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Md. Senate president vows malpractice reform

December 01, 2004|by TAMELA BAKER

tammyb@herald-mail

HAGERSTOWN - As demonstrations go, this was a fairly polite one.

Doctors turned out en masse Tuesday for Maryland Senate President Thomas V. Mike Miller's luncheon address to the Hagerstown/Washington County Chamber of Commerce.

Some carried signs emblazoned with their rallying cry - and the name of their coalition - "Save Our Doctors, Protect Our Patients." Some wore buttons. Many wore their white coats.

Their message to Miller was simple: They want reform of the state's malpractice laws, and they want it yesterday.

By the time lunch was served, signs were propped against the dining room wall at the Sheraton Four Points as the physicians chatted strategy over their salads.

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Miller quickly promised the doctors reforms - just exactly when, and what final form they would take, remained at issue.

"I'd use the phrase 'help is on the way,' but it didn't work for John Kerry and it sure as hell isn't gonna work for me," he quipped.

Miller, a Prince George's County democrat, met with Gov. Robert Ehrlich and House Speaker Michael Busch several times in recent months to iron out legislation to deal with the state's soaring malpractice insurance costs. Physicians statewide face premium increases this month of about 33 percent, or more. Medical Mutual Liability Insurance Society of Maryland, which insures most of the state's physicians, reports that from 2000 to 2003, the average cost paid per malpractice claim grew by 65 percent.

While most of those payments are settlements rather than jury awards, Dr. Dan McDougal told Miller that "most medical cases are very complex. Is the jury system up to handling them?"

"I don't know," Miller said. As part of the reforms, he said, Ehrlich wants 12-member juries in malpractice cases. "I don't have any problem with that," he added.

Miller said the leaders have found themselves at an impasse over where to get the money for a proposed stop-loss fund that temporarily would subsidize malpractice premiums until other reforms, such as caps on malpractice awards, begin to bring costs down. While Ehrlich wants to take the money from the state's general fund, Miller favors a 2 percent tax on HMOs, similar to taxes already paid by other insurers. Until now, HMOs have been exempt from the tax in Maryland.

The problem with taking the money from the general fund, Miller said, is that it is limited already.

As the state recovers from recession, he said, "there are no new revenues to deal with it."

Even as he was speaking, House Republicans were meeting in Annapolis calling for Miller and Busch to take immediate action on malpractice reform. The Republicans want the leadership to call a special session to address malpractice, said Washington County Delegation Chairman Christopher Shank.

But they also want action on legalizing slots. The added revenue, Shank said, would eliminate the need to tax HMOs for the malpractice stop-loss fund. While he maintained that slots and malpractice reform were not tied, he said using slots revenues for education would free up general fund money for the stop-loss fund.

Even if slots were not legalized, Shank said, Ehrlich has other options for paying for the fund - such as $70 million in unallocated revenue that resulted from closing a tax loophole that allowed multistate businesses to operate in Maryland without paying corporate taxes.

And although the stop-loss fund is meant to be a temporary measure, Miller conceded after the luncheon that if a tax were levied on HMOs, it likely would not be repealed when the fund was no longer needed.

"I heard pretty much what I expected to hear" from Miller, said Karl Riggle, a Hagerstown general surgeon and a "Save Our Doctors, Protect Our Patients" organizer. Miller gave "no direct answers" to the physicians' questions, he added.

While Miller said "the governor needs to compromise" on the stop-loss fund, Riggle had another idea.

"I think they both need to compromise," he said.

Members of the coalition were to travel to Annapolis today in yet another lobbying effort, and plan a 1 p.m. news conference on the issue. They will were to meet with staff at North Arundel Hospital, Riggle said, bringing to five the number of hospitals with ties to the coalition.

"There are little fires scattered throughout the state," he said.

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