AOA: Congress Must Establish Professional Liability Insurance Reform to Protect Patients from 'Paying the Price'

4/17/2002

From: Heidi Ann Ecker of the American Osteopathic Association, 202-251-3951

WASHINGTON, April 17 -- Congress must pass professional liability insurance reforms to stop the increasing problem of reduced patient access to quality affordable health care, says the American Osteopathic Association (AOA).

"Over the past few years, medical insurance premiums and payments have escalated out of control causing a number of health care quality, access, and cost problems," says AOA President James Zini, D.O. "Physicians are being forced to leave their communities to practice in states with better professional liability insurance reform laws. But, few states have sufficient laws and patients are paying the price. Congress must enact reforms today."

Only six states have broad professional liability (PLI) reform: CA, IL, IN, MI, UT, WI. While a number of states have passed laws to: limit non-economic, economic damages (23); limit attorney fees (14); enforce mandatory or discretionary roles on collateral sources (29); and address periodic repayment damages (29), the AOA does not believe these varied laws go far enough.

"What we are talking about here is the domino effect," says Dr. Zini. "Patients lose access to doctors when high premiums encourage physicians to move to states with more affordable liability insurance. Patients lose quality health care when a lack of physicians forces community hospitals to limit the types of services provided. Patients lose affordable health care when litigation costs are passed on to patients through increased insurance premiums and out-of-pocket medical expenses. In the end, the odds are stacked against our patients."

The AOA supports the six basic principles of the 1975 California "Medical Injury Compensation Reform Act" (MICRA), that, when utilized as a group, demonstrate the ability to address the aforementioned problems: (1) periodic repayment of future expenses or losses; (2) limitations on non-economic damages; (3) offsets for collateral sources; (4) joint and several liability reform; (5) limitations on attorney contingency fees; and (6) establish uniform statutes of limitations.

"Over its 27-year history, MICRA has demonstrated the ability to lower premiums and other costs associated with professional liability insurance without limiting an individual's access to the courts," says Dr. Zini. "This is not a new issue. Congress has been trying to pass PLI reform for years now."

The U.S. House of Representatives approved PLI reform provisions six times since 1995: (1) Common Sense Product Liability and Legal Reform Act, H.R. 956, 1995; (2) Balanced Budget Act of 1995, H.R. 2491, 1995; (3) Health Care Coverage Availability and Affordability Act, H.R. 3103, 1996; (4) FY 1998 District of Columbia Appropriations Bill, 1997; (5) Balanced Budget Act of 1997, H.R. 2015, 1997; and (6) Patient Protection Act, H.R. 4250, 1998.

"These reforms are beyond necessary. Patients are losing access. Patients are losing health care. Patients are plain losing and they desperately need Congress to take action and reform the PLI system," says Dr. Zini.

The rate of medical malpractice cases has doubled in the past ten years, with over 120,000 lawsuits filed against 500,000 physicians at any one time. "It is a tragedy to hear of so many malpractice cases when we know that 70 percent of all claims are resolved with no payment to the patient," says Dr. Zini. "It's even more tragic to hear that less than half of every dollar paid in a malpractice settlement gets to the patient knowing that related litigation costs are eventually passed on to patients through increased insurance premiums and out-of-pocket medical expenses."

"Liability insurance problems aren't simply a specialty problem," says Dr. Zini, a family physician from Mountain View, Ark. "There are documented sources like Medical Economics (Aug. 24, 1998) that indicate services carried out by primary-care physicians during an ordinary office visit are the largest source of malpractice claims." Dr. Zini says such activities account for 20 percent of all reported claims.

Further, hospitals are closing trauma centers and limiting patient services. Nursing homes are closing. Safety-net programs relying on physician volunteers can no longer operate. "Others -- blood suppliers, medical supply companies, pharmaceutical companies, and medical equipment manufacturers -- are all also affected," reports Dr. Zini.

The AOA is dedicated to helping patients win back affordable quality health care through PLI reform. That's why over 150 osteopathic physicians (D.O.s), student doctors and supporters of osteopathic medicine are meeting with nearly 200 Members of Congress on April 18 for National D.O. Day. Members of Congress meet with the osteopathic medical community because they know over 100 million patient visits are conducted by D.O.s each year.

AOA represents 47,000 osteopathic physicians (D.O.s), promotes public health, encourages scientific research, serves as the primary certifying body for D.O.s and is the accrediting agency for all osteopathic medical schools and health care facilities.