Herzik said, though he added "neither side goes blameless" in their attempts to deceive.
Gail Tuzzolo, spokeswoman for People for a Better Nevada - a group tied to the Nevada Trial Lawyers Association and sponsor of Questions 4 and 5 - agreed sniping has caused confusion, but blamed doctors and insurance carriers.
"I'm so frustrated because the opposition just lies," Tuzzolo said.
Larry Matheis, executive director of the Nevada State Medical Association, which supports Question 3, responded, "With the facts, I believe the public will come along."
Question 3, known as the Keep Our Doctors in Nevada Initiative and backed by physicians, businesses and insurance carriers, would cap pain and suffering awards in medical malpractice cases at $350,000 and limit fees that attorneys can get for representing patients.
Doctors argue that the high cost of medical malpractice insurance is driving physicians from the state and that rates will be lower, and more doctors will stay, if Question 3 passes.
The Legislature last year rejected the petition, but approved a law with the $350,000 limit on non-economic damages, with several exceptions. Because the petition was not approved in its entirety, it will appear on the November ballot.
"Reforms that were adopted weren't clear enough and had exceptions, so they were ineffective," Matheis said.
Question 3, he said, "adopts language that has worked in other states" to rein in skyrocketing insurance costs.
The two trial lawyer measures are called the Insurance Rate Reform and Reduction Act and the Stop Frivolous Lawsuits and Protect Your Legal Rights Act.
Questions 4 and 5 are proposed constitutional amendments that, if passed by voters in 2004 and again in 2006, would negate the provisions of Question 3 if it passes in November - or any laws that may exist when the two measures take effect.
Question 4 would roll back insurance rates - something opponents claim has already been ruled unconstitutional - and prohibit limits on attorneys fees.
Question 5 is described by proponents as the answer to end frivolous lawsuits that drive up insurance premiums. It also would void any laws passed in the meantime limiting damage awards.
But opponents counter it's a crafted farce that would amount to a blank check for attorneys by preventing judges from reducing excessive jury awards or attorneys' fees and prohibit legislators from imposing such limits.
"It's an antidemocratic way to try to cut off debate. ... and do it in the only way you can get away with it - being less than candid," Matheis said.
Dr. Michael Fischer, a Carson City eye surgeon and president of the Nevada State Medical Association, called Questions 4 and 5 a "sneaky way for trial attorneys to make sure they line their pockets."
The lawyer's group counters it's doctors who are trying to scam the public by falsely claiming physicians are leaving the state.
Opponents of Question 4 also say an increase in insurance rates is more likely than the promised rate rollback. They note a consultant's report says the question gives insurers relief from the rollback if they can show they'd be deprived of a fair rate of return.
Critics of Question 5 note a recent opinion from the Legislative Counsel Bureau says that proposal wouldn't provide "in any substantive way" more protections or penalties against frivolous lawsuits.
Secretary of State Dean Heller recently entered the fray, accusing the Nevada Supreme Court of bias after Tuzzolo's group successfully petitioned the high court to order Heller to reword Question 3.
The lawyers argued language explaining why the measure was necessary was misleading because it stated physicians were leaving Nevada "at an alarming rate," when figures provided by the state Board of Medical Examiners suggested otherwise.
Matheis said the number of doctors coming into the state are not keeping pace with Nevada's booming population or compensating for those who have left.
A statewide poll commissioned by the Las Vegas Review-Journal in September showed voters favoring all three measures, though support for Question 3 was slipping.
Brad Coker, managing director of Mason-Dixon Polling & Research, Inc., the Washington, D.C.-based firm that conducted the poll, said voter confusion could lead to the question's defeat as well as success for Questions 4 and 5.
On the Net: Nevada Secretary of State: http://www.easyvoter.org/nevada/2004-general/3.html