Six Additional States Face Medical Malpractice Insurance ‘Crisis,’ AMA Reports
The American Medical Association yesterday added six states -- Arkansas, Connecticut, Illinois, Kentucky, Missouri and North Carolina -- to its list of those with a medical malpractice insurance "crisis," the AP/Nando Times reports. High malpractice insurance premium rates have prompted many physicians to end their practices in the six states, which has affected access to care for patients, according to the AMA (Carter, AP/Nando Times, 3/3). An AMA report released last June found that the cost of malpractice insurance had reached "crisis proportions" in 12 states and approached such levels in 30 additional states (California Healthline, 6/18/02). The AMA yesterday said that 18 states today have "severe" problems with high malpractice insurance premiums, the Chicago Tribune reports. "Things are worse now for these states because of the marked decrease in access. There is something terribly wrong when dedicated professionals, who have trained for years, want to give up the work of a lifetime and retire, move to another state or stop offering high-risk procedures," AMA President Dr. Yank Coble said (Japsen, Chicago Tribune, 3/4).
The House next week will debate a bill (HR 5) sponsored by Rep. James Greenwood (R-Pa.) that would cap noneconomic damages in malpractice lawsuits at $250,000 and limit punitive damages to twice the amount of economic damages or $250,000, whichever is higher, the AP/Times reports. The legislation passed in the House last September but failed to pass in the Senate. President Bush supports the bill (AP/Nando Times, 3/3). Bush on Jan. 16 announced a proposal to cap noneconomic damages in malpractice lawsuits at $250,000; limit punitive damages; require payments of damages over time, rather than in a lump sum; limit the amount of time that patients have to file malpractice lawsuits; limit the amount of damages that physicians must pay when other parties, such as a health insurer, made payments to compensate for losses; and link the share of payments paid by defendants to their level of culpability (California Healthline, 1/17). House Ways and Means Committee Chair Bill Thomas (R-Calif.) and House Ways and Means Health Subcommittee Chair Nancy Johnson (R-Conn.) yesterday called on the General Accounting Office to study the cost impact of malpractice lawsuits on Medicare. In a letter to GAO Comptroller General David Walker, the lawmakers wrote that concerns about malpractice lawsuits have prompted physicians to "recommend tests, refer patients to specialist and prescribe medications more often," which can lead to increased health care costs, according to a committee release. "The threat of being sued affects decisions made by doctors, and ultimately leads to higher costs for the Medicare program," Thomas said (House Ways and Means Committee release, 3/3).
In related news, HHS yesterday released a report that found "problems associated with medical litigation have significantly worsened" over the past year, according to a department release. "More doctors, hospitals and nursing homes in more states are facing increasing difficulty in obtaining insurance against lawsuits, and as a result more patients in more states are facing greater difficulty in obtaining access to doctors," the report found. The report, titled "Addressing the New Health Care Crisis," found that one-third of U.S. hospitals reported an increase of 100% or higher in malpractice insurance premiums in 2002, and more than 25% of hospitals said that they reduced of eliminated or services because of higher malpractice insurance costs. In addition, the report found that the number of judgments of $1 million or more in malpractice lawsuits reported to the National Practitioners Data Bank increased from 298 in 1991 to 806 last year. "It is important to fix this broken litigation system now, and continue to make meaningful quality improvements in our health care system to reduce medical errors," HHS Secretary Tommy Thompson said (HHS release, 3/3). The report is available online at http://aspe.hhs.gov/daltcp/reports/medliab.pdf. Note: You must have Adobe Acrobat Reader to view the report.
Physicians have conducted work stoppages in several states to protest high malpractice insurance costs, but "there is a deadly silence from physicians' groups on the crisis of inadequate doctor discipline," Dr. Sidney Wolfe, director of the Health Research Group at Public Citizen, writes in a New York Times opinion piece. Lawmakers have debated legislation that would cap noneconomic damages in malpractice lawsuits to address high malpractice insurance premium rates, Wolfe writes. However, he adds, the "major cause" of the problem is not high damage awards in malpractice lawsuits, but the failure of state medical boards to discipline the small percentage of physicians who account for "most of the money paid out" in the lawsuits. According to the National Practitioner Data Bank, 5% of physicians accounted for 54% of the payments of damages and settlements in malpractice lawsuits, Wolfe writes. The malpractice insurance "problem is not the compensation paid to injured patients, but an epidemic of medical errors" that state medical boards and legislatures should address, Wolfe concludes (Wolfe, New York Times, 3/4).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.