Pa. Med-Mal Crisis Deepens

October 23, 2002

A new poll commissioned by the The Hospital & Healthsystem Association of Pennsylvania (HAP) and the Pennsylvania Medical Society has found that four out of 5 Pennsylvanians consider malpractice jury awards “out of control,” and that the lack of ability of medical liability insurance is affecting health care in the state.

The Poll’s conductors asked 805 adults about their impressions of the medical liability insurance crisis and its real and perceived impact on their health care. The poll’s findings: Nearly 7 of 10 Pennsylvanians believe that the current crisis is “very” or “somewhat” likely to affect their medical care. Also, nearly 4 of 5 Pennsylvanians say that jury awards in medical malpractice cases have gotten out of control. Nearly half of all Pennsylvanians have heard of doctors leaving the practice of medicine or leaving the state, or doctors’ offices or other health care facilities closing as a result of the medical liability insurance crisis.

More than one-third of those responding “yes” say that their doctor has left the practice of medicine or left the state, or their doctor’s office or health facility they use has closed as a result of the medical liability insurance crisis. In addition, four out of five Pennsylvanians “strongly” or “somewhat” support legislation to help control the rising costs of medical liability insurance that doctors and hospitals pay.

These polling data follow last week’s release of a survey by The Project on Medical Liability in Pennsylvania, funded by The Pew Charitable Trusts, that shows growing concern among individuals and small-business owners about the impact of rising malpractice insurance costs on their own health care costs—and on their access to health care services.

Meanwhile, the Greater Philadelphia Chamber of Commerce announced it will hold a panel discussion examine the impact of the state’s medical malpractice crisis and how it can be resolved at a “Rethinking Philadelphia” forum to be held Wednesday, October 30, 8 a.m., in the Grand Ballroom of the Park Hyatt at the Bellevue.

A distinguished panel will discuss the issue in-depth and offer their opinions and suggestions. The Honorable Leon Katz, a retired judge from the Court of Common Pleas of Philadelphia County, who is now a mediator and arbitrator with the Pennsylvania Bar Association, lends his expertise; as well as Timothy L. Knapp, vice president & counsel of The Insurance Federation of Pennsylvania, Inc.; and Richard D. Lackman, M.D., F.A.C.S., professor and chairman of Orthopaedic Surgery of the Hospital of the University of Pennsylvania. The fourth panelist, Erin Zezzo, represents those significantly affected by the medical malpractice crisis: average Pennsylvania citizens.

“Over the past two years, the Chamber has been working with our elected officials in Harrisburg to get meaningful medical malpractice reforms passed,” said Joe Mahoney, Senior Vice President, Greater Philadelphia Chamber of Commerce. “There has been significant progress this year, but there is still much that can be done. This ‘Rethinking Philadelphia’ forum allows us to increase public awareness of this issue. It is crucial that the exodus of doctors subsides for the economic and physical health of our region.”

In related developments, attendees of the annual House of Delegates meeting of the Pennsylvania Medical Society in Hershey, Pa. urged elected officials to take control of the medical liability crisis.

“Escalating insurance rates, including the surcharge from the state-run MCARE Fund, combined with state law requiring doctors to carry insurance could snap the thin thread from which health care is hanging,” said Edward H. Dench Jr., MD, newly-installed president of the Medical Society. “Changes are desperately needed to preserve the patient-doctor relationship and ensure health care availability for the 12 million Pennsylvanians and the millions more who visit our state every year.”

The delegates laid out seven areas they believe should be addressed by the governor and state legislature. First, elected officials should lower the total required insurance level for physicians and prohibit other entities like health insurance companies and health care systems from requiring additional coverage above the state limit. This would immediately lower premium levels.

Second, the MCARE Fund should either be declared insolvent or be provided immediate financial aid. Third, officials should suspend the requirement for MCARE Fund payments to maintain licensure until there is adequate medical liability insurance reform and tort reform.

Fourth, lawmakers should invoke the emergency provision for an amendment to the state constitution involving the prohibition against ceilings on jury awards, specifically for non-economic damages; in addition, attorney contingency fees should be capped so that injured parties receive more of their awards.

Fifth, the Joint Underwriting Association should be required to immediately reduce premium levels to those comparable to the private insurance market, until such time that additional private insurance carriers return to Pennsylvania and the JUA is again an insurer of last resort.

Sixth, officials should quickly develop a long-term solution involving fundamental system changes in the out-of-control judicial system, including the Society’s proposal to eliminate the common law cause of action and replace it with a statutory system that would include a patient compensation fund.

Finally, lawmakers should pass legislation to void provisions in health insurer contracts with physicians to allow a temporary emergency surcharge on bills to cover the costs of liability insurance.

Delegates also committed to work towards reinstatement of the court rule involving early expert report as a means to dismissing non-meritorious cases. In addition, if the state fails to bring liability insurance costs to an affordable level, members of the House of Delegates discussed the possibility that doctors across the state may need to change their medical licenses status to “inactive” to avoid breaking the law if they are unable to pay the high premium rates.

“Without sufficiently effective actions to address the urgency of the crisis by the end of the year, many physicians may be forced to give up their Pennsylvania licenses to avoid breaking the law if they can’t find funding for the increased cost of liability insurance,” Dr. Dench said.

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