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General Assembly must act quickly on malpractice issue

November 16, 2004

Whoever said that "the wheels of justice grind exceedingly slow" probably wasn't talking about the Maryland General Assembly, though the legislature sometimes seems incapable of acting on an issue without first studying it half to death.

There's no time for that sort of approach on medical malpractice, unless lawmakers want to deal with some real deaths.

That's because Medical Mutual insurance company, a physician-run insurer that covers most of the state's doctors, has won state approval to raise its rates, on average, by 33 percent. In its request for the increase, the firm cited soaring payouts as a result of malpractice lawsuits.

And 33 percent is just the average increase. Doctors in so-called high-risk specialties, such as obstetrics, face much higher increases.

Unlike your neighborhood service station, which passes on higher oil prices to the people who buy gasoline, doctors can't pass on their increased costs. Contracts they have with HMOs prevent that.

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Nor can they elect to go without insurance, because few hospitals would grant uninsured doctors privileges to practice, knowing that any liability would fall back on the institution.

So who is at fault? It depends on who you talk to.

The trial lawyers say that the cause is bad medicine practiced in a profession unwilling to police its own members. Maryland Senate President Thomas V. "Mike" Miller, a trial lawyer himself, blames Medical Mutual for keeping too much cash in its reserve fund.

The doctors say it's lawyers seeking a big payday who are putting the health-care system at risk and driving up costs by filing frivolous suits.

The doctors are asking for a comprehensive solution from a legislature that is accustomed to doing things in a piecemeal way. (Who but the crew in Annapolis would have passed the Thornton Commission's education-funding plan without a clue as to how it would be funded - and still be squabbling about it two years later?)

Lawmakers will have to throw off their natural tendency to drag their feet and act quickly on this issue, unless they want to see an exodus of doctors and severely reduced access to care.

We strongly suggest that the legislature take three steps:

· Promise doctors a comprehensive solution to their problem within a year's time.

· Create a "stop loss" fund before Christmas to soften the impact of insurance increases.

· Begin studying other state's approaches, including the California MICRA law, in preparation for a special session in the summer of 2005.

This is going to be a painful process, but the payoff, in addition to enhancing the health of the state's citizens, will be that if Maryland gets it right, doctors will be drawn here.

The other possibility is that if Maryland doesn't get it right, lawmakers will have to explain to their constituents why they have to drive 100 miles for medical services they used to get much closer to home.

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