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Tuesday, March 09, 2004

MORE FROM THE JOURNAL-CONSTITUTION....

Lead editorial and reply in today's paper. More of the same from both sides, I'm afraid:

Fans of tort reform try deception

Supposedly, doctors across Georgia are quitting in droves because of skyrocketing malpractice insurance rates resulting from jury awards in the gazillions. The alleged exodus is so great that women can't even find obstetricians to deliver their babies.

The solution, according to the state's medical associations, is to limit how much juries can award victims of serious malpractice for their pain and suffering. A Republican-backed bill in the Senate would impose a $250,000 cap on such awards as a way to bring down the soaring insurance premiums and allow doctors to stay in business.

It's a persuasive argument, until you look beyond anecdotes and study the facts.

For example, tort-reform advocates claim a growing shortage of obstetricians and gynecologists in the state. But the American Medical Association says that in 2000 there were 1,256 ob-gyns in the state. By 2002, that number had grown to 1,312.

Last year, 18,134 physicians were practicing in Georgia, according to the Federation of State Medical Boards. In 2000, 17,151 doctors practiced in Georgia. So over three years' time, the number of doctors practicing in Georgia increased by nearly 1,000.


How many of those OB/GYN's are still delivering babies? I have tried to find the numbers cited above on the FSMB site but cannot find them. Do the numbers reflect physicians who are actively practicing medicine, or are they the number of licensed physicians who may or may not be working? Moving along:

No one denies that medical malpractice costs are climbing, but the evidence does not suggest that profligate juries are to blame. Between 1998 and 2001, the amount of money paid out by malpractice insurers nationwide rose 8.2 percent. Yes, that increase could justify a bump in insurance rates, but it clearly can't explain the stratospheric hikes in premiums that doctors describe.

It can if you realize that insurers must not only plan to pay off today's claim, but must set aside funds for tomorrow's as well. MAG Mutual (PDF) has noted that their awards greater than $ 1 million have risen from 11 in 2001 to 20 in 2003. The "stock market bubble" is blamed as a cause of the premium increases, which is not allowed under Georgia law.

Now for the counter-punch....Insurance costs put health care in jeopardy :

Access to quality health care is the issue. Soon it may be access to any health care. Consider the following: 40 percent of all radiologists no longer interpret mammograms, and nearly one half of all pathologists no longer read Pap smears due to the inherent limitation in the accuracy of the tests. Result? Your access to quality health care is limited.

Emergency trauma coverage by neurosurgeons is no longer available 24 hours a day, seven days a week at the majority of hospitals in metro Atlanta because of increased liability premiums. Result? Your access to quality health care is limited.

No certified insurer is writing any new insurance for hospitals in our state, because of increased risks. Twelve percent of ob-gyn doctors in Georgia have stopped delivering babies in the last year -- due primarily to increased liability premiums. Six-hundred physicians in Georgia will retire or leave the state in the next year -- primarily because of increased liability premiums.


The solution according to State Sen. Tom Price (R-Roswell):

A coalition of groups -- medical and otherwise -- has proposed responsible solutions that would not limit one dollar of economic (real) damages an aggrieved party may recover. Reason would be restored to a system by keeping lawyers from shopping for the most favorable jury; requiring that expert testimony be taken only from a true expert, not a hired gun; and allowing juries to determine a percentage of responsibility for both plaintiffs and defendants to end gold-digging for a deep pocket.

Here is what I wish he had added:

Despite what the plaintiff's bar may tell you, medical malpractice litigation today is not about protecting patients. It is a lottery. Many patients with legitimate claims are turned away by attorneys because they don't think they will get a large enough award to make it worth their while. Meanwhile physicians are faced with large jury awards where there was no negligence on their part. The medical liability system is unpredictable and affordably underwriting insurance in an unpredictable market is difficult if not impossible. Georgia should take the lead in making the medical liability structure reliable, predictable, and fair. Physicians who practice bad medicine and attorneys who abuse the system should be held accountable. Only then will health care be secure for all of Georgia's residents throughout the state, now and for years to come.

Let the congregation say Amen!
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