A Diagnostics & Imaging Week

Common Good (Washington), a legal reform coalition, said that identical bipartisan bills that advance an idea developed by Common Good and researchers from the Harvard School of Public Health (Boston) have been introduced in both the Senate and the House of Representatives that would enable states to create special health courts on a pilot project basis.

The Senate bill was introduced by Sens. Michael Enzi (R-Wyoming) and Max Baucus (D-Montana). The House bill was introduced by Reps. Jim Cooper (D-Tennessee) and Mac Thornberry (R-Texas). The bills authorize funding for states to create alternative administrative health systems, including health courts, on a pilot project basis.

The Health Coalition on Liability and Access (HCLA; Washington) also applauded the effort to address what it referred to as “the serious crisis in patient access to care caused by a broken medical liability system.”

HCLA said it was encouraged by the “bipartisan recognition that our current system is neither ‘fair’ nor ‘reliable’ and called on Congress to enact “common-sense reforms” that have been proven to be effective at the state level.

“Across the country, patients can’t get the care they need when they need it because our nation’s broken medical liability system is forcing good doctors to relocate, retire early or leave medicine altogether” said HCLA Chairman Shawn Martin. “States like California and Texas have successfully implemented their own solutions. It’s time Congress enacted comprehensive medical liability reform so all Americans have access to the quality care they deserve.”

Common Good said the bills, known collectively as the Fair and Reliable Medical Justice Act, “are backed by a broad coalition of prominent organizations in patient safety, healthcare and public policy,” including the American Academy of Family Physicians, American College of Obstetricians and Gynecologists, American Osteopathic Association, Consumers Advancing Patient Safety, the Joint Commission on Accreditation of Healthcare Organizations, the National Committee for Quality Assurance and the Progressive Policy Institute.

The hallmark of health courts would be full-time judges with healthcare expertise, whose sole focus would be on addressing medical malpractice cases. Special health courts would be devoted to addressing healthcare issues. Special health courts would ensure that patients injured by mistakes would be reliably compensated, without having to pay one third or more to lawyers.

“Sens. Enzi and Baucus and Congressmen Cooper and Thornberry are leading the way to restoring reliability to medical justice in America,” said Philip Howard, chair of Common Good. “Reliable justice is essential to controlling skyrocketing costs and restoring a culture of openness. Special health courts offer justice reliable for patients and doctors alike, providing speedier and more equitable compensation for medical errors and affirmative rulings to improve patient safety and judicial consistency.”

Common Good said the current medical liability system “works poorly for everyone. Patients with valid claims wait years for settlement. Doctors who did nothing wrong litigate for years, with the risk of a ruinous verdict hanging over their heads. This unfairness leads to nearly universal distrust of justice, undermining candor and good judgment.”

Lawyers group slams malpractice insurers

Also on the medical-liability front, the American Association for Justice (AAJ; Washington) has issued a report maintaining that the medical malpractice insurance industry has been “price-gouging” doctors through “excessive” premiums and “needlessly contributing to the growing cost of healthcare.”

Written by Jay Angoff, former state insurance commissioner in Missouri, the study is based on recent annual reports from the top 15 medical malpractice insurers as rated by A.M. Best. The report, titled “No Basis for High Insurance Rates: An Analysis of the 15 Largest Medical Malpractice Insurers 2006 Financial Statements,” says that these insurers artificially raised doctors’ premiums and “misled the public” about the nature of malpractice claims.

According to the study:

  • The medical malpractice insurers saw losses and projected losses plummet by 48% in the 2003-2006 period.
  • These incurred losses have declined every year for the past five years.
  • The combined 2006 surplus for the insurers is 43% greater than their surplus in 2003, five times the state-minimum surplus for insurer stability.
  • Just three of the 15 insurers issued dividends to doctors in 2006.

AAJ Chief Executive Jon Haber said medical malpractice insurance companies “have been price-gouging doctors, padding their pockets with excessive premiums and driving up the cost of healthcare. Cynically, these same insurance companies have been blaming high premiums on a so-called ‘malpractice crisis’ that doesn’t exist. We have an insurance crisis, not a medical malpractice crisis.”

The new report also cites the difference between two types of losses in the insurance industry — incurred losses and paid losses. The industry evaluates its performance based on incurred losses, which include projections of future payments, and not paid losses, which are actual claims payments. The Angoff-written report takes into account both paid and incurred losses, and shows that although both have decreased, malpractice rates for doctors continue to increase. “No matter how you look at it, doctors and patients are getting ripped off by the insurance industry,” said Haber.