NU Online News Service, May 18, 2:46 p.m. EDT–The American Medical Association said it has added Rhode Island to its list of states with a medical malpractice insurance crisis and removed Texas.
Two years ago Texas adopted legislation capping non-economic damage awards against physicians and health care institutions at $250,000, which the AMA said had improved the insurance marketplace.
The AMA said in Rhode Island there is a crisis because, in the words of AMA Trustee Dr. William G. Plested, "An unrestrained legal assault" has eroded the state's health care system "to the point where physicians are restricting services and patients are losing access to care."
According to a survey by the Rhode Island Medical Society cited by the AMA, 49 percent of physicians there said increasing medical liability costs have caused them to discontinue or consider discontinuing certain services.
The poll also recorded that 48 percent of Rhode Island physicians said increasing medical liability costs have forced them to consider leaving the state or giving up clinical practice.
Dr. Plested commented that what is needed is a fix for "a jackpot justice system that is bad for our patients, bad for health care, and bad for local economies. It's time for Rhode Island's state and federal representatives to stand up and do what is necessary to ensure that when patients need care, physicians are there to provide it."
Other states on the AMA liability insurance crisis list are: Arkansas, Connecticut, Florida, Georgia, Illinois, Kentucky, Massachusetts, Mississippi, Missouri, New Jersey, Nevada, New York, North Carolina, Ohio, Oregon, Pennsylvania, Washington, West Virginia and Wyoming.
AMA said Texas is off the list because since reforms, access to care is increasing and claims are down.
The organization added that physician recruitment and retention is up, especially in high-risk specialties. New insurers are entering the Texas medical liability market creating more choices for physicians. Subsequently, competition is increasing, and all five of the largest insurers in the Texas medical liability market have announced rate cuts.
The rate cuts will produce about $50 million in savings for Texans, according to AMA calculations.
"Lawmakers and voters acted to bring Texas back from a meltdown of their health system," said Dr. Plested. "We urge Rhode Island's state and federal lawmakers to consider the example of other states and look to proven remedies when considering medical liability reform."
The AMA report was supported by the American Insurance Association which said it has found that since the legislative changes in 2003 the medical malpractice insurance market has changed.
Fred Bosse, AIA vice president, Southwest region said, "New doctors are coming to the state, along with new insurance carriers, and the number of lawsuits being filed is decreasing."
Most importantly, he continued, "medical malpractice insurance costs are decreasing, which ultimately benefits all the stakeholders in this system including patients, doctors, hospitals and nursing homes."
He noted that earlier this year there was testimony before a Texas House committee that two of the state's top insurers of physicians are cutting their rates and a third is freezing its rates
AIA said more insurers are scheduled to implement rate reductions this month. In addition, it said Texas has added 82 obstetricians, 94 internists, 35 neurosurgeons, and 475 family practice doctors. In Corpus Christi, 47 new doctors have begun practice, a stark contrast to the 40 physicians they lost in the five previous years.
"Without the key provisions in the reforms, such as placing a cap on non-economic damages, this kind of turnaround never would have occurred," Mr. Bosse said.
"The bottom line is the number of doctors coming to Texas is up and the number of med mal lawsuits filed in Texas is down; the number of insurers coming to Texas is up and the cost of med mal insurance is down," he concluded.
Not all observers were willing to attribute improvements in the Texas market to changes in thee law.
Ross Eisenbrey, with the Economic Policy institute in Washington said that if you make legislative change and shortly after there is a good affect on rates would be, "wrong to attribute it to change in the law. We have seen cyclical changes in premium because of investment performance."
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