Re: What will universal healthcare be like?

On 7 mar, 10:50, "Capitalist Pig" <cochon-capitali...@xxxxxxxxxxx>
wrote:
Physicians pay malpractice insurance and the cost of the premiums is
driving them out of business. I read recently that in Las Vegas the
cost of medical malpractice insurance annual premiums have risen in
some cases from $40,000 to $200,000.


The truth is that the global costs are low. And the reason for
the high premiums are elsewhere.

Don't grab and run with any old special interest report, stay
with academic sources or an honest newspaper

****


Rising doctors' premiums not due to lawsuit awards
Study suggests insurers raise rates to make up for investment declines

By Liz Kowalczyk, Globe Staff

Re-igniting the medical malpractice overhaul debate, a new study by
Dartmouth College researchers suggests that huge jury awards and
financial settlements for injured patients have not caused the
explosive increase in doctors' insurance premiums.

The researchers said a more likely explanation for the escalation is
that malpractice insurance companies have raised doctors' premiums to
compensate for falling investment returns.

The Dartmouth economists studied actual payments made to patients
between 1991 and 2003, the results of which were published yesterday
in the journal Health Affairs. Some previous studies have examined
jury awards, which often are reduced after trial to comply with
doctors' insurance coverage maximums or because the plaintiff settles
for less money to avoid an appeal. Researchers found that payments
grew an average of 4 percent annually during the years covered by the
study, or 52 percent overall since 1991, but only 1.6 percent a year
since 2000. The increases are roughly equivalent to the overall rise
in healthcare costs, said Amitabh Chandra, lead author and an
assistant professor of economics at the New Hampshire college.

''One of the things we know about medical malpractice payments is that
they're usually made when an injury occurred," he said. ''The injury
has to be treated. And if it's more and more expensive to treat
injuries, then that will be reflected in payments."

Meanwhile, malpractice insurance premiums for internists, general
surgeons, and obstetricians have skyrocketed since 2000, jumping 20 to
25 percent in 2002 alone. In Massachusetts, ProMutual Group, which
covers about one-third of the state's doctors, raised rates an average
of 11 percent last year, 20 percent in 2003, and 12.5 percent in 2002.
Some specialists, such as obstetricians, now pay almost $100,000
annually for their malpractice insurance. ProMutual executives said
they will not raise premiums this July, primarily because increases in
the number of claims have slowed.

''It's not payments that's causing this," Chandra said. ''The simple
explanation that comes to mind is the underwriting cycle. If they're
making less money from the investment side of things, it's going to
cause [insurance companies] to raise rates."

The study's conclusions are sure to generate praise from some
malpractice lawyers and outrage from many doctors and insurance
company executives, who argue that jury awards are out of control and
the solution is a cap on noneconomic damages for plaintiffs, commonly
referred to as ''pain and suffering" awards.

The American Medical Association, a national organization based in
Chicago that represents doctors, and the Physician Insurers
Association of America, a coalition of malpractice insurers based in
Maryland, are lobbying for a nationwide $250,000 cap, and President
Bush has made a cap on noneconomic damages a key component of his
malpractice reform proposal.

Another study published in the same issue of Health Affairs found that
doctors are gravitating toward states that cap malpractice awards,
particularly obstetricians. Between 1975 and 2000, the number of
obstetricians increased 40 percent in states that enacted caps during
the 1980s, compared to an 8 percent rise in states without caps.

Doctors and insurance executives criticized the Dartmouth study on
payments for several reasons.

''We don't think this study will have much effect because there are
too many other studies that contradict it," said Dr. Donald Palmisano,
past president of the medical association and a surgeon in New
Orleans.

He said other studies have found that doctors' malpractice premiums
increased more quickly in states without caps on pain and suffering,
bolstering the group's position that caps are a solution to the
problem.

Dartmouth researchers drew their data from the National Practitioner
Data Bank, to which insurers are required to report payments made on
the behalf of physicians. The physician insurers association as well
as the federal government have criticized the data bank because
payments to hospitals are not reported -- unless a payment also was
made to a doctor in the case. Because of this, Chandra acknowledged,
his study could have slightly underestimated payments.

Dr. Barry Manuel, ProMutual's chairman and a surgery professor at
Boston University, said that study's authors also did not account for
the rising cost of defending malpractice cases. Last year, ProMutual
paid $97.4 million to settle claims, plus another $20.5 million to
defend unsuccessful claims and $11 million to defend claims in which
the patient was successful in winning a monetary settlement or award.

''What we've seen at our company is there's been some moderation in
frequency of claims but the severity continues to rise," Manuel said.

Marc Breakstone, a Boston malpractice lawyer, called the Dartmouth
study a ''beacon of truth. This absolutely proves that the propaganda
of the AMA and the PIAA is just that, it's nothing more than
histrionics," he said.

Liz Kowalczyk can be reached at kowalczyk@xxxxxxxxxx
© Copyright 2006 The New York Times Company


.

Quantcast