High Double Digit Malpractice Premium Increases in Rhode Island for 2005:
The first three paragraphs in the story in the September 20, 2004 issue of the Providence Business News by Staff Writer Marion Davis entitled "Malpractice insurers eye steep hikes" accurately highlight the worsening malpractice insurance cost crisis in the state.
http://www.pbn.com
"In the wake of a 42.8-percent rate hike this year, the state’s largest medical malpractice insurer wants to raise premiums by another 19 percent, adding an average of $7,000 to the cost of each of its 1,500-plus policies.
If approved by the state Department of Business Regulation, the proposed hike would make NORCAL Mutual Insurance Co.’s premiums 2.4 times higher than what they were, overall, in 2000. The actual cost of each policy varies by medical specialty and other factors, and some doctors have seen bigger hikes in that time period.
NORCAL’s rates have a particularly big impact on Rhode Island because since its entry into the market in 1994, it has seized a sizable market share: 64 percent of direct premiums written in 2003. But the California-based insurer is not alone in its skyrocketing premiums."
http://www.pbn.com/stories/printdetails.php?id=108669
The responses of the approximately 3,835 Rhode Island physicians* to this further uncontrollable increase in medical practice overhead are consistent with physician responses in more than half of the other states in the nation also in crisis:
"A recent survey by the Rhode Island Medical Society found that 12.3 percent were closing their practices, 26.5 percent were retiring early; 16.9 percent planned on leaving the state; 24.4 percent planned to reduce their patient load, and 32 percent were reducing the services they offered."
*detailed statistics on the medical markets in all 50 states are available at the Kaiser Family Foundation site at: http://www.statehealthfacts.org .
In this type of deteriorating business environment, many, if not most physicians are inclined to agree with the perspective of Rich Lowry, author of Legacy: Paying the Price for the Clinton Years, as expressed in his recent essay entitled "Suing the OB-GYNs: Our legal system doesn’t exactly welcome life into the world":
"Many of the lawsuits are over children with neurological damage such as cerebral palsy. The theory often is that a doctor's negligence during childbirth kept the baby from getting enough oxygen. Edwards successfully sold this theory to juries. It is problematic at best.
A recent ACOG study concluded that less than 10 percent of cases of neurological impairment were caused by events during labor, and even in most of those cases the problems were not preventable. Deliveries by Caesarian section have increased from 6 percent in 1970 to 26 percent today — to make it harder for a trial lawyer to argue that a C-section would have prevented a baby's disability. But a study last year found that cases of cerebral palsy had remained steady despite the increase in C-sections.
Of course, there are instances of real medical malpractice, which should be compensated. But it cannot be the case, as the pattern of lawsuits now suggests, that nearly every obstetrician in America is incompetent and negligent. Krauss points out that medical insurance rates for OB-GYNs don't differ according to experience or prior suits the way, say, auto insurance rates do. That's because there is no predicting who will be hit by the pervasive and random suits.
The lawyers who game this system are simply scoundrels. Not just in how they coax millions out of the American health-care system, but in how they play on the understandable emotions of heartbroken and scared parents, telling them an alluring lie: that no tragedy in this life is unpreventable, that nothing goes wrong without it being someone's fault, a fault that can be precisely calibrated and paid out in a settlement or jury award.
America should make itself safe again for doctors who deliver babies."
THE RECENT EXPERIENCE WITH MEANINGFUL REFORMS IN TEXAS:
Recent developments in Texas with its 47,201 physicians, 411 hospitals and population of over 21 million (versus 3,835 physicians, 11 hospitals and 1 million citizens in Rhode Island in 2002) do offer some hope that the right kind of state-based reforms can help both all non-negligent physicians and all truly injured patients.
As described in detail in the previous eleven postings on this site, the multiple structural defects in the medical liability insurance market in Rhode Island and other states demand a multifaceted and coordinated legislative reform effort.
Just such a "three-pronged" reform effort was conceived, organized and implemented in the Texas State legislature in September, 2003.
Its dramatic one-year impact is summarized in the following fact sheet from the Home page of the current Republican Governor of Texas, Rick Perry who says that "medical liability reforms are healing healthcare in Texas":
http://www.governor.state.tx.us/divisions/press/tortreform/factsheet.htm
Medical Liability Reform Fact Sheet:
"In the one year since we passed major medical liability reforms, patients are experiencing better access to healthcare, communities are recruiting new physicians, insurance costs are down significantly for many hospitals and some doctors, and lawsuits filed against healthcare providers have declined dramatically." - Governor Rick Perry
Medical Liability Reforms are improving patient access to the healthcare delivery system all across Texas. Statewide and local data show a stunning reverse in recent trends with hospitals and communities experiencing much greater success in recruiting physicians, lower insurance costs for hospitals leading to an expansion of indigent and charity care in some instances, a tremendous decrease in lawsuits against healthcare providers, and lower rates for some doctors compared to skyrocketing increases in previous years.
Here are the facts:
Lower Insurance Costs:
Texas Hospitals are reporting a 17 percent decrease in professional liability premiums for 2004-2005 (Texas Hospital Association Survey with responses from 172 acute-care hospitals, 8/23/04.) In 2003 premiums rose more than 50 percent.
Ten new carriers are seeking entry into the Texas market (Texas Department of Insurance report 8/5/04), and the largest carrier, the Texas Medical Liability Trust, has reduced physician rates 12 percent. In the years prior to medical liability reform, 13 carriers left the state and 6,000 physicians had to scramble for coverage.
The largest hospital writer in Texas, Healthcare Indemnity, Inc. has reduced rates by 20 percent (TDI report 8/5/04.)
Lawsuits Down Dramatically:
Medical liability lawsuits in several counties considered high-risk for physicians have decreased dramatically since the new law took effect on 9/01/03:
Patient Access to Care is Improving:
Since medical liability reforms took effect, the number of physicians maintaining or enhancing services has increased dramatically, with nine percent providing new services in addition to maintaining existing ones, and 73 percent making no changes to services they offer (Texas Medical Association Survey, 8/23/04.) Since 9/1/03, 13 percent of doctors have reduced their services, compared to 51 percent who reduced services in the previous two years.
The number of physicians who have found it easier to recruit new physicians to their practice, hospital or community is now higher than the number of physicians who have indicated it is more difficult (TMA survey, 8/23/04.) Of those who indicated it is easier, 97 percent indicated the professional liability climate was either very important or somewhat important in their ability to recruit.
http://www.pbn.com
"In the wake of a 42.8-percent rate hike this year, the state’s largest medical malpractice insurer wants to raise premiums by another 19 percent, adding an average of $7,000 to the cost of each of its 1,500-plus policies.
If approved by the state Department of Business Regulation, the proposed hike would make NORCAL Mutual Insurance Co.’s premiums 2.4 times higher than what they were, overall, in 2000. The actual cost of each policy varies by medical specialty and other factors, and some doctors have seen bigger hikes in that time period.
NORCAL’s rates have a particularly big impact on Rhode Island because since its entry into the market in 1994, it has seized a sizable market share: 64 percent of direct premiums written in 2003. But the California-based insurer is not alone in its skyrocketing premiums."
http://www.pbn.com/stories/printdetails.php?id=108669
The responses of the approximately 3,835 Rhode Island physicians* to this further uncontrollable increase in medical practice overhead are consistent with physician responses in more than half of the other states in the nation also in crisis:
"A recent survey by the Rhode Island Medical Society found that 12.3 percent were closing their practices, 26.5 percent were retiring early; 16.9 percent planned on leaving the state; 24.4 percent planned to reduce their patient load, and 32 percent were reducing the services they offered."
*detailed statistics on the medical markets in all 50 states are available at the Kaiser Family Foundation site at: http://www.statehealthfacts.org .
In this type of deteriorating business environment, many, if not most physicians are inclined to agree with the perspective of Rich Lowry, author of Legacy: Paying the Price for the Clinton Years, as expressed in his recent essay entitled "Suing the OB-GYNs: Our legal system doesn’t exactly welcome life into the world":
"Many of the lawsuits are over children with neurological damage such as cerebral palsy. The theory often is that a doctor's negligence during childbirth kept the baby from getting enough oxygen. Edwards successfully sold this theory to juries. It is problematic at best.
A recent ACOG study concluded that less than 10 percent of cases of neurological impairment were caused by events during labor, and even in most of those cases the problems were not preventable. Deliveries by Caesarian section have increased from 6 percent in 1970 to 26 percent today — to make it harder for a trial lawyer to argue that a C-section would have prevented a baby's disability. But a study last year found that cases of cerebral palsy had remained steady despite the increase in C-sections.
Of course, there are instances of real medical malpractice, which should be compensated. But it cannot be the case, as the pattern of lawsuits now suggests, that nearly every obstetrician in America is incompetent and negligent. Krauss points out that medical insurance rates for OB-GYNs don't differ according to experience or prior suits the way, say, auto insurance rates do. That's because there is no predicting who will be hit by the pervasive and random suits.
The lawyers who game this system are simply scoundrels. Not just in how they coax millions out of the American health-care system, but in how they play on the understandable emotions of heartbroken and scared parents, telling them an alluring lie: that no tragedy in this life is unpreventable, that nothing goes wrong without it being someone's fault, a fault that can be precisely calibrated and paid out in a settlement or jury award.
America should make itself safe again for doctors who deliver babies."
THE RECENT EXPERIENCE WITH MEANINGFUL REFORMS IN TEXAS:
Recent developments in Texas with its 47,201 physicians, 411 hospitals and population of over 21 million (versus 3,835 physicians, 11 hospitals and 1 million citizens in Rhode Island in 2002) do offer some hope that the right kind of state-based reforms can help both all non-negligent physicians and all truly injured patients.
As described in detail in the previous eleven postings on this site, the multiple structural defects in the medical liability insurance market in Rhode Island and other states demand a multifaceted and coordinated legislative reform effort.
Just such a "three-pronged" reform effort was conceived, organized and implemented in the Texas State legislature in September, 2003.
Its dramatic one-year impact is summarized in the following fact sheet from the Home page of the current Republican Governor of Texas, Rick Perry who says that "medical liability reforms are healing healthcare in Texas":
http://www.governor.state.tx.us/divisions/press/tortreform/factsheet.htm
Medical Liability Reform Fact Sheet:
"In the one year since we passed major medical liability reforms, patients are experiencing better access to healthcare, communities are recruiting new physicians, insurance costs are down significantly for many hospitals and some doctors, and lawsuits filed against healthcare providers have declined dramatically." - Governor Rick Perry
Medical Liability Reforms are improving patient access to the healthcare delivery system all across Texas. Statewide and local data show a stunning reverse in recent trends with hospitals and communities experiencing much greater success in recruiting physicians, lower insurance costs for hospitals leading to an expansion of indigent and charity care in some instances, a tremendous decrease in lawsuits against healthcare providers, and lower rates for some doctors compared to skyrocketing increases in previous years.
Here are the facts:
Lower Insurance Costs:
Texas Hospitals are reporting a 17 percent decrease in professional liability premiums for 2004-2005 (Texas Hospital Association Survey with responses from 172 acute-care hospitals, 8/23/04.) In 2003 premiums rose more than 50 percent.
Ten new carriers are seeking entry into the Texas market (Texas Department of Insurance report 8/5/04), and the largest carrier, the Texas Medical Liability Trust, has reduced physician rates 12 percent. In the years prior to medical liability reform, 13 carriers left the state and 6,000 physicians had to scramble for coverage.
The largest hospital writer in Texas, Healthcare Indemnity, Inc. has reduced rates by 20 percent (TDI report 8/5/04.)
Lawsuits Down Dramatically:
Medical liability lawsuits in several counties considered high-risk for physicians have decreased dramatically since the new law took effect on 9/01/03:
- Harris County: 105 lawsuits were filed from 9/01/03 to 7/31/04, compared to 746 lawsuits filed in the three months prior.
- Bexar County: 81 lawsuits were filed from 9/01/03 to 4/30/04, compared to 304 lawsuits filed in the three months prior.
- Nueces County: 32 lawsuits were filed from 9/01/03 to 4/30/03, compared to 108 lawsuits filed in the three months prior.
- Cameron County: 17 lawsuits were filed from 9/01/03 to 4/30/04, compared to 28 lawsuits filed the three months prior.
- Hidalgo County: 17 lawsuits were filed from 9/01/03 to 4/30/04, compared to 96 lawsuits filed the three months prior.
Patient Access to Care is Improving:
Since medical liability reforms took effect, the number of physicians maintaining or enhancing services has increased dramatically, with nine percent providing new services in addition to maintaining existing ones, and 73 percent making no changes to services they offer (Texas Medical Association Survey, 8/23/04.) Since 9/1/03, 13 percent of doctors have reduced their services, compared to 51 percent who reduced services in the previous two years.
The number of physicians who have found it easier to recruit new physicians to their practice, hospital or community is now higher than the number of physicians who have indicated it is more difficult (TMA survey, 8/23/04.) Of those who indicated it is easier, 97 percent indicated the professional liability climate was either very important or somewhat important in their ability to recruit.
Reports from several communities show patients have access to additional physicians and specialists:
- Corpus Christi: Driscoll Children's Hospital has experienced a one-year savings of $204,000 on its liability premiums, plus an additional $250,000 that would have otherwise been allocated to its self-insurance trust fund. The hospital has hired close to a dozen pediatric specialists since September2003 (including two cardiologists, three neonatologists, a hematologist, a plastic surgeon, an anesthesiologist, and a general surgeon.
- Corpus Christi: Christus Hospitals, which are saving nearly $21 million statewide in liability costs, are saving millions of dollars at Christus Spohn in Corpus Christi. The hospital has experienced a net gain of 22 physicians. After losing four neurosurgeons in the three years prior, Corpus Christi recently recruited a new neurosurgeon.
- Rio Grande Valley: Driscoll Children's Hospital has built new pediatric specialty clinics in McAllen and Brownsville in partnership with Valley Baptist Medical Center. Rio Grande Regional estimates $750,000 in liability savings and has recruited two neonatologists.
- San Antonio: Christus Santa Rosa has saved $935,000 in liability costs and expanded specialized care services.
- Beaumont: Christus St. Elizabeth has yielded $1.372 million in savings. Beaumont has also recruited four new anesthesiologists. It was just two years ago that Christus St. Mary's in
- Port Arthur canceled a dozen surgeries over an eight hour period because their anesthesiologists lost their insurance.
- Austin: Austin has gained 16 new obstetricians in a year after losing the same amount over the preceding 2 ½ years.
- Dallas: Baylor Hospital reports that seven reinsurance companies are bidding for their insurance renewal, compared to just one company a year ago. They estimate liability savings in "the seven figures," and doctors insured by the Baylor Health Care System "Health Texas" group can expect a premium decrease of more than ten percent (Dallas Morning News, "Hospitals find healthy savings," 8/23/04).
- Fredericksburg: Two obstetricians placed an ad in the paper thanking voters for passing Proposition 12 and announced they would resume their obstetrics practice."
September 20, 2004:
posted by Bob Coli, MD at 1:31 PM
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