FOR
IMMEDIATE RELEASE CONTACT:July 2002
Are you willing to wait nine months to get for an appointment with to seea specialist, or to travel out of state for to receive specialty care? Floridians could be doing just that if malpractice premiums continue to skyrocket , exacerbateing an already gloomy prediction: the United States will be short 50,000 physicians in 2010 and 200,000 by 2020.
Unfortunately, Florida is a leader in the following trends that promise to seriously compromise access to medical care. Some insurance experts call this "the perfect storm" because so many things are happening at the same time:
After more than a decade of stablerates for malpractice insurance rates, Florida physicians and those in seven otherphysicians in eight states saw two or more liability insurers raise ratesrate increases of by at least 30% or more in 2001. – and Florida physicians were among the hardest hit.
In fact, Florida internists, general surgeons and OB-Gyns paid the highest rates in the nation in 2001. Worse, iIndustry analysts are predicting that premiums will rise again this year and into 2003 – by another 8 to 18 percent. Premiums are highest in south Florida, but the increases are quickly moving throughout the state.
Annual malpractice insurance premium ranges
|
Internists |
General Surgeons |
OB-Gyns |
|||
|
Florida |
$27-55,700 |
Florida |
$63-159,000 |
Florida |
$143-203,000 |
|
Michigan |
$18-24,000 |
Texas |
$34-134,000 |
Texas |
$70-161,000 |
|
Illinois |
$16-28,000 |
Michigan |
$67-94,000 |
New York |
$89-115,000 |
|
Texas |
$15-26,000 |
Illinois |
$50-70,000 |
Michigan |
$88-125,000 |
|
New York |
$17-21,600 |
Ohio |
$33-60,000 |
Illinois |
$89-111,000 |
Due to enormous financial losses, some insurers are pulling out of the malpractice market altogether le including some in Florida leaving physicians without policies. Saint Paul Companies, the nation’s second largest malpractice insurer, stopped writing malpractice insurance earlier this year, citing $1.50 in claims paid for every $1 in premiums. PHICO, the third largest insurer in the stateFlorida, wrote $7.7 million in premiums in 2001. However,The company was forced into liquidation this past February by insurance officials in its home base state of Pennsylvania when it’s surpluses fell too low. PHICO to less than $7-million. It gave its 219 Florida policyholders 30 days to find new coverage.
But where to find it? Clarendon National also exited the Florida market, while another state carrier – Zurich American Insurance Co. – recently announced that it would no longer cover small physician groups or individuals. Some A significant number of the remaining 40 or so companies that offer malpractice carriers insurance are expected to follow suit as they are reevaluating their policies and deciding whether or not they’ll to continue to write them.
Insurers blame the rate increases on skyrocketing jury awards. While the number of lawsuits has held steady, the average jury award jumped from $1.95 million to $3.39 million between 1993 and 1999. This is a 79% increase during this time, with an additional 43% added on in 2000.
Florida is one of the highest-growth states. In 2000, the state ranked third in the nation for total malpractice jury awards – with $321,079,744 in awards paid by insurers. Only Pennsylvania ($352,309,905) and New York ($632,996,221) were higher.
Neurosurgeons, obstetricians, radiologists, emergency physicians and other high-risk specialists have been hardest hit. In some places, these specialists – even those without a history of lawsuits – cannot find an insurance company willing to provide coverage.
As a result, some physicians are leaving Florida and other high-rate states like Pennsylvania, West Virginia, Mississippi, Texas and Nevada. An Orlando neurosurgeon moved his practice to Louisiana last year partly, he said, to escape Florida’s soaring malpractice rates. Two partners in a three-physician Orlando OB/GYN practice recently relocated to North Carolina and Georgia, leaving just one partner here. Three Orlando orthopedic surgeons have moved to other states since January of this year.
Others are dropping high-risk procedures and ER call. For example, more and more orthopaedic physicians refuse to take ER call in Central Florida – even though it is required by hospital by-laws. In one Florida county, only one neurosurgeon will take ER call. "These patients are the ones who sue," one physician said.
"They come in from auto accidents or other emergency situations like aneurysms, and sometimes don’t have the best outcomes. And the malpractice lawyers are just waiting for them to call."
Radiologists and other physicians who do diagnostic procedures are also increasingly at risk for lawsuits. A radiologist in the New Port Richey area has stopped reading mammograms at a private clinic, and other Florida radiologists are following suit.
Still other physicians are retiring early. They are closing their practices instead of finding "replacements" – because there are none to be found.
Hospitals in Central Florida and most of the state require physicians to carry medical malpractice insurance. However, some physicians in south Florida – where rates are among the highest in the nation – are foregoing malpractice insurance altogether, or "going bare." Because the hospitals need the physicians’ services, they are allowing this bylaws exception, while requiring proof that the physician can pay a malpractice award of $250,000.
The danger of going bare? If the physician has no malpractice insurance, it’s likely that lawyers and plaintiffs will shift their focus to hospitals and others – not addressing the real issue of excessive jury awards.
Tort reform?
Many states are looking at tort reform – capping "pain and suffering" awards (i.e. non-economic damages) for malpractice suits. While Florida currently has a $250,000 limit on these awards, it applies only if both sides agree.
Proponents say tort reform takes the incentive out of excessive medical malpractice suits. Under such reform, victims would be paid or reimbursed for their medical care and lost wages, while pain and suffering, jury awards, and trial lawyers’ settlements or fees would automatically be capped.
In April, a bipartisan coalition of representatives introduced a federal tort reform bill, however most efforts are being led state by state. California adopted tort reform in 1975, and other states are looking at that model for guidance, as it has been successful out west. Few California physicians are leaving the state as many cite their malpractice insurance is affordable – allowing them to do their jobs. Many local physicians are hoping the Florida legislature will cap pain and suffering awards at $250,000 for all medical malpractice cases, which will help to keep malpractice insurance costs down.
It appears that the public may support tort reform as well. An April poll of 1,000-plus Americans showed that:
Facing the "Perfect Storm"
Many see the malpractice issue as yet another "lightening bolt" in a state with one of the worst nursing shortages in the nation, a rapidly growing elderly population, high numbers of uninsured residents, declining reimbursement, and seriously overcrowded emergency departments.
In fact, many health professionals in Florida believe that the worst is yet to come for our already over-taxed health care system. The question is: what can we, as citizens and health providers, do to "batten down the hatches" against the forces that threaten our healthcare systems?
Malpractice reform may be one answer.
1. Medical Liability Monitor 8. Health Affairs, Jan./Feb. 2002
2. Jury Verdict Research 9. Internal Risk Management Institute
3. Florida Hospital Association 10. USA Today, 12/3/01
4. Health Care Liability Alliance 11. Pennsylvania Medical Society
5. American Medical News, 12/3/01 12. Wirthlin Worldwide Poll for Health Care Liability Alliance
6. The Orlando Sentinel, 1/20/02 13. Tallahassee Democrat
7. Amednews.com
This Health Issues release is located
on the Internet at: http://www.floridahospital.org/
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