European Stars And Stripes (Newspaper) - December 8, 1985, Darmstadt, Hesse This year if the traditional lawsuit is the fairest and most efficient Means of dealing with personal and property damage cases " malpractice lawyers for their part argue that doctors should not be singled Oul for Protection. Ii the courts Are jammed with civil suits they add. Only 3 percent of them involve rna Prat a unlike the 1970s crisis this one has to do w Ith Cost of insurance not availability. Whatever changes in tort procedures lawsuits have continued to proliferate even in California. Insurance companies have raised their rates accordingly to Light or Settle suits. James Corcoran. New York s insurance commissioner Early this year granted a 52 percent Premium increase to a Carrier in that state. He conceded it was ridiculous but said state Law required insurance companies be solvent As a result. Neurosurgeons in a High suit area like Long Island now pay More than $100.000 a year Lor coverage their colleagues in Pennsylvania Are paying $59.370 this year an increase of 104 percent Over 1984. Says or. Sylvan Eisman. A lawyer and internist in Philadelphia there Are Loo Many lawyers especially in Urban areas looking Lor Patricia Dianzon is not too sure that s the cause. The conventional Wisdom is that the number of lawyers is related to the number of suits. I have no figures to support perhaps doctors in part Are victims of their own Al Luence. How Many of doctors have gone broke none responds malpractice lawyer Lawrence Grant of Paoli a. In answer to his own question. Malpractice insurance is just a Cost of doing business. This crisis in t a crisis. It s just an attempt by physicians to defeat their Only enemies Justice and the insurance companies tugged otherwise payments to claimants in 1978 were about 57 percent of Premium income. In 1982 the ratio was 110 percent according to Best. In other words medical malpractice insurers Are losing Money says Joseph Nardi. President of medical services Lor the St. Paul fire and Marine insurance co. If we re so profitable Why in t there an insurance company on every Street Comer says Timothy Morse senior marketing officer Lor the same firm. Scott Baldwin replies Back in the Early 1980s, the companies were investing their reserves at those Nice 20 percent interest rates. There was Somo rate cutting among the companies because they were fighting Over Premium dollars to invest at those Nice returns. So now interest rates Are Down and the companies Are hitting the soft touches the doctors who can Alford it. I Don t blame the doctors. I d be mad people like Scott Baldwin just Don t understand the insurance business the companies argue. One year s balance Sheet Means nothing. For instance. In most states a minor can sue Lor birth injuries until he or she reaches adulthood. St. Paul says it gets 40 percent of its suits three or More years after the alleged injury. It currently has one that dates to 1962. Given those time spans and the seemingly Ever rising rate of suits and jury awards the companies to stay solvent and satisfy state insurance examiners must put aside huge sums As reserves against future claims. The Scott baldwins see the income irom these reserves As profit. The companies As prudence. To look at one Good year As an example of profitability they say. Is to ignore the Long tall suits and their settlements drag across years of balance sheets. The Bedpan Mutual generally do not have the massive reserves nor sometimes the underwriting experience. They Are similarly beset. The average claims against the doctor companies were 12.17 per 100 physicians in 1979 and 20.3 in 1983. Best gave Only six an a rating in a study of 33 of the doctor companies. A lot of the others Are in a bad says Tierny old is Normal. On the other hand companies like his being a owned by doctors can be very effective in screening out the High risks in their own profession. Normal Tor instance slopped anaesthetists from leaving the operating room while surgery is in Progress. On average the american doctor pays about the same Lor malpractice insurance As he did 10 years ago 3 percent of Gross income. But the premiums for specialists Are As noted much higher. A family doctor in i Arkansas May pay $1,400 As opposed to $80,000 for a " brain surgeon in it. Lauderdale. This could change the distribution of health care and May already have i in new York who fatal Are High Only 25 percent i of the Young doctors who serve their Hospital residency Mobers 1985 i. A if m in the state stay on to practice there. In recent years the increase of obstetricians per 100.000 people in new York has been 17.5 percent. In the rest of the country it is 26 percent. Parts of Florida another High Premium state have shortages of baby doctors we see it potential mass exodus of senior specialists Harlan Knudson. Executive director of the washing Tor medical association we won t he without care but we my lose some of the Quality of the Rural sections of Nevada most of the Senle have seen that already. It s a disaster and May be what will happen says or. . Pal Crow of the Otyce of Rural health at the University of Nevada year the Oul of state company that covers Nevada said Rural family doctors who also delivered babies faced still Premium increases. Twenty percent of them made Good on a threat to quit obstetrics four obstetricians in Ely got a Bill for $160.000 for the next year. They were delivering about 100 babies a year. In collect they were paying $1,600 a baby Lor the parents to sue them says Crow in Yerington. Which has about 4.000 people the doctors All quit and the women have to drive 60 Miles to Fallon. The Rural doctor is at double risk Lor suit because he s held to downtown san Francisco standards and he can t share the risk with a Hospital. The average doctor in Rural Nevada pays about $7,000 now. Next april it will be $11.000. If he delivers babies it will be $16.900. Ten years ago it was something like $1,000 or $2,000. He s probably netting about $60.000. What s he going to do there s a limit what a Rural doctor can pass on to his patients. Once you kill a system of Rural health it s very difficult to build it up again. My comment to the trial lawyers is they re driving the doctors out of business. They won t accept reasonable limits in what they sue for. Malpractice is made out to be very complicated. To Rne it s very simple. You get this huge insurance Reserve built up. And people Are taking a shot at ii the future Lor Nevada is Uncertain so it is Lor the rest of the country. One worrisome aspect is that studies show Only about 10 percent of the medically injured Ever sue. Many of the non users Are poo who do not know yet the Legal recourse open to them. There Are those who criticize the insurance companies for not being Clear eyed enough in the Days o High investment returns to see what was coming. The state regulators did t always help either Sayr Danton Florida and new York kept rates under control deficits built up claims built up and now premiums Are going up to meet the California skirted the problem to a degree because companies there can put a rate increase into effect and ask Lor stale approx later. Bui regardless of who is to blame Lor the current state of affairs it is John o. Patient who will ultimately pay the Bill. He already is paying $1 billion a Day Lor health care. Cog says that 74 percent of its obstetricians have passed on at least part of their Premium increases to their patients. Rale jumps have added $1.000 to the Cost of having a baby in new York s Long Island. In the atmosphere of litigation doctors Are increasingly practising defensive Medicine extra lab tests and any other procedures to flesh out the Chart against future suits. The Ama puts the Cost of this at $ 15 to $40 billion a year. No one knows for sure this May not necessarily be a bad thing. Danton has said some defensive Medicine is precisely the increased care which the malpractice system is designed to but assuming defensive Medicine helps Stem the lawsuit Binge it will not do it single Anderly. Says Tim Morse of St. Paul you eliminate malpractice from occurring by better education of doctors As to the risk areas improved doctor patient relationships better peer review of doctors by doctors by tort the Ama has embarked on a Campaign to do just that. A panel in new Jersey recently completed a study of malpractice. It recommended doctors take 150 hours of consecutive study every three years to update their practice. It also recommended bar associations set up review boards to screen the activities of malpractice attorneys. High malpractice costs can be ascribed to no single the report said not incompetent doctors generous juries or aggressive attorneys. Rather it is an accretion of weaknesses in the malpractice the stars and stripes Page 15
