Tribune: Malpractice insurance crisis could limit care

  1. Protest highlights growing problem
    By Jon Van, Tribune staff reporter. Tribune staff reporter Tim Jones contributed to this report

    January 3, 2003

    Patients face losing access to medical care as a malpractice insurance crisis spreads across the nation, the president-elect of the American Medical Association warned Thursday.

    The crisis was underscored this week, when almost all surgeries at four West Virginia hospitals were canceled as a protest against high rates. While Dr. Donald Palmisano said he doubts that similar actions will become widespread across the country, the AMA chief said soaring insurance costs are reducing physician availability to patients.

    "There's a crisis in 12 states now and the situation is serious in 30 others," said Palmisano, who is a lawyer as well as a physician. "The cost of medical malpractice insurance has become so burdensome that some physicians are moving to other states where they can afford to practice.

    "Physicians are retiring early because they can't afford the insurance. Patients will find it increasingly difficult to find a physician to treat them."

    Meanwhile, in West Virginia, state officials scrambled Thursday to adjust to the work stoppage by more than two dozen surgeons in the state's northern panhandle.

    Four hospitals in the Wheeling area cut staff hours and transferred more patients Thursday in response to the doctors' protest. State officials in Charleston also announced emergency measures to ensure medical service in the region.

    Tom Susman, the state's director of insurance, met with a group of doctors to discuss their grievances with the malpractice system, but no settlement was announced.

    The doctors want the state legislature to make it more difficult for people to file malpractice claims. They also want the state to pay a larger share of the doctors' insurance costs.

    "We have had many meetings with state legislators and past governors. We have asked for help in the past. It seems as if it has fallen on deaf ears," Dr. Greg Saracco said on CBS' "Early Show." "Physicians no longer want to come to work. Physicians are afraid to accept liability."

    While Illinois is categorized by the AMA as one of the 30 states "in trouble" rather than in crisis, the general counsel at Rush-Presbyterian-St. Luke's Medical Center in Chicago said there is a full-fledged crisis for academic medical centers.

    Because Illinois law holds hospitals liable for actions taken by physicians affiliated with them, hospitals--and especially academic medical centers--have borne the brunt of a rise in malpractice awards from juries in the past few years, the center's Max Brown said.

    Last year Rush was self-insured for the first $4 million in liabilities, but this year, it must cover the first $15 million itself, with insurance companies stepping in only to cover awards that exceed $15 million.

    "The London insurers have told us that no one is going to insure anything under $15 million, and that will probably go to $20 million next year," Brown said. "Academic medical centers must set aside reserve funds to cover this liability, and that money has to come from other programs--from education and research."

    The agency that provides physicians with malpractice insurance in Illinois, ISMIE Mutual Insurance Co., has put a freeze on accepting new doctors for coverage. Rising malpractice awards could threaten ISMIE's reserves if it accepts more physicians, said the organization, which is an affiliate of the Illinois State Medical Society.

    The AMA's Palmisano said that 25 years ago California was in a malpractice crisis that caused the state to limit awards for non-economic damages. The AMA is backing similar legislation in Congress that passed the House last year but stalled in the Senate.

    This year with Sen. Bill Frist (R-Tenn.), a physician, leading the Senate majority, Palmisano said he is optimistic that malpractice legislation may pass.

    However, the Association of Trial Lawyers of America is seeking to focus attention on insurance companies.

    "The insurance industry has too much control over America's health-care system," said Mary Alexander, president of the trial lawyers group. "Insurers place profits over people and threaten the livelihood of America's doctors.

    "It's unfair to ask patients to give up their legal rights so the insurance industry can make higher profits."

    Copyright 2003, Chicago Tribune
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