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Florida Bills Would Raise Malpractice
Insurance and Eliminate the Option to "Go Bare"
Why
we OPPOSE these Bills. (Feel
free to use any information here for your own letters.)
Mail
and E-Mail Addresses of Senate and House Committee Members to
which bills have been referred for review (Word document)
Click here for an e-mail only
list of most of those committee members. (Word)
Download Flyer for Physicians on the Bills with main committee office addresses
only.
SB 972 AND HB 665:
The Senate version of this
bill was filed February, 2005 by Sen. Dennis L. Jones, a chiropractor
from Pinellas County. An identical version of the bill was filed
in the House by Rep. Frank Farkas, also a chiropractor from Pinellas
County.
The main proposals of the
bills are:
· To increase the minimum amount of malpractice insurance
coverage for ALL physicians.
A. For physicians NOT performing
surgery OR WITHOUT HOSPITAL PRIVILEGES, you would be required,
as a condition of licensure or renewal, to have in malpractice
insurance coverage, escrow or letters of credit :
$250,000 (currently $100,000)
per claim and a minimal annual aggregate of not less than $750,000
(currently $300,000)
B. If you HAVE HOSPITAL PRIVILEGES
OR perform surgery in an ambulatory center or hospital, you would
be required, as a condition of licensure or renewal, to have
in malpractice insurance coverage, escrow or letters of credit
$500,000 per claim (currently
$250,000) with a minimum annual aggregate of not less than $1
million (currently $750,000).
· To remove the statute language that allows
physicians to 'go bare'.
('Going bare' is a form of self insurance in which the physician
currently must prominent post notice that he or she does not
carry malpractice insurance and agrees to be financially responsibility
up to the amounts of currently required insurance coverage.)
GOING BARE WILL NOT BE PERMITTED if these bills pass (unless
the physician is part-time and has less than 1000 patient contact
hours per year.)
During my conversation with Sen.
Jones' legislative aide, she read the "Talking Points"
to me. Sen. Jones' view is that only 7% of doctors are 'bare',
that this bill would close a loophole in the law that allows
them to do that. To him, this is about patient protection and
fairness to the other 93% of physicians who DO pay malpractice
insurance. He thinks that the amounts of insurance currently
required are old and inadequate for costs today.
Why
We Oppose the Bills:
1.
The bills do not protect or help patients in any significant
way.
2.
The 7% of physicians who 'go bare' are still financially responsible.
There is no widespread problem with non-payment.
3. Those 7% are nearly all physicians
in high risk specialties like general surgery, orthopedic surgery,
neurosurgery, thoracic surgery, OB-GYNs and now, an increasing
number of radiologists. To carry malpractice insurance at CURRENT
rates would range from $180,000 to over $250,000 per year. Florida
has the highest premium rate in the nation.
4. This bill will raise malpractice insurance
for ALL physicians 37-45% which will make it even more difficult
for the 93% who have malpractice insurance to keep it. It
also threatens the ability of these physicians to stay in practice.
5.
These Bills do NOT promote ethical health partnership, and are
unjust. They place
undue burden and do not promote the good of patients or physicians.
The only beneficiaries are malpractice insurance companies.
5.
The bills do not begin to address the real problems in healthcare, including those of malpractice,
patient injury and compensation (even when not malpractice),
or other issues.
Urge your Senators to vote NO on
Senate Bill 0972, and your Representatives to vote NO on House
Bill 0665. Click
here for mailing and e-mail addresses of committee members
reviewing the bills. Click here
for an e-mail only list of most of those committee members.
1.
These bills do not protect or help patients in any significant
way.
a)
Determinations of awards in medical malpractice are NOT based
on how much insurance coverage the physician has. They are based on medical costs and
economic loss that results or will result from the injury, and
the intangible 'pain and suffering'. Most physicians carry the
minimum amounts because of the high costs. Most cases involving
an award (not settled) exceed insurance coverage. The bills do
not add benefit for the patient.
b) Physician's who chose to 'go bare', are
still financially responsible by law. The difference is that payment is made from their
personal assets instead of insurance. If they do not pay, they
permanently lose their license.
c) There is NOT a problem with
payment of judgements by physicians without malpractice insurance. In fact, physicians who have 'gone bare'
are often more willing to settle the claim rather than risk all
their assets either in payment of significant legal costs or
risk a jury verdict. . . whether or not they have provided substandard
care.
The option to go bare has been
available since 1986. Research going back to 1997 shows that
only 5 physicians have been disciplined for non-payment of a
judgement against them. Three of those five eventually paid.
The other two permanently lost their licenses. (Source: Florida
Medical Association)
2.
The 7% of physicians that 'go bare' are nearly all physicians
in high risk specialties like general surgery, obstetrics-gynecology, nuerosurgery, thoracic surgery.
Radiologists are beginning to chose that option. More recently
a small number of internists are 'going bare'.
A 2003 survey by the American
College of Obstetrics and Gynecology showed that 33% of Ob-gyns
in Florida had 'gone bare'. In 2002, 14 of 16 neurosurgeons in
Broward County had 'gone bare'(Source: Testimony to Judiciary
Committee in Washington, DC March, 2003). I also read (but need
to find the source) that all neurosurgeons in Miami/Dade area
had gone bare. Significant numbers of general surgeons have gone
bare.
3.
For these physicians, and a growing number of others, the current
insurance situation in Florida does not make it viable for them
to maintain malpractice insurance.
Florida already has the highest malpractice premium rates in
the nation! And, it is estimated that if this bill passes, it
would raise premium rates another 45% for surgeons and other
physicians who have hospital privileges, and 37% for all other
physicians.
In 2003 the average malpractice
premium in Florida (outside of Dade County) for general surgeons
was $174,000 per year for a minimal amount of insurance. It was
$226,000 in Dade County. (Source: Medical Liability Monitor).
I do not know the average 2004 rate, but I do know that the highest
rate in the nation was in Miami where it cost $277,000 in 2004
for a general surgeon. In 2003 the cost was $249,000 for Ob-gyns
in Miami. (Source: Medical Liability Monitor & Medical Malpractice
and Access to Health Care (and GAO-03-836)
The average cost of running a
general surgery office was $227,000 in 2003 (Source: Statistics:
Medical & Dental Income and Expense Averages 2004 Report).
One estimate of average physician monthly cost for planning for
a solo practice is $25,000 per month (Source: Medical Economics).
A few physicians I spoke with in Central Florida say their expenses
ran closer to $28,000 per month in 2004 with current staff requirements.
With NO SALARY, a general surgeon
currently has to earn over $400,000 per year, just to stay in
practice and pay malpractice insurance! What solo or small group
practitioner can do that? Physicians in Central Florida are cutting
staff and services in an effort to maintain their practices and
more are deciding to 'go bare.'
4.
These Bills do NOT promote ethical health partnership, and are
unjust. The only beneficiaries are malpractice insurance companies.
As I look at the problems of
healthcare, what underlies all of them in one way or another
are failures to create and maintain ethical health partnerships.
That includes relationships among ALL individuals and groups
that are part of or impacting healthcare, including doctors,
patients, insurance, government among others. Part of what is
ethical is what takes into consideration the well-being of all
and avoids placing undue burden on any. This bill, even if filed
with positive intent, will have a negative effect on all of us
except insurance companies. They are the major benefactors, whether
or not that was intended. It will be unjust to physicians, and
ultimately to patients.
5.
The bills do not begin to address the real problems in healthcare.
Moreover, this bill is the wrong
medicine for the illness. It will take much more fundamental,
and more difficult changes, to address the problems of healthcare,
including malpractice and patient injury and fair compensation.
This bill seems like adding more to a remedy that we already
know doesn't work very well and that actually adds to the distress
of the system.
Urge your Senators to vote NO
on Senate Bill 0972, and your Representatives to vote NO on House
Bill 0665. Click
here for mailing and e-mail addresses of committee members
reviewing the bills. Click here
for an e-mail only list of most of those committee members.
As always, I welcome your constructive
comments and suggestions about the material on this website and
how we can all be most effective in co-creating the kind of healthcare
system we all want. E-mail me at ideas@ethicalhealthpartnerships.org
© Dawn Lipthrott,
Ethical Health Partnerships, 2005 www.ethicalhealthpartnerships.org
(May be copied and distributed
as long as this identifying information is retained on copies.)
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