Medical Malpractice Insurer Raises Rates by 45 Percent (after lawsuit limi

[papau]

Malpractice Insurer Raises Rates by 45 Percent (after lawsuit limits law passed by Florida).

http://ap.tbo.com/ap/florida/MGA415NIWOD.html
Jan 1, 2004
Medical Malpractice Insurer Raises Rates by 45 Percent
The Associated Press

SARASOTA, Fla. (AP) - A medical malpractice insurance carrier is raising its 2004 rates for Florida doctors by an average of 45 percent.

GE Medical Protective, which covers about 2,500 doctors - or about 5 percent of the state market - said the increase had been approved by the state Office of Insurance Regulation.<snip>

The Legislature earlier this year passed limits on some types of lawsuit losses in many medical malpractice cases in an effort to restore the market and stabilize premiums, which many doctors said were threatening their practices.

The law required insurers to factor in the new law and regulators determined that their rate requests should be lower by about 8 percent on average because of the damage limits and other changes in the law. <snip>

[revcarol]

1. "But Jebbie, you promised..."

called bait and switch. Well-known consumer robbery tactic.

[Systematic Chaos]

2. Here in Las Vegas

We have NO official trauma center for people who get mangled in accidents or whatever. Also, when making an appointment for my wife at the Gynecologist office there was a sign right there at the service desk saying that HALF the OB-GYN's in Vegas have left due to malpractice insurance rates, and that appointments would very likely be scheduled for two weeks or more down the line.

What is it going to take for the people to become fed up enough with this BS to affect some real change? :shrug:

[Mikimouse]

3. Hahahahahahaha! Sorry guys, but that ...

fourth vacation house in the Caymans will just have to wait a few more years. Poor babies! I say, let the 'physicians' (really nothing more than businessmen in white coats), and the insurance vultures eat each other. When it is no longer possible for 'physicians' to gouge the consumer, it will be ineresting to see how many there will be who stick around. Those who stay will be the ones who were dedicated to healing in the first place.

[micsca]

13. No clue as to what physicians make

Physicians are getting hammered in California. I work for an internist. She made $42,000 a year and works at least 65 hours a week. Other primary care doctors around here make $50,000-$60,000 and work as many hours. If you do the math, she makes less per hour than her nurse, who makes $13 an hour.

The National averages for hourly wage rate equivalents for primary care doctors is about $33 an hour.

Our county is one of the worst ones in the country for practicing medicine. 25% of the physicians have left private practice in the past two years. Many have retired or work for the prison system, which pays far more than they can make in private practice.

Sure, there are some physicians who make a lot of money, like some eye doctors who do a lot of LASIK stuff, but that is not the norm.

Medicare payments rates haven't come close to keeping up with the practice expenses, and doctors often see patients where they make no money, or actually lose money seeing patients.

Bash doctors if you want, but who do you go to when you are sick?

[twilight]

15. I have one I need to SUE right now!

and I have no compassion for IT! I hope IT rots in hell because I ALMOST DIED! :grr:

So, tough cookies for dumb doctors!

:dem: :kick:

[Skittles]

27. HELLO

LOTS OF PEOPLE CAN'T DO SH** WHEN THEY GET SICK BECAUSE THEY CANNOT AFFORD INSURANCE.

[Mikimouse]

47. I don't; I don't believe in the system after having worked in it

for 25 years and seeing the gross incompetence and complete lack of care. Sorry to annoy, but I do happen to know what I am talking about.

[Bandit]

55. Bash doctors if you want, but who do you go to when you are sick?

I can't afford to go to any doctor because they charge way too much. A year ago I went in for a physical. It took four hours one day and three hours the next and I was charged eighteen hundred dollars. I have no insurance so it came right out of my hide. You may say they don't make much money but they sure as hell charge a lot. They told me I was getting a break because I had no insurance.

[twilight]

56. gee I guess salaries for docs hasn't gone up in 20 years!

I used to work for doctors. In fact, I did their payroll. One guy was fetching in $110,000 a year and that was in 1984!

This particular doctor was a greedy SOB and he would come in a scream at us if we failed to page him in the OR when his stock broker called! What a pig!

Doctors for the most part make plenty of $. I am just beginning to get the bills from the surgery I had to have because of an incompetent doctor failure to inform me of the problem 2 years ago. So far, the bills are ringing in at close to or more than $20,000.00 and that is just the beginning.

One doctors visit alone was $160.00 for 1/2 hour.

Tell me the pooooor doctor don't make hardly anything again please!

What a pile of shyte!

:dem: :kick:

[RapidCreek]

63. Uh huhh

I won't go see the fucker who killed my father, that's for sure. The one who my lawyer said I could not successfully sue.

I find it odd that someone making 33 bucks an hour can afford a half a million dollar home, a 38 foot sailboat, a Volvo XC90 for his stay at home wife and a Sierra Denali for himself.

My cousin, an intern and son of a financially challenged art teacher, just bought an 800,000 dollar Georgetown brownstone, vacations in Europe and the Islands of the Carribean...His wife stays at home unsuccessfully attempting to get her children's stories and recipe's published. Amazing what one can do on 33 bucks an hour.

Sorry but I don't buy your figure for the national average hourly wage for doctors. It is misleading at best....why don't you supply the mean average. Even if it is accurate, so the hell what? I know quite a few people who perform jobs just as vital, work longer hours and make 10 bucks an hour or less.

Back when I was studying to be a biomedical engineer I used to get invited to "junior AMA" partys. We'd motor around Lake Michigan on a yacht, drinking champaign, eating filet mignon, lobster and shrimp....all for free. I quit going after recognizing the subject of the vast majority of conversations had at these little swarays was how those engaged damn well better make six figures a year when they get out of school. Never once a mention of a desire to serve their fellow human beings...Interestingly these same conciepted assholes balked at paying a mechanic 45 bucks an hour to install an alternator on their automobiles. When I asked why that should be a problem for them, they explained that mechanics weren't highly skilled professionals like themselves. I asked why they didn't install their own alternators, tune their own cars and fix their own brakes. Their answer.....We don't know how.

Yea my heart bleeds...

RC

[salin]

4. broad cast this item whenever 'tort reform' and 'medical law suits reform'

gets bandied about. It is the insurers gouging - not the lawsuits.

[rustydog]

5. What makes me sick is the issue is NOT frivilous lawsuits

that drive the costs of malpractice rates.
It is the good-old-boy club in the AMA and hospitals nation-wide that refuses to finger incompetent, murdering doctors.

If the frigging doctors in every town in America pointed out the incompetents and said, this man/woman kills patients...the problem would resoplve itself.
instead we have a medical system that allows a doctor to slink out of town and set up a killing practice elsewhere.
The insurance companies rake in the dough and Bush and fellow Republican assholes say it is lawsuits that are the problem.

I'm sorry, but if some jerk-off doctor's ineptitude kills a family member,or a wrong body part is removed, you can bet your sweet ass I would sue for Millions upon millions.

It is funny how business ( the AMA is a business) screams about frivilous lawsuits, but business is free to sue (fox news) anyone for any perceived slight and it is not frivilous!

Doctors are not gods and hospitals are not Olympus. Start holding these institutions responsible for their actions.

[DU9598]

6. Debunk the malpractice myths - good talking points from ATLA

<http://www.atla.org/medmal/main.aspx>
This link debunks the whole medical malpractice crisis. Sen. Edwards talks from the ATLA talking points when asked about the "crisis".

[twilight]

17. you got it!

I was wronged by an arrogant idiot of a doctor that is operating on people ON DRUGS!

If I hadn't ditched this murderer I would not be typing this right now. I had to have emergency surgery - it was in this doctors notes - two more weeks I would have DIED!

So, I have no compassion for this cartel of thugs!

:dem: :kick:

[david_vincent]

25. Well put!

I agree 100%. My ex-brother-in-law is a medical malpractice lawyer who made a very handsome living from suing incompetent doctors and winning. The cases he handled involved people who were crippled for life due to the screwups inflicted on them by doctors, anesthesiologists, etc. If we're supposed to feel sorry for these people who are being protected, rather than policed, by the AMA then I say just take a look at innocent people who have to spend their entire lives in wheelchairs, or brain damaged, because their doctors messed up or some piece of equipment malfunctioned.

[RaRa]

37. Nothing is as simple as it appears

When my dad was practicing, he had to report every "intent to sue" he got from a lawyer. Often nothing happened, but the lawyer had to send these notices to avoid missing any statute of limitations. Well, from the insurance company's standpoint, every report was a little mark against my dad because it forced them to investigate etc. You would not believe the ridiculous claims that were made in these initial allegations. Also, lawyers have to include everyone tied to a case initially, and later can drop the names. Well, sometimes my dad's only involvement was concurring that someone was brain dead. But, he would get lumped into a lawsuit only later to have his name dropped. Didn't matter, he had to report it. As a consequence, my dad almost lost his insurance (had about 5 or so of these intent to sues - none ever went to court or settled etc) over these things (he was in a high risk area - neurology - lots of serious cases and he wasn't the primary care physician so easy to sue). But, he often did say that it was amazing how good doctors would be sued, and he would see real cases of malpractice and nothing would happen.

[radfringe]

49. 4-fold problem

just my 2-cents, and I'm no expert

in no particular order

Yes, there are "sue-happy" patients out there and this does drive up the cost - however more often than not patients that do sue do so as a last resort, either they are not getting answers from medical staff/institutions and/or there is no accountability being enforced

Hospitals/AMA do not hold doctors/staff accountable - more often than not a doctor is not censured or suspended from practice, or they are allowed to just set up "practice" elsewhere

There are the ambulance chaser lawyers out there, and those that advertise big settlements on the tube - which may contribute to people rushing to sue

Insurance companies that continue to insure doctors with a "record" of mal-practice suits - instead of canceling the insurance policy, they hike the rates and this gets spread around to other medical practioners. Many insurance companies just settle to get rid of a lawsuit - yet they continue to insure the medical practioner

What's this all mean? ACCOUNTABILITY and RESPONSIBILITY

[truth2power]

53. Great sig, Rustydog. LOL! n/t

[Mairead]

7. Anyone who has a problem with all this

should be voting for Kucinich, because his Medicare-for-all healthcare program would solve it. With a single 'insurer' across the whole nation, bad docs --crooks, duds-- would effectively be forced out of practice right away.

[micsca]

24. Single-payor not the answer

Single-payor system is not the answer. I work in the healthcare field and am very familar with healthcare financing. The common comment is that a single payor system has a low overhead and would save money. I used to believe this also, but I discovered this simply is not true.

Suppose you need buy something and your solicit bids from two companies. The first company will sell to you for $800. The second company will sell to you the identical product for $1,000. Who will you by from? Of course you will buy from the first company. But suppose the second company comes and tells you that their administrative expenses are only 2%, but the first company’s administrative expenses are 15%, so their product is will save you money. Would you believe them and buy the product for $1,000 instead $800 from the first company? That is the basic argument for the single-payer system. The total amount of money spent by Medicare is more total dollars than the private plans that supposedly have higher administrative expenses plus their profits.

Medicare HMO’s get paid less money than if the patient were in Medicare. The HMO’s have supposedly higher administrative expenses and also make a profit. They also provide MORE care (prescription drugs and preventive care) than Medicare does. They do this all with less money than Medicare spends per patient.

The largest administrative expenses for Medicare and Medicaid are not the costs that are paid by the government. I was shocked when I started working for a doctor and found out how much money they have to spend to be compliant with Medicare. The costs are at least 15% of the totals revenue they make for all patients, not 15% of the revenue just from Medicare patients. Doctors have to meet the same Medicare requirements (expenses) for all of their non-Medicare patients. Hospitals don’t have it any better. Nurses spend 30 minutes doing paperwork for every hour they spend providing patient care. Doctors often spend 3-4 hours a day doing paperwork after they spend 7-8 hours seeing patients. (I didn’t include this physician time in the 15% number. The 15% is just the billing and documentation costs physicians have to spend). This means that the healthcare system spends at least $200 billion a year doing paperwork because of the Medicare system. That is almost the as much as the total spent by the Medicare program. If you include that amount, the administrative expenses of Medicare are closer to 50%, not 2%. Besides, the 2% isn’t correct. The figure doesn’t include all the money spent by the legislative branch, judicial branch, and other non-HCFA agencies of the government, which are significant.

The U.S. is the only industrialized country that doesn’t have socialized medicine. I thought surely there must one country where is works well. I spent months I looked at data from around the world. I couldn’t find one country where socialized medicine was working well. All were experiencing some type of crisis of their own definition.

I think that HMO’s are a disaster and private health plans like Blue Cross are crooks. They make huge amounts of money off of the healthcare system. Congress created HMO’s in 1973 to lower the cost of Medicare, which were growing far faster than their planned. Any proposal, like the GOP’s, that expands private health plans power is a mistake. But just because that is a mistake, we don’t have to propose a bigger mistake by suggesting a single-payer healthcare.

My mother-in-law lives in Sweden. She has a very painful condition that causes bleeding in her uterus. She is in so much pain that she cannot hold a job. She needs to have a hysterectomy, but the government won’t let her until she bleeds enough so that her hemoglobin drops to a life-threatening level. Only then can she have the operation. This is certainly not very humanitarian. This isn’t just isolated cases that things like this happen. This is the norm in every country that has socialized medicine.

I see everyday that Medicare doesn’t cover all the care that seniors need. They have to pay for it themselves or do without. I think to myself how glad I am that I’m not in Medicare. Expanding this program to everyone is not be a desirably situation.

The issue comes down to rationing. Rationing is necessary because resources are limited. (Even if we wish they weren’t limited.) HMO’s ration by denying care. Government program ration care as well, but a government employee or Congress decides what to allow or not allow. Managed Care rations by bean-counters deciding what to authorize or not to authorize. The free market rations by price but is inequitable because the poor cannot participate in the same level of care as the middle-class and wealthy. Socialized medicine is rationed in other countries by waiting lines. Limiting doctors, hospitals, drugs and medical equipment creates those waiting lines.

Whoever pays the bill is the one that rations the care. Who should decide on what care YOU receive? (You, an HMO, or a government employee?) Those are the basic choices. There aren’t any other choices that I can see. I believe that every individual should decide on what care he or she needs. This necessarily means that the patient needs to pay the bill. And if the poor can’t afford it basic healthcare, then they need to be given the cash every year so that THEY can decide on how best to get their healthcare. This means that the healthcare solution is something similar to Medical Savings Accounts. Interest, I found out that Communist China has also started using Medical Savings Accounts.

As progressives, we have to propose solutions that will make things better for the country. I once believed that a single-payer system will accomplish that, but it will not.

[SharonAnn]

45. A lot of your facts are wrong so you'd better go do your

homework before you start making statements like the above.

If you're trolling for the Republicans and their constituency, you'll have to get better at it.

[BigDaddyLove]

57. Because I know next to nothing about...........

Healthcare and it's costs, I'm curious as to which facts (in your opinion) micsca got wrong and why you think she/he needs to do more homework.

That post seemed fairly well reasoned to me, can you provide more information on the subject?

[Mairead]

59. Well, for starters micsca's claim that low overhead isn't true

That's simple nonsense, as the study by Woolhandler and Himmelstein makes clear. There's tonnes of real data from Canada, the UK, and the US--overheads in the US for-profit system range on the order of 25-31%. Medicare is either 3% or 8%, I don't remember which. Canada is, I think, 15%, and the UK is 6% the last I looked.

[Rose Siding]

42. I'm sure Tom DeLay would race that onto the floor

of the House for Dennis (once hell freezes over)

[Mairead]

48. I'm sure that Dennis's plan has the most public support.

Far more support than anyone else's plan. So it has the best chance of becoming law as well as offering the best chance of solving this problem.

[Praetorian]

8. Rant From an Insurance Agent/Risk Manager

My fellow DU brethren, allow me to enlighten this topic from my perspective.

I could go into some long drawn out stories about my industry and why we charge Dr.'s so much for insurance. I could go into stories from industry where people seem to sue for any old reason.

This one statement, however, normally helps most people understand this situation.

Physicians belong to the oldest Good Old Boys club in America. They are Not governed by a national group, they can easily kill you or me on the operating table while drunk or stoned to the hills and then lose their license in that state, only to transfer to another state to continue practice.

Better yet, that good old boys club (AMA) will come to their aid and throw down the gauntlet "that lawsuit was frivolous" "our guy did nothing wrong, it's just people emotions and endless search for deep pockets".

Well, it's all BS. These Doc's need to start regulating themselves and weeding out the bad ones themselves. While they work in the background to protect every shitty doctor out there, they are faced with only one reality; this country has only one way to stop a bad doctor, break him or her financially so they can't afford to get started agains elsewhere. On top of it, you get the added benefit of smearing them in the press in a highly publicized lawsuit.

Until Physicians (AMA) begin taking out the trash, massive lawsuits are the only way for the rest of us to step in.

I'll wait for all the Doc's here to flame for a while. This is reality and anyone who knows anything about the Huge number of claims that are filed every year and lawsuits that are settled quietly without anyone every knowing are astronomical.

Tell me, when was the last time you walked into a Dr.'s office and found a certificate on the wall listing the number of suits or med mal claims filed against your Doctor? There are only two parties that know that info, the Doctor and the Insurers. If you see rates increase, why do you think that is???

Flame on.

[nothingshocksmeanymore]

10. I agree in part with this which is why insurance carriers also need to

be reformed. They are the ones that actively hide this info as "work product" and for that matter, many of the costs involved with malpractice cases are due to the behaviors of THEIR defense attorneys who have NO restraint when it comes to running up costs defending cases where they really should settle.

But I do suppose that is the next step...first doctors help give carriers what they want...then carriers go after doctors.

If INSURANCE reforms were passed and carriers HAD to disclose more, I venture to guess we would see immediate reductions in costs.

BTW the AMA is a lobbying organization.. What needs to occur is that medical board fellowships need to be pulled on Docs that don't live up to them..if you are a board certified physician who is not practicing in accordance with your board certification, you should lose that certification.

[Praetorian]

11. Sorry But...

Your friendly neighborhood Insurer is legally bound Not to release more information. You see, there is this HIPPA law that won't allow even the release of patient info without the patient's authorization. Then you also have a similar restriction to Doctor Client priviledge that exists in which Insurers violate rights of Doctor's if they release claims history to someone other than the client or an agent authorized by the client. Once released to the Agent, said agent cannot share loss history under the same priviledge or right of the Doctor.

In short, I can't tell you that Doctor X had this claim or that, it's simply illegal and will never change.

Sorry my friend, but there is only one industrial remedy, take the law into a national playing field, force all Doctors or, better yet, medical professionals into a national registry and force said registry to be listed as certificate holder and loss notification recipient. Once done, there would be a single resource that would allow you to review the past activities of your medial professional.

Now, here's the really hard sell. Force a rule that says you lose your license to practice anywhere in the US if you've been deemed responsible for the death, dismemberment or crippling of a patient.

It's ridiculous to believe Insurers are at fault for this. If they settle a case out of court, the physician sues them for settling as they know their rates are going to skyrocket after a paid settlement/loss. If they don't settle, they incur costs that are attached to the clients losses and the client premium still skyrockets. Lose lose.

General and Professional Liability cover you against events in which you've been NEGLIGENT. If you want to blame high premiums, you have no other choice but to blame it on the Negligence of the clientele. As long as you allow those who are repeatedly negligent to move from state to state and continue to practice, you will only see premiums continue to rise.

[nothingshocksmeanymore]

16. HIPPA is a brand new law from last year..Insurance has been doing

this for decades and in matters concerning subpoenas, there are exceptions to HIPPA besides which the patient can sign a waiver waiving HIPPA protections....which many would GLADLY do if it menat they got a fair shake by a carrier

YOur remedies are short sighted and are lacking in several areas. When a patient dies it is often impossible to determine of the fault lies with the doctor, the medications ( too many dangerous ones being fast tracked, the hospital or the delay in approval for care)

Your remedy scapegoats only one aspect of the source.

[Praetorian]

35. Losing Sight NSMA!

I know it get's hard for a lot of onliners to maintain focus but you really should try.

Subpoena info is often locked to protect the personal information of those in question. See Rush Limbaugh as an example.

Hippa releases will go so far, you're so right! All you have to do is get your patient to waive their hippa rights so that their Doctor can get a better rate on insurance in the ultimately vain hope that said savings would be passed on to the patient???? Gosh, you sound kind of Republican there don't you?

As to the causes, let's make this easy and I'll give you some personal data to boot.

My Mother,Rest her Soul, had some medical problems in her abdominal area; ended up having two sonograms <sp> and ultimately a stent placed in a renal artery.

THREE YEARS LATER, IT WAS DISCOVERED SHE HAD LIVER CANCER. After a disagreement with the Doctor's that were treating her cancer, she requested ALL of her medical records to transfer to another Doctor. I lost her about a month later. Within a week of that, I was erading through the endless reports that were contained in my Mother's files. Guess what? That very first sonogram <sp> that was performed three years earlier noted a walnut sized growth in her liver. The person who read the sonogram <sp> actually went far enough to highlight this finding in the first para. of the report.

A couple of years ago, my wife I and I lost our baby to a miscarriage (she was 3.5 months along). Our fabulous physician asked that we go to the Emergency room, which we did. He met us there, confirmed the loss and ordered her release the next morning. A little over a month later, I came home early from work only to find her on the floor and unable to stand. Within 2 hours she was undergoing and emergency DNC..... a treatment that should have been ordered at the time of the loss.

Just recently, my father has had a little under half of his lung removed due to lung cancer. Did great for a couple of weeks and then spent over 4 months battling an ongoing infection in his chest cavity. This infection was treated by two doctors who performed NO CAT SCANS and no Xray's. They continued with stronger and stronger antiobiotics until he was almost dead. Two weeks ago, they opened him up and found that they original surgeon had failed to properly seal a Bronchial tube. Said tube was literally leaking into his chest wall for months while they treated him with Antibiotics.

Now, these are three separate instances in three different states. Surely, you must be right! Surely these problems were caused by insurers?!

Again, as I said before, I am now in Insurance and have been for a long time. I can't begin to tell you the number of claims I hear about in my small city. They range from drunk during surgery to stoned during surgery to assigning a PA to previous scheduled treatments while the Doc. is on the golf course.

I don't claim to know it all! I don't claim to have all the answers, but I can guarantee you one simple thing. Until these Doctors start regulating themselves the way they should be you will never see a remedy to the cost of Med Mal.

It's obvious you know nothing about my industry. It's the law of large numbers. Right now, there are just too many Doctors out there who are between moderate to high risk for insurers. The more these Doctors continue to repeat, the more the entire available pool of Doctors within a certain state will be too small to spread the risk in any way other than that seen as overly burdensome.

You simply cannot continue to ask Doctors to pay only small amounts of premium when their entire field is riddled with Doctors who practically beg for a lawsuit.

Lastly, and for what it's worth, I have never sued a Doctor. Nor have I threatened.

Let's not forget, I'm not talking about the effect of Doctors with minor pleas of patients "he made me more sick" or "he treated my Mother last year and now she's dead"! I'm talking about the huge screw-ups, like the three listed above from my own history. Like the one's noted in an above post about Doctor's leaving in 3 feet long probes after surgery!

What does your foolish plan do to put a stop to that kind of crap? Nothing! But I'll bet you and your Doctors like yours better anyway!

[nothingshocksmeanymore]

44. Can we not get personal? I didn't say there weren't bad doctors

and I know your industry well...I sue them everyday and know their behaviors well.

I don't know enough about the individual cases you offered concerning your family to render an opinion and am sorry for your experiences but I take your word.

I also noted in another post that often these mistakes are not of intentional neglect but of too many patients loaded onto doctors by hospital and HMO's looking to maximize profits at the expense of patient care.

I agree there is not adequate policing? Do you know what the budget is for the state medical quality assurance board in your state? Is it adequate to police and pull licenses from the number of doctors practicing versus the number of complaints they receive?

I don't beleive I offered a specific plan, but I also know that carriers demanding confidential settlements or requiring hold harmless clauses when they settle contribute to the problem.

I further know that all these problems were present PRIOR to the time that carriers took a beating in the market and prior to the time that they demanded tort reform and got in in many states...so by defending your industry in this matter you have opted to shoot yourself in the foot should you decide to sue.

Again, I am very sorry for your personal experiences and have afew I can share myself. I got into my business when my father was left blind and minus a leg from an injury so I am not without a few stories as well.

As far as subpeonas are concerned I think you were reading INTO my post. Patients wave their HIPPA rights when their OWN attorneys are seeking their records..so it goes to reason that if there were another condition in which it would serve their BEST interests to waive their privacy rights (on a case by case basis) they would.

Finally, I have not followed the Limbaugh case close enough to know if HIPPA was the basis on which his records were ordered protected by the judge.

[liberalnurse]

18. Now it looks like the right-wingers and

medical malpractice insurer's have created their own..."Good Old Boy's Club".

[micsca]

28. Doctors are not the main cause of the problem

Doctors are partly to blame. They don’t police themselves well enough.

Insurance companies are partly to blame, they are trying to make up for loses in the stock market.

Lawyers are partly to blame. They do file frivolous lawsuits.

Juries are mostly to blame. They award excessive judgments for non-economic damages, and they wrongly convict doctors who did nothing wrong, but the patient had a bad outcome.

In my state, California, the insurance companies do not set their rates. The state sets each company’s rates by medical specialty, by carrier. One company may charge $10,000 a year for their internists and another company may charge only $9,000. The following year, the first company may charge $9,000 and the second company charge $10,000. It is based solely on the claim-made and loss ratios, by specialty, for each carrier by year. The carriers can’t jack up rates even if that wanted to. I suspect other states do something similar.

The malpractice crisis isn’t nationwide. It is only in certain states. If the fault were that there were a bunch of bad doctors killing and maiming patients, then you would expect rates high everywhere in the nation. Perhaps the reason is something else.

California made a medical malpractice crisis in the early 70’s. A law was passed (MICRA) which limited punitive damages to $250,000 and also limited to amount that lawyers can make. If a lawyer wins a $1,000,000 lawsuit in California, he gets less money than a lawyer in a different state who wins a $1,000,000 lawsuit. This means of course that the injured party gets more of the money. California has no malpractice crisis now. Enacting similar tort-reform

Ultimately, it is not the doctors that pay the high cost of malpractice premiums; it is the patients and taxpayers. It is in everyone’s best interest to have lower malpractice costs.

[JanMichael]

9. Republicans are liars. They KNEW this would happen. It's happened...

...before and it'll happen again.

The insurance rates are simply not dependant on reward caps. They say they are, they keep saying that they are...BUT THEY AREN'T!

[mainer]

12. from a doc's perspective -- and not a flame

I no longer practice medicine. So I have no financial stake in this discussion. But from my own experiences in medicine (and as the spouse of a physician who recently retired at 51 out of exhaustion with that career) I will tell you that physicians are not the bad guys you all seem to paint them as. The vast majority of docs I know are caring, hardworking people who went into medicine -- believe it or not -- because they really DID want to do good. At the University of CA (San Francisco) where I went to med school, my classmates were committed, idealistic young men and women who had dreams of actually saving lives. Certainly, many of them lost those ideals along the way. Maybe it had to do with the $100,000 plus in school debts they wound up saddled with. Maybe it's the cynicism that comes with back-breaking hours of training. (I saw surgical residents forced to work 120 hours a week.) Maybe it's the fact that some docs don't really start earning their high incomes until they're thirty years old -- an age when many other career people already own their own homes -- and feel they have to make up for lost time.

The truth is, many internists I know feel lucky to make $100,000 a year. Admittedly, this is a rural state where docs in general don't earn a lot. But considering their heavy responsibilities, their decade plus of training, and their long hours, I do not believe you can honestly call them a "rich bunch."

Nor would I characterize them as a "boys' club" anymore. Many of my friends are women docs. Many of them are incredibly socially conscious. Many of them are devoting a large portion of their practice to Medicaid patients -- who may not even bring in enough payment to cover the cost of caring for them.

And if you want to blast docs, think of one in particular who's TRYING to change things: Howard Dean.

So please. Stop it with the doc bashing. I know folks like to talk about evil docs. But after decades of hanging around physicians, I cannot think of ever having met a single one who was evil.

[Praetorian]

14. Not Bashing You......

Simply pointing out the obvious.

Allow me quote you: "I know folks like to talk about evil docs. But after decades of hanging around physicians, I cannot think of ever having met a single one who was evil."

Now, allow me to say that you either don't understand or just fail to see the point here. You "cannot think of ever having met a single one who was evil" has nothing to do with it. I, for one, am not portraying Doc's as Evil.

I am, however, portraying your industry for what it is. It simply places the bad acts of Doctors into a black room and refuses to acknowledge the problems.

Convey to all of us, in your years of experience, how many Doctors did you meet that ever had to stand up to a Med Mal charge?

You see, I already know your answer, you're going to say none, or one or two, maybe even five. Now, reasonably speaking, if you've been a Doc. for more than 25 years and have met more than 200 fellow Doc.'s in your time, you've met more than 50! That is a pure and simply fact. 25% of this nations Doctor's have been implicated in a Medical Malpractice claim. Of those, more than 80% are found guilty. Of those, more than 90% continue to practice.

Also, you say "Maybe it's the cynicism that comes with back-breaking hours of training. (I saw surgical residents forced to work 120 hours a week.)"

Sure, we all know about this and most of us laugh about it. You, as well as I, know that this practice of "initiation" began decades upon decades ago when Doc's were on short supply and needed to work the hours. It also prospered because many felt it was good to prep the Doc.s in case of military need.

Now, well, things are different. There are more than enough Doc's to go around, more than enough to fill the hours. Yet this practice continues as part of the "ritual" or "rights of passage" to become a Doc.

Lastly, you say "Nor would I characterize them as a "boys' club" anymore. Many of my friends are women docs. Many of them are incredibly socially conscious."

If you expect any of us to believe this, I'm sorry but it's just not going to fly. Look how many women are in Congresss and the Senate. Would you dare make a statement that those two bastions are Not still good old boys clubs?

At it's heart, the medical profession still see's itself better than the rest. Your industry fosters the resentment that you showed in your post by making you feel you've made all the sacrifices in the world just to help out the sick and needy. I know this may come as a shock to you but I don't own a Mercedes, a BMW, a Cadillac or a GMC Yukon.

What shouldn't surprise you is my wife's Doc. is 28 years old and drives a Mercedes Coup. My wife's OB-Gyn Drives a Porsche and my Doc drives as Escalade.

[Elanor]

21. no way

(1) There are in fact very few females in Congress.

(2) Medical school is four years, internship is 2, residency varies. If your wife's doctor is 28, she's exceptional. My father began practicing medicine when he was 32.

My family practice doctor, aged around 40, takes home 30,000/year. She does a fair bit of charity work; donates one day a week to a local free clinic. She's still paying her medschool loans. Her husband, a PhD, makes more teaching at a university.

There are certainly wealthy doctors, but they don't compare to CEOs and they aren't uniformly evil people, or even uniformly republican.

[Praetorian]

34. Sorry, Eleanor but that's the way it is.

Sorry. I hate to see this type of denigration online but have grown to expect it.

Just don't lose yourself to it. Some people online do post truths and actually know more about some subjects than you do.

[mainer]

39. and she denigrated you ... how?

She talked about her own family physician. She didn't deserve the response that "other people know more about this than you do." Unless YOU happen to know her family physician personally.

[mainer]

36. well, actually you are absolutely wrong about the "boys' club"

>>Lastly, you say "Nor would I characterize them as a "boys' club" anymore. Many of my friends are women docs. Many of them are incredibly socially conscious."

If you expect any of us to believe this, I'm sorry but it's just not going to fly. Look how many women are in Congresss and the Senate. Would you dare make a statement that those two bastions are Not still good old boys clubs?
<<

We weren't talking about Congress and the Senate. We were talking about medicine and whether it's a boy's club.

I think you are operating under assumptions that are decades old.

When I went to medical school, way back in the 70's, 40% of my class was already women.

Today, the number of women applicants has just surpassed the number of men applicants to medical school.

The president of the Maine Medical Association is a woman. In Maine, the governor's top advisor on health issues, Dr. Dora Mills, is a woman.

HMO's now PREFER to hire women because patients demand it.

I am a woman M.D. I ought to know.

You asked: how many docs do I know who were sued during their careers? Probably most of them. And no, 80% of them are NOT guilty. My husband was sued twice. (Once for an incident he WASN'T EVEN PRESENT IN THE HOSPITAL FOR. But since his name was one of several doctors in the chart, he got swept up in the suit.) He fought both suits. He won both times. Many docs who are NOT guilty of malpractice settle out of court because it's cheaper than defending themselves, or their insurance companies refuse to foot the bill for a court defense.

Now, as for whether docs make a ton of money? I doubt many 28-year-old doctors are driving Mercedes, unless they come from inherited money.

The average doc graduates from med school at age 25, and finishes his post-grad training at 28 if he's an internist, at 30 if he's a general surgeon, and at 32 or 33 if he's a neurosurgeon. How is he supposed to afford a Mercedes?

[Malva Zebrina]

22. that is nice

I still had to call for an appointment with my doctor on the DAY I wanted an appointment. I tried once. twice, three times--at 8am in the morning. No appointments available.

This is mid coast Maine--somewhat rural but up and coming. Will you please tell me why this local hospotal and this group of doctors adopts this?

If one is in need of care, do they need to be so anxious about an appointment--and have to call once, twice and so on in order to speak to their doctor?

Pfyyyooooeye== I will pursue alternative medicine-=-this is getting ridiculous. No doctor is on a pedastal--they may have been idealtistic when they were young and starting out--but let me tell you, I am an retired RN--I saw it and I see it now as a vulnerable client.

Uh UH--we are ALL good people, dear retired doctor. From the old school, retired RN, who was taught to "stand up" when a doctor entered the floor and the station,and who did so faithfully in complete adoration of any doctor, I say--phooyey on you all.
If you have allowed yourself and your profession to fall into this trap, then who is to blame?

[nothingshocksmeanymore]

29. I do agree with you in several regards

Many of the mistakes attributed to practitioners are literally created by HMO's and the ridiculous numbers of patients doctors must see a day simply to get their bills paid.

In San Diego, certain hospitals are offering to guarantee physician's incomes in return for referrals which SHOULD be illegal and IS but for how they word the contracts...then the doctor is one the hook to the hospital to refund them any additional income they make over the guarantee'd amount.

There are many conflicts and again, doctors often foot the malpractice bill being the one in closest proximity to the patient care when in fact disasters are contributed to by HMO's, hospitals and poor training on prescribing by drug manufacturers.

I know many young dedicated and caring doctors who REASONABLE HAVE to worry about money given how indebted they are on their student loans..they really aren't greedy and are good docs, but the design of the business is now prohibitive as are their costs.

Still the 95% of good docs don't want to pay for the deliberately uncaring negligent bad docs either and they are forced too..state licensing agencies are often underfunded and can't keep up as well.

[kanrok]

43. I sue doctors and I do have a financial stake in this

But I think you'll be surprised at my take. I have a very high regard for all health care professionals, especially doctors. They generally are the best and the brightest among us. They perform what John Edwards calls acts of "casual heroism" on a daily basis. (as do all health care workers). When I go to my doctor for my annual physical I want to believe him or her when they tell me I'm in good health. I don't hate doctors at all, even those who cause catastrophic injuries to my clients. Almost always the malpractice was based on negligence, not intentional acts. I also believe that doctors are getting squeezed financially. I believe doctors should be paid extrordinarily well for their services, and that the bulk and the majority of malpracitce is caused by a minority of doctors. The way malpractice carriers set rates, it's just like a car owner having his or her rates increased because their neighbor got drunk and caused an accident. I've been proudly doing my job for many years, and I believe that the next time doctors strike because of malpractice rates being do high, they should consider picketing in front of the insurance companys' front door.

[MidwestTransplant]

19. This was never about malpractice insurance rates

it was about Republicans trying to diminish a source of democratic contributions at the expense of the general population.

[Pale Blue Dot]

20. The pundits ignore one obvious fact in these situations

Insurers generally do not make money off of the premiums. They make money by investing the premiums. When the stock market is doing poorly, and when interests rates are low, as has been the case for the past few years, then insurance company MUST raise rates to make up for the lost revenue.

Large jury awards have absolutely nothing to do with it. That's what they found out in Nevada, and that's what they're finding out in Florida.

[revcarol]

26. BINGO!! You won the jackpot!!

If doctors had to pay the full amount of what the medical malpractice actually cost, they would police their own and get rid of the bad apples.

But they have been shielded from this by the company's investing the premiums in the stock market and making a profit. Subsidizes the premium and makes a healthy profit for the insurance company.

Now that the stock market isn't doing so well...doctors are having to pay the whole premium plus the profit for the insurance company.

Add to this the fact that the repugs don't want malpractice lawyers to contribute largely to Democrats and want to force them out of business because they contribute to Democrats, the stage has been set for "Medical Malpractice Reform."

[papau]

30. Finnfan is close to truth - but you are a little off. I've reviewed those

rate setting procedures over the years - I recall the moment in the 80's when the process had to take into account the time value of money - for the FIRST TIME! :-)

The rates were indeed set to make only a small "underwriting" profit (not a loss), with the investments providing the majority of the profit.

But in the greed is good eighties the casualty companies found they could invest long - as in stock - for their short term liabilities - a big no no from the risk management perspective - and make a lot.

Now under Bush they are finding a GOP that wants to help them recover their investment losses - in ALL LINES OF BUSINESS - from rate increases in malpractice combined with cut backs on claims.

From Reagan to the current Bush the insurance companies found that they could lengthen the claim liability - a good thing for risk management given the stock investments - by just not settling claims - leading to more lawsuits.

The actual cost - in terms of premium - of law suit settlements was about 5% on the claim tail used to develope the premium - not a heck of a lot even if doubled to 10% to reflect the current situation. Doubling the part of the premium that funds 5% of the cost is about the same as a 5% premium increase.

The premium increases Doc's are getting hit with are GOP casualty insurance company greed - and actions to cover-up investment mis-management/losses due to poor liability/asset matching.

Doc's are getting screwed today as to income - and a few surgeons making a few hundred thousand after 15 years of near no money while in "training" - and buying that vacation house in the islands from that money - is not going to change the fact that becoming a Doctor is a lousy financial decision.

I had a super primary care doc that inspired my youngest to go into the profession. In his late-thirties he gave up and became a salesmen. Becoming a salesman allowed him to get out from under his 150,000 of med school debt (bankrupcy does not work for med school debt if you continue in the profession because of a special anti-doc law) and to stop worrying about the 70,000 of money owed but unpaid to him after 5 years because of non-payment and slow HMO/Insurance company payment.

Single payer does solve all of this - allowing the doctor to stop being a slave to insurance company profits and bank debt collectors - assuming single payer begins a serious use of government in the provision of health care, including a rewrite of bankrupcy law.

Internship is a word no longer used - but first year residents get about 30,000 and by third year are at 40,000 - and after getting board certified at that point make under 100,000 per year for the remaining 25 years from age 35 to retirement at age 60. Some make a lot - and indeed are large businesses. But there are much. much easier, and cheaper, ways to becoming a small business that earns a lot. These are the top 1% of the population in smarts - and we treat them like shit. Only the 500,000 software engineer's that saw their jobs go to India under Bush have had a worse 3 years - in my opinion.

[Malva Zebrina]

31. I have nothing to say but

:nopity:

[papau]

33. smile :-) great point!

I was pissed at the world today because the pain meds were not working well - then I saw a kid in a wheelchair and remembered the great life I have had.

Your point is well taken:

:toast:

:-)

[Malva Zebrina]

60. I don't know how to take your post

and I am sorry that your pain meds are not "working" but a long time ago I realized that "there by the grace of God go I" is actually an insult to those who suffer. I do not feel comfortable making myself comfortable on the suffering of others. I know many people have been taught that to consider those who suffer more than they, is the right and the most saintly thing to do, but I do not and have not subscribed to that Christian way of thinking. I will not make myself feel better by looking at and comparing my problems to those who suffer.

[mainer]

38. Excellent points

Agree with everything you said. Single Payer is really the way to go.

Medicare is actually a pretty good system. My physician-husband always felt they were easier to deal with than the many insurance companies that always tried to give him the runaround. Plus, the overhead for Medicare administration is extremely low. If only we could get a single-payer system that was just an expansion of Medicare, we might actually be able to afford health insurance for all.

You're right, too, about medicine being a mediocre financial decision. I left medicine about 15 years ago to pursue another career, and am making many times more income than I did as a doctor. It's the only reason my husband was able to retire -- because I LEFT medicine.

[nothingshocksmeanymore]

46. Thanks Papau. This is the best post I have ever seen on the issue.

[pasadenaboy]

41. Actually, both are true

If insurance companies can make enough money off investment income, they don't mind charging less than they pay out, provided the investment income they get from holding the premiums before they pay them out is sufficient.

However, with higher jury verdicts or other costs, it does drive up the cost of premiums, as the amount of premium needed to generate the same amount of profit has to go up.

[RapidCreek]

65. There you have it!

Congrats you win the ceupy doll!

Frivolous Lawsuits? Sometimes. Shitty doctors? Sometimes. Patents getting screwed? More often than not. Malpractice insurers going belly up? Never happened....never will.

RC

[loudnclear]

23. Who didn't know this would happen? The public get screwed once again.

And it couldn't happen to nicer people. The ones most likely to sue for malpractice are the ones who could afford to do so. This stuff has little affect for the majority of us working bloaks, they wouldn't let us near the court room anyway.

[kainah]

32. One more problem single payer resolves

It amazes me that people don't use this as another reason for single payer. Half the reason a lot of people end up suing their doctor is because they have to have the resources to pay for future medical care. And that amount, with the tremendous medical inflation, is virtually unknowable.

But, imagine if EVERYONE had guaranteed access to HEALTH CARE! Poof! Lots of these medical malpractice cases would immediately disappear.

[pasadenaboy]

40. Its a free market

If these guys were making a ton of money, there would be a lot of competition to get into this line of business. They are not, so nobody wants to insure doctors in Florida.

The damage limits haven't been tested and could be thrown out by the courts. No insurance person worth their salt would take those into account until how they will actually work is proven.

[FlaGranny]

51. A good many of the physicians in Florida are not even

from the US. They do come here (and other major metropolitan areas) because they can make more money than they can in their home countries - India, Pakistan, Iran, Philippines, China, Cuba, Haiti, etc. There are a few Brits, Canadians, Germans, and a rare Australian, but they are a drop in the bucket compared to those physicians who come from poorer countries. The competition for med school is nearly all coming from these poorer countries. Does anyone know the actual percentage of foreign students in American medical schools?

[Ilsa]

50. Insurers tried to raise rates in TX after Prop 12!!!

An insurance group that covers doctors and hospitals that have been dropped by other insurers approached the Texas Dept. of Insurance asking to raise rates by about a third on doctors and 68% on hospitals. The Dept of Insurance turned down their request, though , because we just passed Prop 12 (medical tort reform/liability limits) in Sept. 2003.

Gov. Goodhair made a show of indignation about it, but it was too late as the local newspapers realized that it is the insurance companies driving this business.

[kodi]

52. 1 reason i like dean is he can address this issue from personal experince

i have an uncle and brother who are medical doctors, and each lives quite comfortably. yet i know how hard they work and their personal commitment to their patients.

truly the problem with insuring the medical industry is not alone either bad doctors, evil insurance companies or patients with a penchant for law suits.

it apears to be an alamgum of the three.

there is a lot of truth that the "good old boys" network is a problem in that poorly performing doctors are protected b an unwritten code of silence.. and who in the world misunderstands that term as referring only to males? come on, its a euphemism to describe cronism.

how can anyone blame a corporation for trying to increase its profits? that's what they are formed to do in the first place. its when the ethical responsibility they are supposedly vested in by their state granted license is abused that they appear to be evil.

and i know a few people who will sue a doctor for what may not be the fault of the physician, but not many of them. what the right trumpets is the one in a million law suits whose decison is in 7 figures (and usually are reduced upon appeal).

a single payer system, which scrutinizes objectivily the performance of a physican and performance reviews of said physican by both physicians and other people in the health care system seem to be the best way to remove incompetent physicians or reduce their negative impact on all parties involved. and you wont get this in the current system.

i think if we have a national health care system, and a doctor screws up, the cost of recovering the difference between the state of being which a patient would reasonably be expected to have with adequate care versus the actual affect to their lives of the incompetent care can in most cases(but not all) be readily be recovered. in part, this would mean that in such a system, each physician would be doing pro bono work for aggrieved patients from the incompetence of other physicians as a part of the protection they would garner from lawsuits under such a systyem. this would force physicians to shoulder the burden of the incomptence of other doctors and i am sure that the competent doctors would readily want the incompetent ones removed from such a system.

one question i have always had when incomptent doctors are mentioned is "how the hell did they get thru medical school?"

[Unforgiven]

54. Here's Hoping

That each and every doctor that supported legislation to limit lawsuit amounts, are the very same that see increases in their premiums.

[ellie]

58. Oh doctors!

After my father contracted an antibiotic-resistant staph infection in the hospital, the POS heart surgeon told my family that he must have contracted it from the tube the paramedics shoved down his throat to get him to breathe. Of course it wasn't the pig valve they put in his heart, hell no! The same one that had to be removed because it seemed that is where the infection was coming from, you know, it was pus-filled. The isolation ward he was in was filled with people who had antibiotic-resistant staph infections, no doubt contracted from the ambulance ride! Right. My father died after a six-week struggle and after the POS said to us, "Mr. ____ is a strong man. I thought we would be dead weeks ago."

After my father died, my mother contacted a lawyer about suing that POS, but the lawyer told her that it would cost too much money. We would have to hire our own experts to testify against him. So, my mother didn't sue. But she did get a nice big bill in the mail, nearly half a million dollars, for his stay. I will never forget her face when she opened the envelope. My god, she said. They want me to pay them for killing him.

Later, this POS doctor operated on my aunt and killed her too. The hospital he works at touts itself as the "Heart Place." What a crock of shit.

I am sure he enjoyed his holidays.

[goforit]

61. These Insurance companies have got to go! They're robber barrons!!

Unbelievable!!!

[Malva Zebrina]

62. Look, we hire people to advise us as to our health

we pay doctors to do this. We, who have worked all of our lives to pay people for their services, hire doctors in the exact same manner as we hire plumbers or electricians or any other. Doctors are not, I reapeat are NOT any thing extraordinary when it comes to the services offered and that is exactly the way they should be viewed. They are NOT saints and they are NOT saintly. We pay them, and we should expect the services we pay for. Period.

They asked for that and they have been in control of that service for a long time, exploiting the position that they are in some way very , very good and nice -people--they are as nice as the plumbers and the electricians and I am sorry that it cost them so much to educate themselves into that profession, but, that is NOT the fault of the client.\\


I am sorry to say but doctors cannot expect to be those who will not get sued because they cut off the wrong leg. That it cost them so much to gain that licsense is too bad. It is about time that the doctors in this country become less snotty and less elite about their "knowledge"--they can do harm and they do do harm and they have in the past covered up the harm that they do .

[MattNC]

64. i think i'm smart

but man i don't understand health care policy at all...

[stevebreeze]

66. Medical malpractice is less then 1% of health care spending

Can any informed person really think limiting the people right to redress their grievances to a set dollar amount will lower overall health care spending significantly?

single payer is the ONLY answer!

:kick: