Commentary from Philip H. Gilbert,
DCMS Executive
Vice President
| This is a question of whether local patients will be able to access affordable healthcare. | Often called a professional liability or malpractice insurance problem, it's actually much simpler: it's a question of whether local patients will be able to access affordable healthcare. And it's something we need to understand. |
This current emergency is different then the insurance problems in the `70s and `80s, which were based on increasing malpractice claims. Today even though the number of negligence claims has remained stable, the amounts being paid in judgments and settlements have been increasing exponentially. Insurance carriers are pulling out of the Florida market, the events of September 11 are affecting the availability of reinsurance for the carriers, and doctors are increasingly unable to either afford or get liability insurance.
You don't see the crisis yet, because it's not reflected in the cost of your doctor visit co-pays; government and managed care cost-containment efforts prevent doctors from passing on the insurance cost increases to the patient.
If it were only a matter of First Coast doctors facing higher insurance bills, most people wouldn't see it as a crisis. Most physicians' incomes as comfortable enough to weather a few knocks, right?
But it's so much more. It's a real possibility that your doctor's practice may lose its insurance altogether, and not be able to keep its doors open. Physicians may have to move to other states, and the hospitals that rely on them may have to stop providing some services. The next time you need an OB/GYN or a neurologist, you may soon face the same crisis that patients in states like Nevada do now: there won't be anyone to provide you with that service.
Or your physician may have to practice with bare-bones coverage, and declare personal bankruptcy defending against claims that may or may not have any merit.
Doctors are in a total no-win situation, and their efforts to continue providing patient care in Florida are threatened with each passing day. They can develop and propose solutions, as can policy makers such as the governor and the members of the Florida legislature, but they are limited in what can be done because of a judicial system controlled by trial lawyers. This powerful lobby, intent on getting huge commissions out of million-dollar settlements, has fought against any reasonable solution to the problem of sky-high damage awards and the collapse in insurance these damages cause.
The only way the system will change in time to preserve our access to healthcare is for all of us to understand the consequences of letting the system continue in the direction it's going. The looming crisis in physicians' insurance and their ability to be there when we need them is a problem that only "we the people" can solve, by forcing our lawmakers to address the problem now.
Jacksonville Medicine / November-December 2002
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