Insurance crisis crunch felt statewide (FL Medical Malpractice)

The medical liability insurance crisis is disrupting Floridians' access to health care statewide, a Florida Hospital Association report issued Thursday shows.

From the Panhandle to Miami, skyrocketing medical liability premiums are forcing doctors and hospitals to eliminate or cut back services, the report says.

Seven hospitals, from Doctors Hospital in Sarasota to Parkway Regional Medical Center in North Miami Beach to South Bay Hospital in Sun City Center, have closed their obstetric units. Four other hospitals have reduced or limited obstetric care.

Tallahassee Community Hospital has closed its mammography unit and four other hospitals have reduced mammography services.

Orlando Regional Healthcare System reported wait times for mammograms increased from 20 days to 150 days in 2002.

The Bert Fish Medical Center in New Smyrna Beach reported cutbacks have forced its medical staff to transfer 100 to 200 patients a year to other medical facilities to receive care.

The second half of the report concerns the impact of the medical liability crisis on specialists who are on-call for emergency room duty.

Sarasota Memorial Hospital, a publicly owned medical facility with a national reputation for research and innovative treatment, reported on-call speciality coverage has been eliminated in neurology services and reduced or limited in gastroenterology, neurosurgery, hand surgery and psychology services.

But the lack of on-call specialists for emergency room duty does not translate to limited access of care at Sarasota Memorial, said Dr. Bill Colgate, the hospital's vice president for medical affairs and an emergency room doctor.

"We have the same access to specialists as we had before," Colgate said. "We just have to route the request through the patient's primary care physician."

At the most, Colgate said, the lack of on-call specialists could mean a delay but not a lack of treatment.

The 230-member Florida Hospital Association gathered the information from surveys returned by individual hospitals.

"This is just a snapshot of what's happening, but it clearly shows that the medical liability crisis is forcing hospitals across the state to stop offering or to curtail health care services that Floridians need," said Wayne NeSmith, president of the Florida Hospital Association.

Neither Manatee Memorial Hospital nor Blake Medical Center, the two acute care medical facilities in Manatee County, are listed on the report.

Although neither Manatee Memorial Hospital nor Blake Medical Center had to eliminate or cut back services, according to hospital officials, access to health care has been curtailed locally in other areas.

Currently, only one of Manatee County's five kidney specialists, Dr. Stephen L. Berkes, has medical liability coverage to serve more than 300 patients on dialysis.

Like many other kidney specialists across the state, Berkes and his fellow nephrologists lost their coverage when Farmers Insurance Group recently pulled out of Florida.

Dr. Thomas N. Braxtan, the new chief of staff at Manatee Memorial, and his partner, Guruswamy Ramamurthy, hope to receive word today that they have been insured through GE Medical Protective.

The news pleased Rep. Bill Galvano of Bradenton, the newly elected Republican representative for District 68, who made a call to a local insurance agent to help Braxtan get insurance.

"Dr. Braxtan is a reputable physician," Galvano said. "It makes you stop and say, 'Hey, what's going on here?' when someone like him, a hospital chief of staff, can't get insurance."

Manatee County's two other nephrologists, Dr. Celestino Palomino and Dr. A. Daniel Celaya, have submitted requests for leaves of absence from Manatee Memorial, Blake and the four dialysis centers serving Manatee County until their insurance problems are resolved.

A spokeswoman for Palomino and Celaya said they have placed applications with several companies and hope to receive word soon that they will be covered.

Until then, Palomino said Berkes will be hard-pressed to care for more than 50 patients a day.

"Three of us can handle the load," Palomino said, "but it will be very hard for just one nephrologist to keep up."

Several other physicians, such as Dr. Denise Baker, have had to limit their practices because of skyrocketing liability insurance premiums.

When Baker's carrier pulled out of Florida this summer, she said she had no recourse but to stop delivering babies, which meant 97 pregnant patients had to find new doctors to deliver their babies.

When faced with the cancellation of malpractice insurance last summer, Bradenton surgeon John V. Dunne said he was forced to limit his practice because he could not afford the high premiums charged by his new carrier.

Board-certified in chest surgery, general surgery and vascular surgery, Dunne, 66, said his premium would have been $103,000 to continue his surgical practice. Even though his practice is now limited to the treatment of veins and cosmetic laser surgery, Dunne still has to pay $77,000 for medical liability coverage. And because he is with a new insurance company, he has to pay "tail coverage" or a lump sum that will build a reserve in case he gets sued during the first year.

At least six other Manatee physicians have opted for early retirement or decided to leave the state when faced when premium increases ranging from 50 to 350 percent.

And as insurance premiums continue to rise, reimbursement rates for doctors and hospitals are declining.

Medicare reimbursement cuts of at least 4 percent are expected this month. The decreases come on top of a 5.4 percent rate decrease in 2002. By 2005, the Medicare cutbacks in reimbursement rates are slated to total 15 percent.

Private insurance companies are following suit, the Florida Hospital Association said.

Baker said her income in the past decade has been reduced by at least 66 percent.

As reimbursement rates fall, the cost of business goes up, propelled, the medical community says, by skyrocketing medical liability premiums.

If something isn't done, doctors say, they will be forced out of business, especially those in high-risk specialities such as neurosurgery, obstetrics, emergency care and orthopedics.

"The problem is very real," said Dr. Colgate from Sarasota Memorial. "We may soon be without neurosurgeons if they don't get their medical malpractice problem solved."

The medical community blames frivolous lawsuits and multimillion dollar awards to settle medical negligence claims.

The answer, says the medical community, is tort reform or caps on judgments similar to those enacted in California.

Trial lawyers say large settlements are not to blame: Patients' right to sue must be protected.

"In Florida, medical malpractice premiums account for less than 1 percent of total health care costs," says a report from the Academy of Florida Trial Lawyers. "Medical costs rose 13 times faster than malpractice premiums from 1988-98. . . . This shows that medical malpractice insurance is truly an amazing value when one considers that medical malpractice is the eighth-leading cause of death in the United States and that medical errors cost the U.S. economy between $17 billion and $29 billion each year."

The trial lawyers lay the blame on the insurance industry. Sensing a lucrative market in the boom years of the past decade, numerous insurance companies jumped into medical malpractice insurance with no experience, the academy says. These companies kept rates artificially low while at the same time investing heavily in a booming stock market. When the market turned soured, those same companies ended up overexposed with no way to cover themselves except by raising premiums.

Fixing the problem, Galvano said, will require addressing problems in all three areas - health care, tort reform and insurance reform.

"When I was just starting out in law, a mediator told me that if at the end of the day, one party is still happy, you have not done a good job. We are going to have to see some commitments from all three entities to fix the problem," Galvano said.

... are you perchance an attorney?

No. I jsut see 'tort reform' as another usurpation of my rights. No different to me to tell me I can't sue someone who has grievously wrong me for every penny he is worth than to tell me I can't have a gun, or can only have certain kinds of guns that are properly registered. My rights are my rights. Period. I do not voluntarily surrender them. If peacefull and civil means to express my rights are eliminated then I will eventually have a problem which probably won't be settled peacefully.

So, If yo want tort reform, Fine; just re-legalize duelling. I would much prefer really hurting someone who has wronged me with a gun, knife, or sword anyway. You don't get the satisfaction of hearing someone scream in the agony of death with a simple lawsuit.

Atlas shrugs. we are very close to Ayn Rand's novel, Atlas Shrugged, coming true. how many corporations have relocated offshore to avoid statist, unreasonable taxation.

I read a story where it was reported that some doctors are quitting altogether. Apparently, they can neither practice medicine OR be compensated reasonably.

The brightest are the first to go. The proles will never leave the hobbit hole. See: the brain drain.

"No. I jsut see 'tort reform' as another usurpation of my rights."

I will be sure to remind you of that when, because of astronomical insurance premiums, you can no longer find a decent Doctor to help you when you or your loved ones are hurt or when most mom and pop stores no longer exist because some dimwitted fool decides to sue them out of existance because he/she bumped their knee on a door or when even the mention of God will get you sued in civil court because some idiot decided just your mention of God infringes on his/her rights or when the ACLU(the scumiest lawyers of all) have made it so that your children are taught that Sex and Drugs are ok at the age of 11.

Lawyers and the people who support them are the reason our children and their childrens children are so screwed up. As the old saying goes, "if you lie down with dogs you get up with fleas".

No. I jsut see 'tort reform' as another usurpation of my rights.

The tort system is lawyers using government to pass laws making it easier and easier for them to cash in on junk cases. In criminal cases, conviction requires a unanimous jury vote on an evidence standard of "beyond a reasonable doubt". In civil cases, all it takes to find a defendant liable is a majority vote on "preponderance of the evidence"!

Here's how I would do tort reform: require a unanimous jury vote on an evidence standard of "beyond a reasonable doubt". Fair access to the courts for all is preserved, while the big expensive mass of court-clogging junk suits melts away.

..and besides, finding a human who will make an error is one hell of a lot better odds than finding your fortune through the Lottery...and oh so much easier than working for it.

The implication of this statement is that I would go looking for someone to make a fortune from. I would not and do not. Like all liberals (closet or otherwise) you seem to be reduced to name calling and character assasination. I take extreme exception to this attack on my personal integrity. So retract it or shove it!

Lawyers and the people who support them are the reason our children and their childrens children are so screwed up.

That strikes me as a rather thoughtless (being polite here) statement. Would you please explain how this is so? I think you have made a rather ridiculous and unsuportable statement here. I could find a lot of reasons children (yours, obviously, since you have personalized them with the term 'our children', but not mine) are screwed up today, none of them originating with lawyers. Most of them originating with the welfare (public) school system. You know the one, the one most freepers and other conservatives like to send their children to so that they don't have to accept the personal and financial responisbility of schooling them themselves? Or parents that just don't care about parenting? Or the womens lib movement that has destroyed the family? Or welfare that raises children into fatherless homes of poverty and ignorance? The list could go on and on, but I doubt that lawyers will be in there anywere in any causal manner.

This would be a big step in the right direction. I've never liked the majority decision and preponderance of evidence stuff. It lends itself to way too much manipulation. This would be more than tort reform, this would be a major change in the entire civil law judicial system. It wouldn't affect trials before a Judge though. Not all lawsuits are brought before juries. The only time to want a jury in your civil trial is when you're pushing evidence instead of law.

"I could find a lot of reasons children (yours, obviously, since you have personalized them with the term 'our children', but not mine) are screwed up today, none of them originating with lawyers."

Wrong on both counts.

"Most of them originating with the welfare (public) school system.

One of the main reasons that the Public school systems are in such bad shape is because of the NEA and all the suits they bring against local governments for such things as textbooks not fitting the PC mentality, or to keep Teachers, who are a mennis to society, from being fired, or filing lawsuit after lawsuit to make home schooling illegal.There are many other instances where Lawyers are at the root of the Public school systems problems, and yes there are also Parents who are the cause of some problems.

"Or the womens lib movement that has destroyed the family?

I sure hope you just did a little hiccup on that one and realized just how wrong that last statement was. The Womens Lib org. is famous for the amount of suits it brings to swing society to their way of thinking, Planned Parenthood stands out most in my mind.

"Or welfare that raises children into fatherless homes of poverty and ignorance?

Care to take a guess as to why we have so many people still on welfare, yup Lawyers, if a politician even starts to talk about welfare reform the ACLU and their bunch are all over it. For centuries we existed without govenment supported handouts, because people cared more for each other then what they could get for themselves.

"The list could go on and on, but I doubt that lawyers will be in there anywere in any causal manner.

Agreed, they are in every one of the instances you mentioned with both feet, if not for Monitary Greed for Comunistic Anti-Americanism or Power, I will continue to say most Lawyers would not last one second in the real world.

You know the one, the one most freepers and other conservatives like to send their children to

Got any data to support this assertion?

Like all liberals (closet or otherwise) you seem to be reduced to name calling and character assasination

ROFLMAO! Now, that is just about the most inane thing you have written thus far in this thread.

Wrong on both counts.

You seem to be unable to dicriminate the difference between the law and a lawyer. The NEA and Women Lib organizations are not lawyers. They are private organizations. Just like Free Republic, Young Republicans, Boy Scouts, The republican party, etc. are not a lawyer, they are private organizations. All of them occasionally or frequently use lawyers though, when they need to deal with a matter of Law (which is why so many dems say things like the current persident is selected, not elected. Evil republican lawyers are to blame, not the law). If you have a gripe with the rule of law, well we have no common grounds for discussions. Anarchists, in my experience, don't want law, they want to be the law.

Welfare (began after the war of northern agression) predates the ACLU (founded in 1920). And no lawyer or legal activist organization (which is what the ACLU is, BTW. Not a lawyer)can sue a Politician for anything he does in realation to welfare reform or legislation. Politicians go where the votes are, and they are with welfare system. And you will continue to vote for them regardless of your beliefs because they are the "lesser of evils" (whether you are pubbie or dem the argument is the same). You , and conservative organizations, have the same lobying rights as the ACLU.

I will continue to say most Lawyers would not last one second in the real world.

This is The real world. What world are you living in, some kind of delusional fantasy or something?

And, BTW, though you didn't adress it, I still believe that no responsible parent would (voluntarily) put their children in public school. Sorry to all the conservatives out there that don't want to face your responsibilities for educating your children yourselves, but shame on you for putting them in the government welfare school system!

Got any data to support this assertion?

Yeah, the population of the public school system vs. the population of the private and homeschool system. Compare that with the roughly 50/50 conservative/liberal population at large an you will get the point real quick like. Also look at the number of freepers complaining how their children are being indoctrinated in the public school system. They're not making complaints like that because their children are in private or homeschool.

Now, that is just about the most inane thing you have written thus far in this thread.

I stand by my statement. You made a personal attack on my character in post 26. You have failed to retract that attack. If the shoe fits wear it.

Compare that with the roughly 50/50 conservative/liberal population at large an you will get the point real quick like. Also look at the number of freepers complaining how their children are being indoctrinated in the public school system.

Provide hard numbers and sources to back up your assertions, and what percentage of FReepers you believe are liberals, please?

Oh--and another Question: What always gets larger the more you take away from it?

"You seem to be unable to dicriminate the difference between the law and a lawyer.

I am well aware of the difference, thank you. And before you twist the original content of my posts any further, my assertion is that Lawyers, on the whole, are at the root of most of todays ills. And also are the main cause of high malpractice insurance premiums and thus the shortage of Doctors in some states. Or are you insinuating that most Doctors are incompetent?

Its obvious at this point that you are anti-tort reform and that you think Lawyers can do no wrong, thank god you are in the minority.

Welfare (began after the war of northern agression) predates the ACLU (founded in 1920)."

Shucks, and here I thought the current welfare system was started in 1933 by FDR (ever heard of the New Deal?), almost 13 years after the Anti-American Lawyers group called the ACLU, guess I most be reading an alternative history book.Maybe in your history book the ACLU was also started as a helpful organisation versus one that was established with the downfall of America as its goal?

Florida has a "neurological injury fund"

Good point. The NICA fund is for infants with birth-related neuro deficits--regardless of fault. Moneys received from this fund are predicated by a waiver of malpractice litigation--much like the waivers signed by the families from 9-11 whereby they agreed not to sue the airlines upon receipt of federal funds.

Funny thing--the plethora of attorneys here in Florida want to be consulted before anyone signs the NICA waiver. They want the opportunity to determine whether physicians/hospitals/etc. can be milked for more money than the fund would provide. Another cream skimming scam.

my assertion is that Lawyers, on the whole, are at the root of most of todays ills.

We're in total disagreement. I see you as naming a consequence as a cause.

Or are you insinuating that most Doctors are incompetent?

Not at all. Most doctor are competent. Most automobile drivers are also competent. I am a competent driver, but my rates pay for the incompetent drivers as well. Insurance is insurance. And I'm not so sure that the insurers are so lilly white in this deal either.

Its obvious at this point that you are anti-tort reform and that you think Lawyers can do no wrong, thank god you are in the minority.

I am pro rights, not anti tort reform. I get really upset when someone thinks his (or her) pocketbook is more important than my rights. And I know that that is a minority position. But it is the ruling position. We're not a democracy yet.

Shucks, and here I thought the current welfare system was started in 1933 by FDR

A shame you are unfamiliar with history. FDR just expanded, codified, and institutionalized the system. It started back under Lincoln (a Republican) to help the displaced blacks decending on Washington. Like any thing else, it started unnoticeably innocent and small and just kept growing. Won't ever quit either.

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