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There are worries that a proposed $50,000 surcharge on all MD's in the state could do irreparable harm to New York's health care community. The state's medical malpractice liability fund is underfunded, and state insurance superintendent Eric Dinallo is looking for ideas.
Doctors unable to obtain liability insurance from commercial carriers are required to get insurance from a pool for high-risk doctors called the Medical Malpractice Insurance Plan, which charges doctors at least 290% the going rate of insurance for their profession. The pool is in the red right now, however, and it falls upon commercial carriers to cover any deficits. From the Sun:
Mr. Dinallo said in an interview the fee might be required by law to guarantee the solvency of the state's medical malpractice insurers. But he conceded, "We've built up such a mess" that the surcharge would be difficult to impose, and other solutions will be sought.Lawmakers sent a letter to Gov. Spitzer decrying the idea of a surcharge, writing that it could drive good doctors out of business or out of state. They're also upset that the burden would be spread amongst all doctors, versus the ones responsible for high malpractice costs. Newsday reports that .5% of the state's doctors are responsible for 7% of all malpractice payouts by insurers.Any fee would follow a 14% increase in malpractice insurance rates that went into effect this summer. The rates, set by the Insurance Department, vary by county and specialty. Brain surgeons in Brooklyn currently pay $267,000 annually for malpractice insurance, while general surgeons in Manhattan pay $123,120 and obstetricians in Queens pay $180,490.
A case in point is Dr. Harvey Finkelstein, an anesthesiologist who was unable to obtain insurance from a commercial carrier. He is one of the 475 doctors in the high risk pool and, in November, 630 of his patients were contacted by the Nassau County health department, advising them to get tested for various strains of hepatitis and HIV. Dr. Finkelstein was found to be reusing syringes and multiple dose medicine vials, causing at least some of his patients to contract hepatitis C.
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This is ridiculous! People complain about high prices to see doctors, but when malpractice insurance is minimum $200,000 a year, then doctors need to be pulling at least double that just to break even. Even more evidence that the number one problem w/ medicine in this country is the insurance system, spurred on by a litany of ill founded lawsuits.
Ditto - there's a misconception that doctors make a lot of money. Sure, the specialty surgeons do, but many others are just eking out a middle class life after paying crazy malparactice insurance fees.
Although, perhaps Doctors like Finkelstein shouldn't be practicing at all.
MedMal needs to be taken out of the hands of the court system and put into the hands of third party arbitration. Juries have proven themselves to be completely unable to fairly determine awards.
I signed up just so I could comment on this. This Dr. Finkelstein should not only be allowed to obtain insurance, he should be arrested. Certainly he can't still be practicing, can he?!
Of course there are those doctors who take on high-risk patients and have greater numbers of "medical mishaps" in their practices. But I am never going to feel sorry for someone who deliberately puts people at risk and then can't get insurance. I agree with the head of the Center for Medical Consumers who says they should be looking at how doctors end up with many malpractice cases. Those who have done so through their own incompetence should have their licenses revoked.
One of the points raised in the one of the articles I linked to is why these 475 doctors in the high-risk insurance pool--because they can't get any commercial carrier to cover them--aren't under constant investigation or monitoring. Finkelstein joined the high-risk pool in 1991. Should it come as any shock that his practices as a competent or caring doctor were highly suspect? Next time I see a doctor, I'm going to make a point of asking who his or her insurance carrier is, just to make sure the doc is one of these jokers in the high-risk pool.
There is a two-tiered malpractice system, based largely on actuarial risk: those specialties that have the highest risk and highest payouts pay the most for malpractice. OB and surgical specialties typically pay anywhere from 150K to 250K a year for medical malpractice insurance. In any given year, a fraction of a percent of physicians will get sued, but all the good doctors have to pay for the bad.
This is resulting in a flight of outstanding doctors from those specialties, particularly in states where the settlements are highest: for example, it is nearly impossible to find an obstetrician in parts of Pennsylvania. Women are forced to travel to neighboring states to obtain prenatal care.
For primary care specialties, such as Family Practice, General Internal Medicine and Pediatrics, malpractice premiums are more reasonable: depending upon location, we pay $20K-$30K a year. Most of us faced our first premium increase in '07, to the tune of 30%.
So, as a percent of revenue, malpractice hurts us lower-earning docs, as well. Add to that the cost of renting an office, hiring staff (particularly health insurance costs), buying supplies, etc. and you've got a reasonable income, but not one that necessarily justifies 11-15 years of education beyond high school. My friends in the building trades make more than me. My lawyer friends make more than me. And, of course, my investment banking friends make a filthy lot of money after just four years of college.
Still, after 20 years, I enjoy going into work each day. Most of my friends experience some level of burnout 5 years into their careers.
This is exactly why costs go up for everyone.
I am one of the 600 that got the letters from the health department and guess what!?
I tested postive and have a high viral load!
Nice, eh? Getting a liver biopsy in Jan to see damage!
LB
oh yeah but I don't think every doctor should be penalized for that fools incompetance!!
For example, only those who get sued and the defandant doctor is found guilty should have the insurance surchage.
And there should NOT be a "white coat of silence". Its hurts the patients who are truely damaged by the Finkelsteins of this world.