News and Commentary

Malpractice Fury Raises Concerns About Access

Protests by physicians over rising malpractice insurance premiums may be signaling a political shift that could make doctors see Republicans as their allies, a public-advocacy official thinks.

On April 27, when about 2,000 doctors marched in suburban Philadelphia to protest the rates, Frank Clemente, an official of the advocacy group Public Citizen, recalled what White House strategist Karl Rove said last year. Rove had commented that the debate over a Patients' Bill of Rights had divided doctors from the GOP.

"He said that was the wrong playing field and the Republicans had to get them back," Clemente told the Washington Post.

That's just what seems to be happening in the GOP's embrace of malpractice as an issue that threatens to bury the Democratic-led coalition of patients and doctors seeking broader legal liability for HMOs.

"To have these white-coated doctors marching around state capitols is a tremendous public relations win," Clemente added.

The rally in Pennsylvania was just the latest display of physician outrage and frustration with malpractice insurance premium hikes. Most of the barbs were aimed at trial lawyers, as reflected in one sign: "Doctors Take Oaths, Lawyers Take Money" (but see the Compensation Monitor for some contradictory information).

While managed care organizations, for the moment, seem to have found some shelter through all this, the issue has more than just public relations and long-term public policy implications. Access to doctors may become a chronic problem for health plans.

As the Philadelphia Inquirer noted, "Speaker after speaker warned that young doctors were leaving Pennsylvania and that patients would lose access to health care if mushrooming malpractice premiums were not curbed." Pennsylvania is 1 of 12 states identified by the American Medical Association as being in crisis, with Florida, Georgia, Mississippi, Nevada, New Jersey, New York, Ohio, Oregon, Texas, Washington, and West Virginia.

Physicians, state medical societies, the AMA, and the American Association of Health Plans are among those who have been petitioning state and federal legislatures to resolve issues that contribute to the problem.

Without definitive action, several scenarios promise to play out in the crisis states. Many doctors will retire early, others will move to states where they can develop more lucrative practices, while still others will leave the profession altogether.


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