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Keene Sentinel, New Hampshire
Sunday, February 27, 2005
As he travels around the country blaming trial lawyers for sending up the cost of health care, President Bush is oversimplifying a problem to the point of misrepresenting it. That's not new for this administration, whose capacity for hyperbole - and worse - is pronounced. The president flatly asserts that the origin of soaring medical malpractice insurance premiums is in the courtroom, not the operating room.
According to government and industry data reported by The New York Times, medical malpractice claims nationally have gone up only slightly during the last decade. The Times went on to report that the main reasons insurance premiums are rising today are that insurers are trying to offset lower-than-expected returns on their investment portfolios and, simultaneously, generate more premium income after a period of intense price competition that actually did in some insurers.
Make no mistake about it, malpractice premiums are an expensive line item on medical providers' budgets. The question is what to do about the problem. The president's favored solution is a $250,000 ceiling on awards for pain and suffering. Medical interests, including the New Hampshire Medical Society, point to California, which has such a limit and where insurance premiums are lower than in many other parts of the country.
But others say the real reason insurance costs are comparatively low in that state is that insurers aren't allowed to raise premiums more than 15 percent annually without a public hearing.
Doctors and lawyers can - and do - disagree about what caused California insurance premiums to settle down. But there are other steps they do agree on. Consider, for example, the launch this month of an organization called the "Sorry Works! Coalition." The unit, an association of doctors, lawyers, hospitals and patient groups in the Midwest, has laid down rules by which medical providers voluntarily disclose errors to patients and their families and make upfront cash settlements.
The practice, based on 25 years' experience at the Veterans Affairs Medical Center in Lexington, Kentucky, leads to more claims payments, but fewer total dollars awarded to unhappy patients. Why? Because patients feel they have been listened to, and costly adversarial proceedings are avoided. There's a bill in Concord today (House Bill 463) that would bring I'm Sorry practices to this state. There's other legislation designed to help reduce medical errors, such as House Bill 514, which would let hospitals confidentially share information about medical problems and practices with each other.
In politics, as suggested by President Bush, everything is clear. In insurance, nothing is (just try reading your homeowner's policy). Hence, the president's high-profile campaign to cap pain-and-suffering awards is a bit too simplistic, and offers little convincing chance of relieving cost pressures on medical providers and, ultimately, their patients. The problem calls for more imaginative solutions involving medical providers, patients and their lawyers.
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