Originally created 11/27/02

Medical malpractice: Crisis or misdiagnosis?



THE MEDICAL MALPRACTICE insurance industry claims there is a "malpractice crisis" in Georgia and they have hoodwinked the doctors of this state into marching on the Capitol to tell their story.

The public should know the other side of that story - the side that sheds the light of truth on the malpractice insurance premium crisis and what has caused it. The truth is that our medical community has misdiagnosed the condition that plagues them, and they now seek to cure their suffering by imposing unwarranted limitations on their patients' rights to obtain appropriate compensation for the harm caused by malpractice.

THE FICTION: Just as they did in the economic downturns of the 1970s and 1980s, medical malpractice insurance companies are raising premiums they charge doctors and hospitals and blaming lawsuits and lawyers for their financial woes.

Now they are prescribing tort reform as their panacea. However, a recently published study by the Consumer Federation of America entitled Stable Losses/Unstable Rates reveals the fallacy of the insurance industry's claims. That report shows there is virtually no correlation between claims payments and premiums that insurers charge doctors and hospitals.

The report makes it clear that what has happened over the course of the last two years is absolutely consistent with what has happened in each of the two previous "insurance cycles" of the past quarter century. When the markets go down, premiums go up and the insurance industry blames the civil justice system and demands "tort reforms" rather than looking inward for solutions to its self-created crises. Georgians should reject such disingenuous claims this time.

THE TRUTH: There is no malpractice crisis in Georgia. There may be a malpractice insurance premium crisis - but that crisis has nothing to do with Georgia's civil justice system. In fact, the number of medical malpractice claims that result in payouts has steadily decreased throughout the past decade. And the total amount paid out to victims of medical malpractice has increased at a rate far below the health care inflation rate over that time period.

The real issue is the bad business decisions made by the malpractice insurance industry during the economic boom of the 1990's - decisions that benefited Georgia's doctors and hospitals then, but only now are coming home to roost in Georgia.

THE FACTS:. The insurance industry today is "making up" for its improper investment speculation and rate-setting decisions of the 1990s.

During the 1990s, malpractice insurers of this state decided to charge physicians and hospitals inappropriately low insurance premiums in an effort to capture a greater share of the premium-paying physician and hospital markets.

Insurers charged those low rates because their investment portfolios were swollen with profits that would more than offset their claims obligations and because they ignored their own actuaries' recommendations to raise premiums to levels that would insulate them from declining investment returns.

With the current state of the capital markets, insurers have belatedly realized that they did not save enough premium or investment dollars to cover the harmful medical errors committed by their doctors and hospitals.

BECAUSE MALPRACTICE premiums track the economy rather than insurance claims payouts, the legislative remedies that the industry now proposes will be useless. They will not lower the premiums physicians and hospitals are being forced to pay to the insurance industry.

They have never had that effect anywhere. But they most assuredly will deprive truly injured malpractice victims of appropriate compensation for their injuries and will shield the insurance industry and malpracticing physicians and hospitals from accountability.

Before we get caught up in the hysteria the insurance industry is trying to create, our elected officials need to take a long look at whether there is a crisis and whether the proposed legislative remedies will have any positive impact on our society.

Doctors who are willing to look at all the symptoms - all the facts - will arrive at the same prognosis: the insurance company's proposed cure will be a meaningless placebo or worse.

DOCTORS AND HOSPITALS need real solutions to their malpractice insurance premium problems - not worn out rhetoric offered to cover up the real cause of those problems. Let's be careful not to commit "policymaking malpractice" by only listening to the self-serving cries of the insurance industry.

Let's look at all the facts and decide what is best for the patient - for our society. Sometimes the proposed cure is worse than what's ailing you. In this case, we can avoid making that medical error, but only if we are willing to examine the whole story.

(Editor's note: The writer is the public and political affairs director for the Georgia Trial Lawyers Association. Until this summer, he was chief lobbyist for the Medical Association of Georgia.)