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Malpractice issue still needs work, insurance chief says

March 23, 2005|by BOB MAGINNIS

In January, after the Maryland General Assembly overrode Gov. Robert Ehrlich's veto of a bill designed to give physicians some relief from soaring malpractice insurance costs, most involved said the bill was just a first step toward more comprehensive reform.

But on Monday, Maryland Insurance Commissioner Alfred Redmer Jr. offered a gloomy assessment of the chances for further progress.

"There will not be substantive legal reform for several years," said Redmer, in Hagerstown to publicize a new program to help consumers deal with insurance problems.

Redmer said the governor, doctors and the press did an excellent job of laying out the problem.

"As patients became informed and educated, they called legislators and demanded they fix the problem," he said.

Instead, Redmer said, legislators gutted the governor's bill and "took the financial pain from the doctors and transferred it to the patients."

That pain came in the form of a 2 percent premium tax on health-maintenance organizations that Ehrlich opposed, saying he want to use general-fund money instead.

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The tax was not the main reason for the veto, Redmer said.

"The governor vetoed it because the reform was stripped out. The result is very little legal reform," he said.

Although the governor has gone back to the legislature this session in an attempt to get another bill passed, Redmer said the opponents of real reform aren't going to act.

"What they're going to say is, 'We just passed something. We need to give it time to work,'" he said.

Redmer, who is on the governor's medical malpractice task force, said that reforms still needed involve issues including changes of venue, using actual paid medical expenses as opposed to those that are billed and making sure that those testifying as expert witnesses actually practice in the specialty they're testifying about.

In fact, the 2004 bill did clarify that physicians who testify have to be board-certified in the specialty they're testifying on.

"I don't mean to suggest that the legislature did nothing on legal reform. It just didn't do enough," he said.

After the 2004 bill passed, HMOs began asking that they be allowed to pass along the 2 percent tax to consumers. When the Maryland Insurance Administration approved the first pass-throughs, Democrats jumped on Redmer.

Senate President Thomas V. Mike Miller said Redmer had committed malfeasance, which Redmer said was a shock.

"My skin is not as thick as it should be," Redmer said.

He added, however, that the approval process was one OK'd by the legislature in 2003.

"In 2003, there was never any question of who was going to pay the tax," Redmer said.

"My assumption is that they knew it was going to be passed on, but they underestimated the reaction from the folks back home," he said.

Redmer said his agency responded quickly because not only did the HMOs want to do the pass-through, they also wanted to make it retroactive. Instead, he said, they were told it could not take effect for 45 days.

As for Maryland's doctors, Redmer said his agency is still in close contact with them, in part because there were technical problems with the 2004 bill which have so far prevented doctors from getting any financial relief.

"We have heard from the doctors and what they're saying is, 'Where's my money?'" Redmer said.

A bill to correct that flaw is in the works and should take effect June 1, he said.

"Then we can implement it and cut checks in a week or two," he said.

Redmer said the long-term prospects for reform will depend on how much pressure citizens put on the lawmakers. Because citizens heard that a reform bill was passed, many assume the problem has been solved, he said.

It hasn't been, if testimony this year before Maryland General Assembly committees is any indication.

Earlier this month, Carol Ritter, a obstetrician/gynecologist from Towson, Md., told the Senate Judicial Proceedings Committee that even though malpractice insurance rates have been stabilized, they're still too high.

Facing an increase that would have taken 80 percent of her revenues, she decided to stop delivering babies in 2003.

Some local specialists have stopped practicing or have limited the procedures they will do.

Of course, if you're healthy, it may not matter to you. Those who are not sure they'll remain that way forever need to push for more reform.

Bob Maginnis is editorial page editor of The Herald-Mail newspapers.

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