The following is an Op-Ed by CMA Past-President John M. Whitelaw, M.D. that appeared in the February 27 issue of the Sacramento Bee.

It is upsetting to watch physicians walk off their jobs to protest the cost of medical liability insurance in New Jersey, Nevada, Mississippi, West Virginia and Florida. But it would be far more upsetting if there were no doctors at all to provide surgery, trauma care, diagnose illnesses and deliver babies.

Some of these physicians are being charged up to $200,000 annually for their liability coverage, and like the proverbial canary in the coal mine, these physicians are trying to warn us about a coming national health care crisis.

California faced a similar calamity in the 1970s. Malpractice insurance was soaring, with some physicians expecting 400 percent premium increases. Worried that soaring costs would drive physicians from California and leave patients without care, then-Gov. Jerry Brown called a special legislative session to solve the medical liability crisis.

The solution then, and now, was the Medical Injury Compensation Reform Act. Before MICRA, California malpractice premiums were among the nation's highest. But post-MICRA, rates stabilized. Take a look at the impact on rates beginning in 1986, the year legal challenges to the law were finally exhausted.

From 1986 to 2000, premiums fell 12 percent in California, while rising 55 percent nationally (in inflation-adjusted dollars). During that same period, rates in Florida rose 809 percent; in Nevada 8,375 percent.

Mindful of the national problem, Democratic Sen. Dianne Feinstein has proposed a law modeled on California's 27-year experience of dealing fairly with injured patients and protecting access to health care. It takes courage for her to challenge the powerful trial-lawyer lobby, which holds significant sway with her party. She is doing so because MICRA is sound public policy.

Under our forward-thinking law, injured patients are entitled to unlimited medical and economic compensation, which often amount to millions of dollars to cover true damages, such as lost wages, medical expenses, rehabilitation, psychotherapy and long-term care costs. Physicians support such full compensation of injured patients.

And under MICRA, patients can also recover an additional quarter of a million dollars in noneconomic or "pain and suffering" awards. The law also limits contingency legal fees so that that seriously injured patients get more (and their attorneys correspondingly less) of the award.

Regardless, the law remains under siege from trial lawyers. But the number of medical malpractice suits has remained stable and awards have risen far faster than inflation since 1986, indicating injured patients retain their access to the courts and fair recovery. And in California, injured patients are compensated more quickly than in all states but Minnesota.

The real reason personal injury lawyers hate MICRA is that it limits the money they make from patient misfortune. Trial lawyers are not an endangered species. But physicians, emergency rooms and safety-net programs for the uninsured are truly threatened, and everyone's access to care is endangered without reform. Stabilizing insurance premiums is particularly essential for the poor, who get their health care from economically fragile medical clinics and health centers.

Here it is in dollars and cents: In California two years ago, an OB/GYN paid on average $47,500 for malpractice insurance. In Florida, she paid $173,000. Neurosurgeons paid $68,436 in Los Angeles County, but $278,829 in Dade County, Fla., and $163,000 in suburban Detroit and New York. In California, an orthopedic surgeon paid $22,730, but in Pennsylvania $90,297.

Why should patients care? It's difficult to put a value on having doctors there when you need them. But patients in Nevada drive hundreds of miles to find obstetricians who still deliver babies. And for accident and cardiac victims, it is a matter of life and death if there is no neurosurgeon or ER doctor at the local hospital.

California has health care problems, but this insurance crisis isn't one of them. That's why the rest of the nation needs to take California's lead and adopt medical malpractice reform.

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Dr. John M. Whitelaw, Jr., M.D. is past-president of the California Medical Assn., the professional organization for 35,000 California physicians.