Used & Abused: It Never Was For Or About The Doctors
In the 2003, tort reformers made a nationwide assault on consumer’s access to the courts and abilities to be fully compensated for wrongs done to them. They used physicians to scare citizens to support their efforts. Specifically, they created hysteria about doctors leaving the practice of medicine and/or the community they practiced in because of their high malpractice insurance premiums. They also quickly added that these insurance premiums were high because of the enormous number of medical malpractice lawsuits. The tort reformers took that one step further by pontificating that those medical malpractice claims were unmeritorious and frivolous, and used their favorite, two battle cries: “lawsuit abuse” and “greedy trial lawyers”. The hysteria worked fantastically for them, but the bottom line is that they took advantage of the doctors to promote and further their own agenda.
Yes, they created this hysteria. The truth is that doctors were neither quitting the profession or moving to other states. The only truth they told was that medical malpractice insurance premiums were going through the roof; but, then again, so were insurance premiums for every kind of insurance coverage.
In Texas, Doctors supported the broad brush, omnibus tort reform agenda of House Bill 4 in exchange for caps on non-economic damages in medical malpractice cases in a revised Medical Liability Act. In so doing, they also signed on in support of a number of special interests’ items.
HB 4 passed, and the doctors not only received the caps they wanted, but a victory in a special called election with a constitutional amendment for caps on non-economic damages in other kinds of lawsuits. All of which, the tort reformers told them would decrease the number of unmeritorious and frivolous medical malpractice lawsuits, and in turn, would decrease their medical malpractice insurance premiums. The doctors bit down on this one like their child patient on a tongue depressor.
Here is what the doctors received for their support: Modest reductions at best in their medical malpractice insurance premiums. The only winners were the tort reformers who received special interests protections and immunity for their wrongdoing and tortious conduct.
Interestingly, the Physician Insurers Association of America (PIAA), a national trade association that represents doctor-owned and/or operated medical professional liability insurance companies, reported on September 12, 2006, that medical liability reforms enacted in 2003 by the Texas Legislature have had an unprecedented impact on both the cost of medical professional liability coverage and the availability of healthcare in the state of Texas.
Lawrence Smarr, president of the PIAA, said the following in support of these claims:
- PIAA’s member company, The Texas Medical Liability Trust (TMLT), filed for its fourth rate reduction since the enactment of House Bill 4 (the Texas Tort Reform Bill) in 2003;
- TMLT’s 7.5% rate reduction for the 2007 policy year, reduced rates on a cumulative basis by 29.5% over the past four years for a savings of more than $55 million for Texas physicians, and declared a $10 million dividend in 2006 and $35 million dividend for 2007.”
- n addition to easing the financial burden for physicians, there has been a drastic change in access to healthcare for residents of Texas. According to the Texas Medical Board (TMB), Texas is licensing an average of 400 more physicians per year than in the pre-reform years. In addition, the TMB is anticipating a record 4,100 applications for new physician licenses in 2006. That figure is 38% greater than last year, which previously was the Board’s busiest year on record.
So, that’s the insurance industry’s assessment of the how well trot reform works to decrease medical malpractice insurance premiums. However, ask your physician if his insurance rates have decreased appreciably since the 2003. Do not be surprised when he says, they have, but not appreciably or enough. You already know he did not tuck his white coat between his legs and flee Texas or the medical profession, but you can sure ask him why he didn’t. Again, don’t be surprised if he said he did not cut-n-run because he knew medical malpractice insurance premiums were high all across this nation and that the reason was the insurance industry’s quest for larger profits, not trial lawyers and medical malpractice suits.
The Center for Justice and Democracy did not find that insurance rates fell, either. In it’s research, the CJD found the truth and revealed the same in it’s report, “The Real Story Of Texas Insurance Rates”. It found the following when recent medical malpractice insurance rate reductions in Texas were viewed in light of three things:
- political pressure, not market forces, brought down rates initially.
- size of prior rate hikes minimized any real reductions that occurred.
- he well recognized insurance cycle has turned, and doctors’ insurance rates are stabilizing everywhere, whether or not a state has enacted caps.
Further, AMA President Nancy Nielsen, MD., hit the nail on the head. “It boils down to this — insurance company profits or patients and the physicians who care for them.” Dr. Nielsen noted that Congress had six months to effectively address harsh Medicare cuts that will harm seniors’ access to care, but the Senate failed to act, and Medicare’s 2008 10.6% cuts began July 1, 2008. Sixty percent of physicians say this cut will force them to limit the number of new Medicare patients they can treat. Over 18 months the cuts will total more than 15 percent, while medical practice costs continue to increase.
Remember that the tort reformers told patients nationwide that doctors were leaving the profession and that the current shortage of doctors would get worse. There is a shortage of doctors. It has very little, however, to do with the unmeritorious and frivolous claims they made to create that hysteria.
Basing the need on physician supply and demand, in February 2005, the Association of American Medical Colleges (AAMC) recommended a 15 percent increase in U.S. medical school enrollment based on a national physician shortage. The AAMC found that a 30 percent increase was warranted because:
- The U.S. population increases 25 million people each decade;
- There is a doubling in the number of people over 65 between 2000 and 2030;
- Effective health care services will keep people healthy and active longer;
- There is an aging physician workforce - one of every three active doctors is over age 55 and likely to retire by 2020; and
- A new generation of physicians who may choose to work somewhat less than their predecessors.
Nowhere did the AAMC mention or even suggest that the shortage was due to or caused by soaring numbers of medical malpractice claims, unmeritorious and frivolous lawsuits, (lawsuit abuse), or greedy trial lawyers.
In June, 2006, the AAMC recommended a 30 percent increase by 2015. This expansion would result in an additional 5,000 new M.D. students annually and should be accomplished by boosting enrollment at existing schools.
Again, not once did the AAMC attribute these enrollment increases to, much less allude to or make passing mention to the resolution of an insurance crisis or the positive effects of tort reform.
Additional Resource: “Medical schools are expanding enrollment to help meet the projected demand for physicians.”
So while doctors went to bat for the tort reformers and politicians, the are getting nothing in return. Maybe next time the tort reformers come knocking, they won’t be so gullible and eager. The doctors will remember that all they (doctors) wanted was a decrease in their medical malpractice premiums. What they got was not meaningful decrease in their premiums, but a slew of special interest, anti-consumer legislation that affects them when they are consumers.
Additional Resource: “TEXAS TORT REFORM LEGISLATIVE HISTORY”
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