New BCBS Survey Points to Impact of Med-Mal Crisis

January 16, 2003

The nation’s medical malpractice insurance crisis is threatening healthcare costs and access to care, according to a new survey of the 42 Blue Cross and Blue Shield (BCBS) companies.

Blue Plans believe that because of rising malpractice insurance premiums, some patients are experiencing reduced access to care as physicians leave expensive malpractice markets, retire early or refuse to perform certain high- risk procedures, according to the survey. They also believe that the cost of malpractice insurance is fueling the rise in the practice of defensive medicine, increasing utilization and adding excessive pressure to the nation’s continuing struggle with rising healthcare costs.

“We believe medical malpractice in the United States is now doing exactly the opposite of what it was originally intended to do,” BCBSA president and CEO Scott Serota said. “Medical malpractice laws were enacted to protect patients in the event of an egregious error in medical judgment or treatment. But today, our medical tort system is so distorted that it is threatening healthcare affordability, access to care — and some would argue it is jeopardizing quality of care.

“That’s taking us in the wrong direction,” Serota added. “Protecting patient rights must start with keeping healthcare affordable and accessible and promoting improved patient care.”

Recent news accounts of physician walkouts and demonstrations in several states, including Florida, Pennsylvania and West Virginia are examples of concerns reflected nationally in the BCBSA study. The survey’s findings also mirror similar conclusions from an American Medical Association (AMA) report last year that identified 12 “crisis” states and 30 other states with growing medical malpractice problems.

There is a growing concern nationally that rising malpractice insurance premiums are causing physicians to cut back on some aspects of care. A majority of Blue Cross Blue and Blue Shield Plans in crisis states report that:

fifty-six percent of BCBS Plans in crisis states say physicians are refusing some high-risk procedures, versus 32 percent for non-crisis states;
fifty-six percent of BCBS Plans in crisis states say physicians are leaving practice or retiring, versus 42 percent of respondents in non- crisis states;
more than twice as many crisis-state BCBS Plans as non-crisis-state Plans report physicians reducing emergency room calls (44 percent versus 17 percent) or refusing to see patients (38 percent versus 17 percent); and,
nearly a third (31 percent) of crisis-state BCBS Plans say physicians are moving practices out of state; a fifth (20 percent) of non-crisis Plans give the same response.

The survey was conducted by the Blue Cross and Blue Shield Association (BCBSA) and includes responses from every BCBS member Plan.

“Keeping healthcare affordable and reducing the number of uninsured Americans is the number one priority of the Blue Cross and Blue Shield System,” Serota added. “The current dash-for-cash medical tort environment is clearly not adding value to the healthcare system as a whole by threatening affordability, access and quality.”

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