Busloads of physicians seek to revive medmal-reform bill

[Rose Siding]

Frustrated by the failure of a years-long lobbying effort to pressure Congress to enact caps on medical-malpractice lawsuit awards, more than 3,000 doctors are expected to descend on to Capitol Hill tomorrow in a show of force the organizers hope could win over the public — and possibly a few crucial votes in the Senate.

Traveling in about 60 buses from Northeastern and Middle Atlantic states, participants in the Coalition for Accessible Physicians event will gather on the West Lawn of the Capitol for a rally. Some will follow the event with visits to member offices and a trip to the White House to meet with advisers to President Bush.
....
“There is a large voice of grassroots doctors … who feel, perhaps, less than served by … organized medicine,” Schulze said last week. Schulze is secretary of the Medical Society of New Jersey.

The American Medical Association (AMA) and a plethora of medical specialty societies have pushed hard for caps on lawsuit awards, claiming that escalating malpractice insurance premiums are forcing doctors out of business.

http://www.hillnews.com/thehill/export/TheHill/News/Frontpage/041905/doctors.html

February 22, 2005
snip>
But for all the worry over higher medical expenses, legal costs do not seem to be at the root of the recent increase in malpractice insurance premiums. Government and industry data show only a modest rise in malpractice claims over the last decade. And last year, the trend in payments for malpractice claims against doctors and other medical professionals turned sharply downward, falling 8.9 percent, to a nationwide total of $4.6 billion, according to data compiled by the Health and Human Services Department.

http://www.nytimes.com/2005/02/22/business/22insure.html?ex=1114056000&en=a34e7aed46a88432&ei=5070

[Bridget Burke]

1. Texas got caps on malpractice awards....

Malpractice insurance keeps going up & medical care is harder to get than ever.

How nice that these MD's have so much free time....

[Tempest]

2. Same thing in California

Doctor's insurance rates have gone up something like 24% since caps were placed in CA.

[NNguyenMD]

17. actually Prop 13 passed in 1988 put the brakes on CA malpractice rate

hikes since MICRA in 1979. I'm not defending caps, but just want to clarify that liability rates in California is very controllable and reasonably priced since the State Insurance Regulator has been given more control over rate hikes due to Prop 13.

The AMA likes to argue that MICRA was responsible for this, but consumer rights groups like Public Citizen and I believe that the credit should be given to tighter industry regulation.

[Tempest]

18. Malpractice premiums up 190% in California since MICRA

Malpractice premiums in California increased by 190% during the first 12-years following enactment of the $250,000 MICRA cap. Proposition 103 Enforcement Project Study, 1995. It took California’s Proposition 103 – insurance reform – to lower and stabilize malpractice premium rates.

http://caoc.com/Micra.htm


Yeah, MICRA really put the brakes on premiums. :sarcasm:

[NNguyenMD]

19. I stand corrected it was 103 not 13, and they are lower now in CA since

its passing. Insurance rates have been very stable by comparison with most other states, namely Texas and NY.

And you misread my post, I said it was the tighter regulation on the insurance industry that put the brakes on malpractice rates, not MICRA.

from my previous post

"The AMA likes to argue that MICRA was responsible for this, but consumer rights groups like Public Citizen and I believe that the credit should be given to tighter industry regulation. "

You CA DUers should know that MICRA legislation in CA is the model that the AMA is feeding the Federal government for a national policy. Its important for you to tell others that it was regulation not capping that slowed the rise in insurance rates. PROP 103, remember it!

[Tempest]

20. Wrong again, Bucko. Rates are still increasing.

In 2002, overall rate increases filed with the California Department of Insurance ranged from 2 to 8 percent, although some areas, such as San Bernardino and Riverside counties, saw increases averaging 18 percent.
http://www.sbcms.org/southcalphysician/2002/may/art1.htm

Although rates are not rising as fast, they are still rising. You claimed rates are lower. They clearly are not.



I didn't misread your post.

In your subject line you claimed MICRA "put the brakes" on malpractice rates. You were clearly wrong.

[NNguyenMD]

21. I didn't say they were lower I said that they

were stable. When the economy sucks (like it does now), the revenue on the interests that MedMal companies make in bonds goes down significantly and according to the GAO every dollar they lose in bonds they must make up by 4 dollars in premiums. Rates go up, rates go down, they were low in the booming nineties, now they're up in the crappy 00's.

If you want another reason why rates might be up, the majority of physicians in CA get their coverage from physician run medmal groups instead of relying on insurance company policy holders. These groups have a larger market share collectively but have lesser capital to cover losses in settlements on a group by group basis. So thus financially speaking they don't absorb losses a well as a major insurance company would, and have to make it up with increasing rates. You could argue that thats another reason why rates are up as well.

And I admit, the subject line on that post was poorly written, but don't just ignore what the rest of the post says, I made it clear that REGULATION was what controlled rates, not capping.

Unbelievable...

[NNguyenMD]

23. Go to Appendix III

http://www.gao.gov/new.items/d03702.pdf

there's a state by state comparison on the increasing premium rates.

[nothingshocksmeanymore]

35. No..they were only reduced by 8% and have steadily risen

and their increases can be DIRECTLY tied to insurance company losses in the stock market.

Prop 103 is proof that the ONLY thing that reliably reduces insurance rates is INSURANCE reform..(btw..pretty clear that was the point you were making as well.

[NNguyenMD]

37. thank you

its a complicated issue with MANY interested parties. Unfortunately the ones who's voices are heard the least are that of patients.

Its a very sad day when doctors in this country ally themselves with big business before recognizing the devasting effect capping will have on consumer protections.

[Liberty Belle]

6. In CA, after this passed, I couldn't find a lawyer to take on

a clearcut case of med malpractice, because there wasn't enough money in it anymore for the attorney. If you're not a vegetable, forget about finding someone to take your case.

[barb162]

27. exactly, your civil liberties are fucked; these kinds of laws

are beyond outrageous

[Horse with no Name]

28. In Texas also

clear cut malpractice killed a 49-year old acquaintance of mine.
Every attorney her family went to said the same thing...right before they said her life wasn't worth enough money to sue.:(

[barb162]

30. and the physicians get off scot free; it is absolutely insane what is

happening with the civil justice system in this country

[Horse with no Name]

32. I just finished a case

I was appalled that Terri Schiavo's family was contemplating legal action against the hospice for her care. In her 15 years of lying in a vegetative state, she never had a bedsore. Not one. That is an amazing feat if you are aware of the incidence of pressure ulcers in these types of settings.
The case that I just finished was a woman who went from home to a nursing home. She was there for 3 months and received a pressure ulcer to the back of her leg that led to the amputation of her leg which led to septicemia which led to her death. This nursing home falsified records which we were able to prove, they lied to the state investigators, which we were able to prove, yet since the woman was in a nursing home, she had no assets, therefore, was not worthy of a settlement. There was an attorney who took the case though.
It was in Texas. Her family received nothing except a body to bury.
This is where it's headed folks if we don't stop this. The physician's do NOT regulate themselves. They will not hold their colleagues feet to the fire even when they know that they are incompetent, and now, it is looking more and more as if they will have no reason to.

[barb162]

33. what a horror story. You are so right, it has to be stopped

The MDs protect each other, there is no way to "out" the bad apples, etc. The state licensing boards almost never take action because most people don't even know of their existence and they often don't review complaints thoroughly anyway. Civil rights are being eroded.

License to kill, pay off a few bucks, adios.

[AlCzervik]

15. well tomorrow is Wednesday, thats usually golf day for Drs.

so maybe they'll only only shoot 9 holes instaed of 18. Caps were a boondogle for insurance companies, they should be bitching at them.

[barb162]

26. there should be NO caps

business to business lawsuits sure have no caps

[tsuki]

38. According to what I have been told in Florida, the problem is not

with caps. The problem is that the insurance company can settle without ever talking with the doctor. Every settlement is a black mark against you, whether you were right or wrong. Every settlement causes your medical malpractice to escalate. So the insurance companies settle, knowing they can back-charge the physician.

[nothingshocksmeanymore]

3. They should call it the Coalition for Repressive Accessible Physicians

CRAP

[Straight Shooter]

4. One more way of demolishing a wall of protection for consumers/patients

Physicians, clean up your own back yard first. You know who the incompetents are within your clique. Get rid of them, and then come crying because of malpractice rates.

Also, stop taking kickbacks in various forms of perks, too, from Big Pharma.

[underpants]

7. LINK-to the definitive organization on this false crisis

http://www.centerjd.org/air/

[DulceDecorum]

13. Good post.

[barb162]

31. it certainly is a false crisis.

The MDs were marching around here and they kept talking about their high rates, like oh poor me, I paid 30,000 this year. They don't mention they made 300,000 this year and maybe committed malpractice a few times this year. I saw a good discussion with a great plaintiff attorney and the AMA guy and other MDs couldn't support one damn thing they said. They kept talking about frivilous lawsuits but had no data to back it up. But the newspapers were only reporting what the physicians said. Thank god they still lost in the legislature. Why should MDs be protected from the wrongs they do

[underpants]

5. 4/20/05 Deaths due to Dr. mistakes fall drastically in two regions

So those people are safe for a while.

[bushisanidiot]

8. Idiot freeptards buy this crap. It's the INSURANCE companies that are

gouging doctors and ALL of us. They are the ones running away with all the cash.. they are using malpractice cases as an EXCUSE TO RAISE RATES!! insurance companies are making as much money these days a big oil and the pharmaceutical companies that AWOL Bush caters to.

[underpants]

9. It lowers their potential liability

the legislation and those who support it deliberately don't say that it will lower malpractice insurance rates they just set it up so you can easily make that assumption.

W usually says something like-"Medical malpractice insurance is too expensive.....we need tort reform" No actual if/then or cause and effect statement there, only in one's mind does it connect. But hey they've been using that tactic for a while now.

[BurgherHoldtheLies]

10. Where were these busloads of docs during the Shiavo case????

When Frist was making his ridiculous long-distance diagnosis via videotape, the AMA was SILENT. They should have been the voice of reason/science and issues a strong statement denouncing any physician making a neurological diagnosis without physical examination (including the religious wing-nut doc from Mayo who didn't actually conduct a physical exam but "observed" the patient then signed an affidavit):spank:

[PA Democrat]

11. In PA, there was a 33% decline in 2003 in number of medical malpractice

lawsuits filed, the payouts on med mal lawsuits were down, and medical malpractice insurance rates continue to climb. But doctors are still being told their rates will go down if caps are passed. Yeah, right. :eyes:

http://www.pacitizensforfairness.com/lawsuits.html

[DulceDecorum]

12. Blame the Insurance Industry

Published Sunday, April 17, 2005
In Kansas City, Kan., another doctor, Joel N. Schroeder, is considering filing for bankruptcy. He is unable to pay a $750,000 malpractice claim that a state judge levied against him on behalf of survivors of an elderly stroke victim. Before the case went to trial, Dr. Schroeder, who contested the accusation, learned that his malpractice insurer, the same as Dr. Slemp's, had imploded.
Both men had coverage from a company called Reciprocal of America. Their lives, and those of thousands of other doctors and lawyers in the South and the Midwest, have been in flux since Reciprocal cratered about two years ago amid a tangled web of business transactions that regulators describe as fraudulent.
<snip>
IN a startling turn of events, the Reciprocal investigation produced information that led to the ouster of Maurice R. Greenberg, the iron-fisted chairman and chief executive of American International Group, the insurance giant.
Berkshire Hathaway, the holding company of Warren E. Buffett, acquired General Re in 1998. This January, as Berkshire lawyers scoured General Re's accounts to respond to Justice Department queries about Reciprocal, they disclosed a questionable insurance transaction that A.I.G. used to improperly spruce up its books.
<snip>
Virginia regulators say they have uncovered improper transactions between General Re and Reciprocal dating back to 1990. But the most significant deals, they said, began in early 2000, after General Re determined that Reciprocal had underpriced its malpractice coverage and was going to be slammed with heavy losses.
<snip>
In the fall of 2001, Reciprocal was confronting nine-month losses totaling $90 million. So the company made its computer programmers work overtime, regulators say. On Nov. 7, 2001, they say, the programmers spent an entire night reducing scores of anticipated claims by about $19 million and then backdated the doctored accounts.
http://www.theledger.com/apps/pbcs.dll/article?AID=/20050417/ZNYT01/504170424/1001/BUSINESS

Osama bought them a few more years of peace and quiet
which is why you do NOT hear these insurance companies complaining bitterly about September 11.

When the US Virgin Islands were hit by Hurricane Hugo, the roofs of the hospitals there were blown off. The feds have regulations and will not give money to a hospital with no roof, electricity or running water. It must first come up to code before it can receive federal money.
No insurance company will allow their clients to practice medicine in such a place where they could easily get sued.
This means that the only medical insurance now available in the US VI is an air ambulance evacuation service to take you off Gilligan's Island.

To make matters worse, Lloyd's of London decided to dump the US VI and so there is now no such thing as insurance there.
US VI law says that one must insure a vehicle before driving it, but there is no insurance company willing to do even that. So everyone there is uninsured.
There are hardly any lawyers there either. Civil law is but a memory.
Who has the money to sue anyone? And which defendant has the funds to pay after losing?

The entire medical industry in the US is dependent on the insurance companies and they have pretty much collapsed. The publicly-traded HMOs are teetering on the brink and MDs are now having a very hard time just making ends meet.

The whole insurance industry is basically one big protection racket. It is closely tied in to US security, national and otherwise. Which is why firms like Kroll International wind up joining forces with firms such as Marsh & McLennan Companies Inc.
http://www.krollworldwide.com/about/governance/jkroll/
http://www.marshriskconsulting.com/st/PDEv_C_228114_NR_306_PI_451178.htm

The drug industry is heading for collapse as well.
Look at the US senior citizens making bus trips into Canada to buy their medication, because they find it easier and cheaper to do so than to purchase them from the corner drugstore.
Big Pharma is the insurance industry's kid brother,
and both of them are going to flat-line soon.

The only ones who stand to make a dime out of this, are the lawyers.
And it will be their last dime.

[blm]

14. Was this part of DeLay's groups of "Physicians of the Year" maybe?

I wonder how the timing figures out, considering that DeLay pursued so many doctors to come to DC for a 1200 donation and a promise of GOP style legislation?

[NNguyenMD]

16. Here's a letter I wrote to my local Assemblyman and State Senator

Senator David Valesky Represents Oneida and Onondaga county in Upstate NY. This was also sent to Assemblymen Joan Christensen and Bill Magnerelli. I sent this letter after having attended "Lobbying day" with the Medical Society of New York. And organization that I have withdrawn my membership from.

Dear Senator Valesky:

On the afternoon of Tuesday March 14, 2005 I had the honor of meeting one of your aides, as a member of the Onondaga County Medical Society and the Medical Society of the State of New York. The context of that meeting involved a number of vital issues, but emphasized one that I feel was greatly misrepresented by this society of which I am a paying member. That issue was of course Medical Liability Reform, and if you remember became the focus of your discussion with the representatives of that lobbying group.
I strongly feel that this interest group grossly misrepresented this issue that has already been thoroughly investigated by the United States General Accounting Office in two major reports released in 2003 addressing the issue of “defensive medicine”, and what the GAO believes to be the real causes of the upsurge in medical malpractice premiums on physicians. I have enclosed both copies of the GAO reports and refer you to page one of GAO-03-836 Medical Malpractice: Implications of Rising Premiums on Access to Health Care, in its investigation of five “crisis states” listed by the American Medical Association the reports plainly says in the first paragraph,
In the five states with reported problems however, GAO also determined that many of the reported provider actions were not substantiated or did not affect access to health care on a widespread basis. For example, although some physicians reported reducing certain services they consider to be high risk in terms of potential litigation, such as spinal surgeries and mammograms, GAO did not find access to these services widely affected, based on a review of Medicare data and contacts with providers that have reportedly been affected.
Also mentioned in this GAO report was the lack of validity to surveys and studies released by the AMA and insurance lobby. I refer you to paragraph two of page one where it says
Physicans reportedly practice defensive medicine in certain clinical situations, thereby contributing to health care costs; however, the overall prevalence and costs of such practices have not been reliably measured. Studies designed to measure physicans’ defensive medicine practices examined physician behavior in specific clinical situation, such as treating elderly Medicare patients with certain heart conditions. Given their limited scope, the study results cannot be generalized to estimate the extent and cost of defensive medicine practices across the health care system.
With regard to the issue of capping the amount of punitive damages patients can pursue in malpractice claims against physicians, the same GAO report did acknowledge that growth of premium rates slowed in states that had already placed caps on punitive damages; however given the vast differences in tort laws from state to state, the GAO concludes on page one paragraph three states that the, “GAO could not determine the extent to which differences in premiums and claims payments across states were caused by tort reform laws or other factors that influences such differences.”
Additionally, the Weiss Rating, an insurance industry rating-firm/watchdog determined in their June 2, 2003 study titled Medical Malpractice Caps: The Impact of Non-Economic Damage Caps on Physician Premiums, Claims Payout Levels, and Availability of Coverage, they conclude that caps have had no significant impact on the lowering of medical malpractice premiums. The AMA vehemently refuted this study; however their rebuttals can be easily debunked if one would simply read the Weiss report. For example:
AMA Rebuttal: The Weiss report bases its conclusions on median malpractice premiums aggregated across specialties and jurisdictions, which obscures the differences between high-risk and low risk medical specialties and legal venues.
Weiss: Actually if you look to page 7 of the Weiss report it states that “Using 1991 to 2002 data published by the Medical Liability Monitor, we examined the median med mal premiums paid by doctors in three high risk specialties- internal medicine, general surgery, and OB/GYN.” The truth is the Weiss report studied the medians in the specialties with the sharpest rise in med mal premiums, versus merely lumping the medians across all specialties as falsely implicated by the AMA. Here’s another example
AMA Rebuttal: The study falsely claims that insurance carriers are raising premiums to compensate for stock market losses. Medical liability insurers typically have less than 10 percent of their investments in the stock market and more than 80 percent of investments in the bond market. Virtually no medical liability insurance company has experienced net investment losses since 1997.
Weiss and GAO: This is actually a distortion by the AMA of how dependent premiums are on the health of the economy. I refer you to page 26 of GAO-03-702 where the authors of the reports formulated that for every dollar lost in interest on bond investments by the insurance carriers, premiums would have to be increased by four dollars to make up that loss in investment revenue. So although it is true that the insurance industry is heavily invested in bonds versus stocks, and does not lose on its investment, its revenue is highly dependent on the health of the economy and a weak economy will result in a lower bond return and significantly higher premiums.
In reviewing the issue of the causes of medical malpractice premium increases both the GAO and the National Association of Insurance Commissioners agree that more data is needed before any executive action should be taken. I refer you to page one of GAO-03-702 Medical malpractice Insurance: Multiple Factors Have Contributed to Increased Premium Rates left column second paragraph down,
GAO is not recommending executive action. However, to further the understanding of conditions in current and future medical malpractice markets, Congress may wish to consider encouraging the National Association of Insurance Commissioners and state insurance regulators to identify and collect additional, mutually beneficial data necessary for evaluating the medical malpractice insurance market.
Senator Valesky I implore you to reconsider the unsubstantiated scare tactics made by both MSSNY and the Insurance lobby, and direct your staff to look further into the issue before you decide what position is best for the patients of Onondaga County. By definition, punitive damages are intended to be deterrents for physician negligence, and are one of the few protections ordinary citizens have in a healthcare industry already in disarray. As a fellow Democrat, we should both recognize the great value of consumer protections, limiting the amount of punitive damages to the paltry sum of $250,000 even in cases of catastrophic events or death would be a tragic blow to consumer rights and the very constituents whom you represent. I write this letter fully aware that I am speaking against the presumed financial interest of my profession; however I feel that this is an important issue that should not be dictated by the overpowering seduction of dollars and cents, but on the very lives that will be most affected. I cannot in good conscience support my medical society, and thus seek your leadership in serving the greater interests of the people of New York.

[barb162]

22. NO caps should be imposed!!!! If someone in their family

gets killed by a drunk driver, they wouldn't want a cap on their lawsuit against the drunk driver. This is simply more anti-consumer legislation, primal scream with this crap already

[NNguyenMD]

24. Louisiana has a cap on BOTH economical and noneconomical

damages limited to $500,000. And I think thats the most any plantiff can get even if there are multiple culprits involved.

But they also have a medical review panel in the likeness of what John Edwards described in the Vice Presidential debates. Its a panel made of doctors and lawyers who determine beforehand whether a medmal case gets to go to trial.

[barb162]

25. if Person X dies from a negligent driver or physician, should the

damages be different? I say no; there is something extremely unjust about that.

[4dsc]

29. Doctors salaries are reason for high medical cost

Malpractice caps is a diversion away from the primary reason health care costs are going up!!

The primary reason for higher health care costs are doctors salaries and the fact that the US has added about 2 million physician is recent years(if my memory serves me correctly).

Medical malpractice only accounts for about 1% of all health care costs!!

[saigon68]

34. A GREEDY UPPER CLASS THAT NEEDS TO BE SUED

FOR THEIR NEGLIGENCE IN HURTING AND KILLING PEOPLE.

[nothingshocksmeanymore]

36. Not accurate. Doctors salaries are actually going down and there

is less FEE FOR SERVICE medicine in America than ever before. The primary reason for increased health care costs is multifactorial but a few examples of WHY healthcare has increased are as follows:

Insurance rates have gone up across the board concommitantly with the insurance industry's losses in the market

CEO's of insurance companies are over compensated

Approximately 70% of insurance premiums are eated up by ADMINISTRATIVE costs (i.e. profits to the insurance industy)

Law passed to LIMIT physician self referrals to physician owned laboratories actually served to CONCENTRATE those laboratories into the hands of large corporations who have essentially price fixed and billed whatever they wanted since they get THEIR lackeys appointed to state regulatory agencies.

The cost of prescription medication has skyrocketed concommitantly with drug companies being allowed to advertise.