Medical myths: malpractice insurance not the only health-care culprit.President George W. Bush in December renewed his call for Congress to rein in to check the speed of, or cause to stop, by drawing the reins.
to cause (a person) to slow down or cease some activity; - to rein in is used commonly of superiors in a chain of command, ordering a subordinate to moderate or cease some activity deemed excessive.
See also: Rein Rein medical-liability claims. Speaking at a White House Economic Conference, Bush called for limits on damages in medical malpractice Improper, unskilled, or negligent treatment of a patient by a physician, dentist, nurse, pharmacist, or other health care professional. lawsuits as a means of curbing rising healthcare costs. "There is no doubt in my mind, by passing real, substantive medical liability reform, it will help control the rising costs of health care," Bush told the conference.
Pete Coors Peter Hanson Coors (born September 20, 1946) is a U.S. businessman and entrepreneur. He currently is the chairman of the Coors Brewing Company in Colorado and vice chairman of its parent company, Molson Coors Brewing Company. , Colorado's unsuccessful Republican Senate candidate, also had called for medical-liability reform. Echoing the White House position, Coors blamed lawyers and malpractice suits as the driver of rising health-care costs in general. Coors' problem in making that case, however, was that Colorado already had effective malpractice-liability limits in place, and doctors' liability actually accounts for only a fraction of rising medical costs.
In fact, despite a recent three-year double-digit rise in malpractice insurance Noun 1. malpractice insurance - insurance purchased by physicians and hospitals to cover the cost of being sued for malpractice; "obstetricians have to pay high rates for malpractice insurance" premiums in Colorado, Bush and other politicians need look no further than this state to see the effect of limits on medical liability. State lawmakers implemented curbs on medical damages in 1988, nearly 17 years ago.
"Colorado probably has the most stringent tort reform in the country, in all areas, with caps on almost every possible kind of recovery--from medical malpractice to skiresort liability," says John Sadwith, executive director of the Colorado Trial Lawyers Association. The association's 1,200 members represent parties seeking to recover, by means of a civil lawsuit, costs related to a tort, or injury that is willful or the result of negligence.
Medical-malpractice payments here are limited to $1 million to cover both "economic" damages such as medical bills and lost wages, and "non-economic" damages--what used to be called "pain and suffering." No more than $300,000 may be assessed as "non-economic" damages.
Judges in Colorado do have the authority to exceed the $1 million cap if they find the limitation would be unfair to the litigant litigant n. any party to a lawsuit. This means plaintiff, defendant, petitioner, respondent, cross-complainant, and cross-defendant, but not a witness or attorney.
LITIGANT. One engaged in a suit; one fond of litigation. due to the extent of damages or loss of income.
Bush wants Congress to limit non-economic damages to $250,000--the same limit set in Colorado from 1988 to 2003. Other provisions sought at the federal level, such as limiting punitive damages Monetary compensation awarded to an injured party that goes beyond that which is necessary to compensate the individual for losses and that is intended to punish the wrongdoer. to reasonable amounts and setting time limits for the filing of malpractice lawsuits, for example, are already part of the Colorado code.
To be sure, problems with medical malpractice litigation An action brought in court to enforce a particular right. The act or process of bringing a lawsuit in and of itself; a judicial contest; any dispute.
When a person begins a civil lawsuit, the person enters into a process called litigation. exist elsewhere.
The American Medical Association American Medical Association (AMA), professional physicians' organization (founded 1847). Its goals are to protect the interests of American physicians, advance public health, and support the growth of medical science. lists 19 states as in crisis, where escalating rates are forcing doctors to limit their practices or abandon rural areas. But 24 states have enacted some limits.
Colorado is one of six states the AMA (Automatic Message Accounting) The recording and reporting of telephone calls within a telephone system. It includes the calling and called parties and start and stop times of the call. says is experiencing few, if any, problems arising from skyrocketing premiums for medical-malpractice insurance.
So what can the rest of the U.S. learn from Colorado's experience?
The limits here were implemented following a five-year period during which physicians' malpractice insurance premiums rose anywhere from 20 percent to 73 percent a year.
After the limits were imposed, however, Colorado physicians experienced a period of relative premium stability. COPIC COPIC Conselho Português das Igrejas Cristãs (Portugese) Companies, a nonprofit insurer owned by a trust set up to further health-care affordability and accessibility in Colorado, provides malpractice coverage for about 80 percent of Colorado doctors needing commercial insurance. Its rates rose less than 1 percent annually from 1989 to 2000.
However, the state's malpractice-insurance rates are again on the move--set to rise an average 15.9 percent in 2005 after two successive double-digit annual increases. Since 2000, rates have risen 2.7 percent in 2001, 6.7 percent in 2002, 14.2 percent in 2003, and 13.8 percent last year. Rates depend on the type of medicine a doctor practices. High-risk specialties like neurosurgery neurosurgery /neu·ro·sur·gery/ (noor´o-sur?jer-e) surgery of the nervous system.
Surgery on any part of the nervous system. are the most expensive and family medicine the least.
Englewood family physician Dr. Nathan Persoff says his malpractice insurance rates probably doubled in the last decade, to around $10,000 a year. Physicians and surgeons Physicians and surgeons are medical practitioners who treat illness and injury by prescribing medication, performing diagnostic tests and evaluations, performing surgery, and providing other medical services and advice. in high-risk sub-specialties easily can pay four to 10 times that amount.
Unlike other businesses, however, Persoff and his fellow physicians can't easily pass on the increased cost to patients and their insurance companies. That's because along the Front Range, about 70 percent of all patient medical costs are controlled through managed care.
"The true crisis is not liability," Persoff said. Rather, it is the lack of a "cost-of-doing-business" factor in managed-care reimbursement Reimbursement
Payment made to someone for out-of-pocket expenses has incurred. rates. He knows of two neurosurgeons who left Colorado to practice in other states, and a third who went to a university setting, places where managed care was less of a factor.
So, are higher malpractice rates reducing access to medical care, as the Bush administration claims? The General Accounting Office last year found that, while practitioners in five states (Colorado wasn't among them) offered fewer high-risk services, such actions did not affect a state population's general access to health care.
COPIC does blame rising malpractice settlement costs for about one-third of the latest Colorado malpractice-insurance rate increases. The number of filed malpractice lawsuits rose to 258 in 2003 from 177 in 2000. While the number of claims relative to the number of insured physicians remained relatively stable across Colorado, the average amount paid out to settle those lawsuits rose to nearly $150,000 from around $90,000.
COPIC also says it has spent an average $3.5 million annually during the last four years to mount defenses to filed lawsuits that were later dropped or dismissed. Only about 16 percent of the lawsuits filed during the last four years actually went to trial, COPIC says, and almost half of those were thrown out.
The GAO reported that in addition to larger losses suffered by insurance companies, other factors figure into rising malpractice premiums. They include declining investment income at some insurers, the cyclical financial nature of the insurance industry, the pressure to drop premiums as profitability declines, and higher costs for reinsurance The contract made between an insurance company and a third party to protect the insurance company from losses. The contract provides for the third party to pay for the loss sustained by the insurance company when the company makes a payment on the original contract. , which smaller malpractice insurance companies rely on to pick up costs in major claims.
According to according to
1. As stated or indicated by; on the authority of: according to historians.
2. In keeping with: according to instructions.
3. National Underwriter Data Services, the medical malpractice "combined ratio," a measure of profitability, was 137.5 in 2003, the latest year for which data is available. This means for every medical-malpractice premium dollar collected insurers have been paying out almost $1.38 in claims and expenses. But lawyers say the losses are due to other expenses than claims paid.
"Doctors are being used by the insurance industry," said CTLA's Sadwith. "They don't really realize that the insurance businesses are losing money (in general), and it's not based on payout of claims. The doctors are almost pawns Pawn(s) may refer to:
Most states, including Colorado, don't require insurance companies to justify their rates publicly, but merely require the rate hikes to be filed with the Division of Insurance before they are implemented. The nonpartisan Congressional Budget Office The Congressional Budget Office (CBO) is responsible for economic forecasting and fiscal policy analysis, scorekeeeping, cost projections, and an Annual Report on the Federal Budget. The office also underdakes special budget-related studies at the request of Congress. said in a report that the costs of malpractice claims account for a very small fraction of total health-care spending; so that even a very large reduction in costs related to malpractice for doctors would have a relatively small effect on total health-plan premiums.
WRITTEN BY JEANIE STOKES Stokes , William 1804-1878.
British physician. Known especially for his studies of diseases of the chest and heart, he expanded on the observations of John Cheyne in describing the breathing irregularity now known as Cheyne-Stokes respiration.