Doctors Protest High Malpractice Insurance Premiums
Miles O'Brien, CNN Anchor: Many doctors in New Jersey threatened to halt all but emergency services on Monday to protest the high cost of malpractice insurance, becoming a familiar story. Similar walkouts have taken place in Florida, West Virginia, elsewhere. And a patient advocacy group staged a counter protest in Florida, saying a limit on damage awards wouldn’t be fair.
With us from San Francisco very early this morning, Dr. Richard Anderson, chairman of The Doctors Company, which provides malpractice insurance.
Dr. Richard Anderson, Chairman, The Doctors Company: Good morning.
O'Brien: And in Washington, Sally Greenberg, a consumer activist. Good morning to you both.
Sally Greenberg, Consumer Advocate: Good morning.
Anderson: Good morning.
O'Brien: Let’s begin with Sally Greenberg, ladies first. What’s the matter with doctors taking some action here, letting the world know that there’s a real problem out there?
Greenberg: Well, we agree that doctors have experienced really high spikes in some states and in some specialties, and we’re sympathetic with that. But we’re also disappointed that doctors have chosen to focus their attention on patients and have basically made war against patients who have been seriously injured by medical malpractice.
O'Brien: Dr. Anderson, how do you respond to that? That’s a pretty strong statement right there, when you’re talking about a doctor who has an oath to follow.
Anderson: Doctors are striking on behalf of patients today. They are striking to preserve fundamental access to important medical services that are being threatened by the tidal wave of litigation that faces America’s physicians.
O'Brien: So, I’m sorry, you—let me understand this. You deny service to give them service? It sounds like some of that Vietnam logic: We have to destroy the village to save it.
Anderson: No, not at all. This need to do control withholding of services with emergencies covered for limited periods of time is on behalf of a much more important issue, and that is that fundamental access to medical care in the United States is being threatened by the excesses of our legal system. In the United States today, there are more than 120,000 claims pending against America’s physicians.
If you’re a neurosurgeon, you’re facing a claim every other year. If you’re an obstetrician, an orthopedist, a trauma surgeon, an emergency room physician, you’re facing a claim every third year.
O'Brien: All right. Sally Greenberg, doctors versus lawyers, and the lawyers have the upper hand. And is that causing a problem?
Greenberg: The real problem with Dr. Anderson’s remedy for this is that the insurance industry, every several years, let’s say in the last 30 years it’s happened three or four times that there’s been a crisis. And what happens in the insurance industry, when the market is good, it enjoys the high rates from the market and instead of raising rates on malpractice premiums, what they do is they use the returns. And when the market goes down, what happens with the insurance industry is they have to look for their revenue stream somewhere else.
So they go to the doctors; they raise their rates. All of us, whether it’s homeowners or auto insurance, have seen our rates increase.
O'Brien: Dr. Anderson, let me ask you this. Instead of going on strike and pointing the finger at everybody else in this, isn’t it time for doctors to look at their own abilities, or perhaps lack thereof, and police doctors more so there are fewer lawsuits?
Anderson: I think the doctors do a commendable job under the restrictions, ironically, of our very own legal system in policing our own. The problem is that the notion that malpractice suits somehow target bad doctors is fundamentally false. Eighty percent of all the malpractice claims in the United States today are found to be without merit. In fact, the principal finding of the Harvard Malpractice Study...
O'Brien: Dr. Anderson...
Anderson: Well, just to finish this point...
O'Brien: ... but if they’re found to be without merit, there is no award that is given to anybody. So maybe this is all a red herring.
Anderson: Oh, on the contrary. There’s no award given to the patient because the suit is without merit. But it takes, on the average, $25,000 to defend each of those claims and consumes three and a half years of litigation. It’s a very serious problem and a very costly problem.
O'Brien: Well, maybe it’s high time that people who bring these cases should pay the cost for carrying their weight in court. Sally, what do you think?
Greenberg: If I can just jump in here. The problem with the remedies that Dr. Anderson and the American Medical Association are looking for is that they’ve done nothing. When they cap malpractice rates, they’ve done absolutely nothing to address the problem of medical errors, which the Institute of Medicine says happen at a rate of 44 to 98,000 deaths every year from medical errors.
Secondly, there’s nothing to guarantee that if you cap the medical malpractice lawsuits that that is going to actually bring down the cost of medical malpractice premiums. And, in fact, in Nevada, which passed legislation last summer, right after legislation passed capping patients’ damages—seriously injured patients—the insurance industry came out and said don’t expect rates to come down. We’re not promising that rates will come down.
Thirdly, if I can make just one last point.
O'Brien: All right, one more point.
Greenberg: There’s nothing in Dr. Anderson’s remedy or legislative proposals, which they’re backing in Congress now, that will do anything to even out this terrible increase and decrease over a period of 30 years, these spikes in insurance rates. We have to get control over that.
O'Brien: All right. Dr. Anderson, let me ask you this. I mean, we’re all human beings here. Doctors are human beings as well. They do make mistakes.
And when mistakes are made, people should be able to get a fair and just claim for, in some cases, things that are permanent and very serious because of these mistakes. It’s difficult to etch in stone something that preserves that right, isn’t it?
Anderson:I think doctors would agree with that point. And, in fact, the California reforms that are being proposed as a model for the nation and are being put before Congress by both Senator Feinstein and President Bush include full indemnification for truly injured patients. I think it’s very important, though, to—that the Institute of Medicine study, which Ms. Greenberg quoted, I think she’s omitted its most salient conclusion. And the most salient conclusion is that there is no relationship whatever—none, zero, zip relationship—between the presence or absence of medical negligence and the outcome of medical malpractice litigation.
O'Brien: Do you want to respond quickly, Ms. Greenberg, because we have to go?
Greenberg: Yes. The proposal that Dr. Anderson is talking about really doesn’t address the overall problem that we’re seeing now, which is a war between patients and doctors. We’d like to see doctors and patients sitting down together and looking for a remedy.
We’re open to creative ideas. What about a no-fault system? What about a system where doctors and hospitals agree to clean up medical errors and to address them and to agree that there’s a problem? That we need to—and then patients in response, if they’re going to get just compensation—remember, seven out of eight patients who are seriously injured by medical malpractice never bring a lawsuit.
What about bringing those forces together, those groups together, and sitting down and resolving this problem without this war that’s going on, where patients feel that they’re being deprived if they’re seriously injured by medical malpractice?
O'Brien: Dr. Anderson, I’ve got to give you a quick final word to balance this out. Go ahead and make the final point.
Anderson: Well, I’m glad to hear Ms. Greenberg proposing change to a system which currently allocates twice as much money to attorneys as it does to actually injured patients. We have a model for effective tort reforms in the United States. The effectiveness of these tort reforms is verified by the Congressional Budget Office, by the Independent American Academy of Actuaries, and by the departments of insurance in the states in which they are present.
So we know that effective tort reforms preserve access to care and ultimately benefit both patients and physicians.
O'Brien: Got to leave it there. Thank you very much, Dr. Richard Anderson and Sally Greenberg. We appreciate you being with us on CNN SATURDAY MORNING.
Greenberg: Thank you.
Anderson: Thank you.