Waking Up Costs

Pennsylvania Doctor Trap Number Two Proposed

Clark Venable — Sun, 10 Jun 2007 10:49:17 GMT

Pennsylvania has chosen an interesting strategy to keep doctors from leaving the state. Rather than fix the current jackpot medical malpractice system they've decided to try to trap doctors that are already here.

The first example of this was something called the MCARE abatement program. The Medical Care Availability and Reduction of Error (MCARE) Act replaced an existing catastrophic coverage fund with a new fund to cover awards which exceeded the primary coverage provided by professional liability policies. Each physician must pay into the fund a percentage of their primary premium to sustain the fund.

The MCARE abatement program (or Health Care Provider Retention Program) provides some financial relief from paying premiums to the fund. How much relief a physician gets depends on the practitioners specialty. And here we come to trap number one. If you accept the abatement, you agree to practice in the state for the year in which you receive the abatement AND the next year. If you leave early, you have to pay back the full amount of the abatement.

The legislature is now working on trap number two--a physician loan forgiveness program. For a period of ten years, for every year a physician practices in Pennsylvania after completing training the state will pay off ten percent of their student loan debt. If they leave early (say, after five years), they have to pay the state back ALL of the money the state paid toward their loans.

Pennsylvania's Lawmakers Could Learn From Texas

Clark Venable — Fri, 08 Jun 2007 04:00:00 GMT

Texas enacted tort reform in 2003, capping damage awards at $250,000. In an article titled "Insurance companies, doctors flock to Texas" David Hendricks passes along some facts I hope Pennsylvania legislators take to heart:

Malpractice insurance rates have fallen an average of 21%
The number of companies offering malpractice insurance in the state has risen from four to thirty
Malpractice lawsuits have fallen 50%
Doctors are coming to Texas, as evidenced by 2,250 pending applications for medical licensure

[Kevin, MD]

At risk: vaccines - The Boston Globe

Clark Venable — Thu, 07 Jun 2007 04:00:00 GMT

The Boston Globe

"Certainly there is plenty of evidence to refute the notion that vaccines cause autism. Fourteen epidemiological studies have shown that the risk of autism is the same whether children received the MMR vaccine or not, and five have shown that thimerosal-containing vaccines also do not cause autism. Further, although large quantities of mercury are clearly toxic to the brain, autism isn't a consequence of mercury poisoning; large, single-source mercury exposures in Minamata Bay and Iraq have caused seizures, mental retardation, and speech delay, but not autism.

Finally, vaccine makers removed thimerosal from vaccines routinely given to young infants about six years ago; if thimerosal were a cause, the incidence of autism should have declined. Instead, the numbers have continued to increase. All of this evidence should have caused a quick dismissal of these cases. But it didn't, and now the courthas turned into a circus. The federal and civil litigation will likely take years to sort out."

[Via PointofLaw.com]

RangelMD on Tort Reform in Texas

Clark Venable — Sun, 14 May 2006 12:56:48 GMT

Texas enacted caps on medical malpractice awards in 2003. The debate there on whether these caps are good or have been responsible for the drop in new malpractice cases by 60%-80% continues.

"Obviously the need is to reduce legal costs, increase ease and access to the system, increase efficiency and speed of proceedings so that justified compensation finds its way to the plaintiff with all deliberate speed, and establish much more consistency in finding fault and awarding compensation. One solution is the establishment of special health courts where neutral expert witnesses would be hired by the court, judges or panels would hand down judgments, and guidelines would be in place for the determining of fault and compensation.

It's easy to see why trial lawyers oppose special health courts because their roles would be significantly reduced. A system like this would be far less susceptible to such intangibles as the fickle mood of a jury or the charisma of the lawyer. We've been talking for years about reducing costs and improving access to health care. Maybe it's about time we started doing the same with our tort system. Proposition 12 may have been the first small step in that direction."

[RangelMD]

Medical Malpractice Law in the United States - Kaiser Family Foundation

Clark Venable — Fri, 27 May 2005 15:38:10 GMT

Medical Malpractice Law in the United States - Kaiser Family Foundation:

" The Kaiser Family Foundation today issued a new report that explains how medical malpractice law in the United States works and provides an overview of recent trends and reform approaches. The Foundation also posted state-specific data on medical malpractice claim payments on statehealthfacts.org, the free online source of current health and health policy data for all 50 states. "