A Real Problem
There is no question that we have a problem. The Medical Malpractice
insurance market is broken and rates are sky-rocketing. Senator
Murray hears from doctors throughout Washington State about the
challenges that soaring malpractice insurance premiums are causing.
In some specialties, like OBGYN, the malpractice insurance market
is failing doctors and patients. In other specialties, it's approaching
collapse. That's putting tremendous burdens on health care providers.
We cannot sustain these soaring premiums. Senator Murray knows
it's a serious problem, and she is working on it in the Senate.
No Quick Fixes
Senator Murray also recognizes that this is
a complicated problem, influenced by a host of factors, and realizes
there are no quick fixes.
This problem didn't develop overnight, and no one policy change
will solve it overnight. Murray has worked with our state's medical
community on everything from Medicare reimbursement rates to research,
and funding a robust public health system. She wants to pass solutions
that will really solve the problems.
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Murray's
Action Plan
Senator Murray signed onto a bipartisan bill (read
the bill, see
cosponsors, bill summary)-
along with Republican Senator Lindsey Graham and Democratic
Senator Dick Durbin - that would make a difference, and
help carry out her malpractice reform action plan.
1.
First, doctors and hospitals need immediate relief
The debate that is occurring on the floor of the Senate
is about a proposal that proponents claim will –
at some point in the future stabilize rates paid by doctors
and hospitals. But there is no guarantee that these savings
will ever be passed onto doctors and hospitals.
That’s not good enough. Doctors and hospitals need
to get immediate relief.
Even if current proposals that cap non-economic and punitive*
damages were passed this year, it is impossible to predict
when, if ever, doctors and hospitals would see relief.
In state’s where this approach has been tried, medical
malpractice insurance rates still continue to rise substantially.
Senator Murray supports a bipartisan bill known as the Better
Health Act of 2003 that would provide immediate relief
to health professionals who experience above average increases
in their malpractice premiums.
How it Works:
- Doctors in high-risk specialties would be eligible
to receive a tax credit equivalent to 20 percent of
their malpractice premium.
- Doctors in lower-risk specialties would be eligible
for a tax credit equivalent to 10 percent of their total
malpractice premium.
- For-profit hospitals would be eligible for tax credits
equivalent to 15 percent of their total malpractice
premiums.
- Non-profit hospitals, it would provide relief through
a new grant program.
2. Cut Down
on Frivolous Lawsuits
Second, we've got to cut down on frivolous lawsuits.
Under the bill Murray supports, every plaintiff attorney
that files a medical malpractice case would be required
to include an affidavit by a qualified health care professional
verifying that malpractice has occurred. No more launching
lawsuits that don't have merit. And anyone who violates
this affidavit is going to be punished with strict penalties
– and those penalties will increase.
- First-time violators will pay costs and attorneys
fees.
- Second-time violators will pay an additional fine.
- And if someone violates this process a third time
– they'll pay court-imposed penalties and will
face disciplinary action by the State bar association.
3.
Protect the Doctors Who Serve Medicare, Medicaid and
S-CHIP Patients
Senator Murray wants to provide additional protections
for doctors who serve patients through Medicare, Medicaid
and S-CHIP.
Doctors with a 25 percent caseload of Medicare, Medicaid,
and State Children's Health Insurance Program (SCHIP)
patients would be protected from punitive damages. Exemptions
would only be allowed for cases involving sexual abuse,
assault and battery, and falsification of records. Other
than that – there will be no punitive damages for
doctors who are doing the right thing and serving Medicare,
Medicaid and S-CHIP patients.
4.
Underwrite the Risk
Furthermore, under Murray's bill the federal government
would look at underwriting some of the risk in malpractice
insurance – just as we have with terrorism and flood
insurance. Doctors should not have to shoulder
the burden of malpractice risk alone. When insurance markets
are broken, the federal government traditionally steps
in to underwrite the risk. We did this when there were
major problems with flood insurance and with terrorism
insurance, and malpractice insurance certainly calls for
a similar solution.
5. Reduce the Number
of Medical Errors
Finally, this bill would help reduce the number of medical
errors by creating a voluntary system for providers and
patient safety organizations to share medical error information
through a National Patient Safety Database, as recommended
by the Institute of Medicine in its study entitled "To
Err is Human." Health providers would be immune from
legal repercussions and would be able to help other doctors
learn from their mistakes. In addition, this bill would
create a new Center for Quality Improvement and Patient
Safety in the Agency for Healthcare Research and Quality
(AHRQ) to promote safety.
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Concerns with Caps
Some people believe that the only answer is caps. And frankly,
a lot of people are spending a lot of money to make that the only
idea on the table when malpractice reform is discussed. Senator
Murray has a couple of big concerns about this approach.
While we can probably all identify cases that don't make a lot
of sense, tampering with the justice system this way poses serious
risk. In addition, insurance regulation has been clearly established
as within state jurisdiction for a long time - federal involvement
should be judicious and respectful of the states. Finally, there
just isn't a lot of evidence that it would work.
The federal government has gotten involved in broken insurance
markets in the past - flood and terrorism insurance are the big
examples. In both of those instances, we provided a backstop to
a broken market.
Senator Murray thinks the bipartisan Graham-Durbin bill is more
effective because it provides:
-
direct financial relief to doctors.
-
It cuts down on frivolous lawsuits.
-
It limits liability for doctors with high Medicaid caseloads.
-
And it will have the federal government underwrite the risk
of malpractice insurance – just as we've done with terrorism
and flood insurance.
This is a much more comprehensive – and ultimately -- more
effective approach. We know it works because we've done it before.
We know it's immediate. It provides help now – rather than
waiting for some trickle-down effect. It also maintains the integrity
of our justice system, and it allows individual states to continue
to deal with this issue as they see fit.
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