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Thursday, December 4, 2008

Pennsylvainia Must Face Physicians' Liability Crisis

Donna Cooper, Pennsylvania's secretary of policy and planning, responding for Gov. Ed Rendell to my Oct. 25 op-ed "Pennsylvania Is Driving Its Doctors Away," raises several interesting points ("We're Trying to Help the Uninsured and Doctors, Too," Letters, Nov. 12).

Yes, about a $1 billion have been paid to the MCare fund over the past five years. This sum is from an extra tax on cigarette sales, mandated by the legislature for this purpose, and by a surcharge on moving traffic violations -- thus most Pennsylvania taxpayers contribute nothing to this fund. True, the state does not underwrite insurance costs for other professionals, most of which are so low they are not burdensome. Attorneys in Philadelphia Apartments pay about $2,500 a year for liability insurance; a surgeon pays up to 40 times that amount.

The 40% reduction in medical malpractice expenses referred to seems to be the reduction in payouts from the MCare fund attributable to tort and insurance reform legislation passed in 1996 and 2002, before Gov. Rendell assumed office. Physicians' annual liability premiums have decreased marginally.

Gov. Rendell is a master in the selective use of data and statistics. The figures I quoted on the number of physicians in Pennsylvania declining 6% between 2004 and 2006 and the figures on physician age in Pennsylvania are from the Pennsylvania Department of Health, a part of Gov. Rendell's administration, and my other figures are from the National Practitioner Data Bank and the American Medical Association Masterfile. I will stand by the figures I quoted. I hope the governor will stand by those of his own administration.

The surplus in the MCare fund is $100 million, and surplus in the retention account is $500 million. The latter was intended to be transferred to the MCare fund to provide abatements that physicians have been afforded for the last several years, but Gov. Rendell refuses to authorize this transfer, and instead advocates legislative action to fund his health-care plan with this money intended to provide liability premium relief to physicians. This is what I meant by the fund "being raided" ("And ladies and gentlemen, his fingers never leave his hand . . .").

Of course, we do not blame Gov. Rendell for an unsustainable professional liability situation that existed here and elsewhere before he took office. Optimism rose when he convened a professionally diverse task force to study the issue even before his inauguration in 2003. But when his own task force was about to recommend a cap on pain and suffering rewards, he refused to let them vote.

The dismissive comments about the obstetrician shortage being longstanding does not help the patients involved. I would comment that if you have dug yourself into a hole, it's time to stop digging. Right now Gov. Rendell is perceived as part of the problem, rather than part of the solution. It is time for him and the state house to man up and address the two important issues of health insurance and physician liability premiums separately.