Doctors group targets state in fight over malpractice-insurance rates

By Alex Fryer
Seattle Times Washington bureau

	Maria Cantwell
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The goal of the measure, some say, is twofold: to assist medical specialists who have witnessed the sharpest increases in malpractice insurance in recent years, and to force opponents such as Sen. Patty Murray, D-Wash., to take a vote that later could be spun by political opponents as anti-physician and anti-family.

While medical-malpractice insurance reform has been a hot issue on Capitol Hill for years, the language and tactics are getting sharper.

And now a doctors group is targeting Washington state — and its two U.S. senators — in a multi-million-dollar national campaign that says physicians are leaving the state, and patients are suffering, because of high malpractice-insurance costs.

The campaign singles out Murray and fellow Democratic Sen. Maria Cantwell, claiming the two lawmakers are forcing doctors out of business because they oppose caps on damage awards.

Observers say the medical-malpractice debate is deeply infused with partisan politics that pits Democrats, whose campaigns are largely supported by trial lawyers, against Republicans, who receive contributions from doctors and insurance groups.

When it comes to health care, policy has taken a distant back seat to politics, said Robert Berenson, a medical doctor and senior fellow at the Urban Institute, a Washington, D.C.-based think tank.

"This (issue) absolutely lines up with who's giving to which party," he said. "This is all being done for political ends."

One fact is undeniable: Premiums for medical-malpractice insurance have increased sharply in recent years.

Premiums for obstetrician/gynecologists rose 22 percent nationally between 2000 and 2002, according to a January report by the Congressional Budget Office (CBO).

In Washington state, malpractice premiums last year averaged $29,049 annually, according to a report from Medical Liability Monitor, which tracks premium rates nationwide. Insurance costs for some specialists can be tens of thousands of dollars more.
 
Some physicians groups attribute the increase to multimillion-dollar jury awards against negligent doctors.

But the CBO determined that lawsuits are only part of the problem.

Insurance companies also raised rates to cope with their own poorly performing investments and a bad business climate in the insurance market.

Advocates for caps on pain-and-suffering awards say such measures reduce insurance premiums for doctors, and the public benefits because doctors stay in business.

The CBO notes, however, that the evidence for such positive effects "is weak or inconclusive."

Nonetheless, the group Doctors for Medical Liability Reform claims in an ad that hundreds of physicians have left Washington state, "leaving a dangerous vacuum of access to health care for its people."

The ad, which ran in The Wall Street Journal and USA Today earlier this month, suggested that the state's business climate was worsened by high insurance premiums and doctor flight.

In bold letters, it stated: "If you're considering more business in Washington State: Before you move in, look who's moving out."

Formed last year, Doctors for Medical Liability Reform is composed of 10 physician groups, including the American College of Obstetricians and Gynecologists and the American College of Cardiology.

Spokesman Jason Kemp said the group decided to focus its national campaign on Washington partly because both U.S. senators voted against malpractice caps last year.

Murray balked at the group's claim that the state's business climate is suffering because doctors are paying high insurance costs.

"Scare tactics on this are harmful to our state," she said. "For someone to put an ad in The Wall Street Journal saying 'Don't go to Washington' is a slam against every citizen in this state, and I take great umbrage to that."

Murray, who is running for re-election this fall, said she would vote against the bill that would limit pain-and-suffering awards for obstetricians. Cantwell did not respond to requests for an interview.

While medical-malpractice costs are hurting doctors, Murray said, the proposed bill would discriminate against women, who would receive a maximum award of $250,000 for a physician's mistake, unless there were "economic" damages such as medical expenses or lost salary.

"They single out women and babies and say to them, 'You are second-class citizens. If something goes wrong, you don't have the protection to make sure you can be compensated,' " Murray said. "I don't know why we would do that to women."

Murray is a co-sponsor of a bipartisan bill that seeks to help physicians pay insurance premiums through grants and tax credits, as well as limiting frivolous lawsuits.

It remains to be seen whether bipartisan measures have much hope in the sharply divided Senate.

A bill to limit damage awards against doctors died in the U.S. Senate last July. Not a single Democrat voted for the measure.

It's not clear whether ideological differences fuel campaign contributions, or campaign contributions fuel ideological differences.

But lists of contributors are as distinct as the Senate votes.

Murray received nearly $110,000 from trial lawyers the past two years, and $16,000 from physicians, surgeons and nurses during the same period, according to Dwight L. Morris and Associates, a campaign-finance research group.

Sen. Judd Gregg, R-N.H., who sponsored the current bill to limit damages for obstetricians, received $89,000 from physicians, surgeons and nurses, but nothing from trial lawyers.

In the end, the debate over malpractice may not amount to much for the average taxpayer.

The CBO estimates that malpractice costs account for less than 2 percent of health-care spending, and Berenson said such measures, if passed, wouldn't make "a dent" in such pressing concerns as small-business health premiums.

"It's a crazy system, and right now it's pure politics," he said.

Seattle Times researcher Justin Mayo and staff reporter Carol Ostrom contributed to this report.

Alex Fryer: 206-464-8124 or afryer@seattletimes.com

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